Conservative Management of Minimally Displaced (⩽2 mm) Fractures of the Lateral Humeral Condyle in Pediatric Patients: A Systematic Review. Issue 2 (March 2017) - Knapik, Derrick M.
Abstract : Background: Fractures to the lateral humeral condyle are common in the pediatric population and can lead to complications related to displacement of the fracture fragment. The ideal treatment for minimally displaced fractures (measuring ⩽2 mm) is controversial. Methods: A systematic review was performed identifying and evaluating studies related to displacement of lateral humeral condyle fractures in pediatric patients. Databases included in this review were PubMed, Biosis Preview, SPORTDiscus, PEDro, and EMBASE. We investigated the rate of subsequent displacement for minimally displaced fractures following immobilization, the time span in which fracture displacement occurs, and the complications related to displacement despite immobilization. Results: Our review of the literature found 6 studies that matched the search criteria. The risk of subsequent displacement in minimally displaced fractures initially treated with immobilization was 14.9% with fracture displacement typically occurring within the first week following injury. Malunion, nonunion, and loss of motion were the most commonly identified complications following subsequent displacement. Conclusions: For minimally displaced fractures of the lateral humeral condyle, appropriate diagnosis of fracture stability and fracture displacement with close radiographic follow-up 1 week following injury dictate the success of conservative management. Level of Evidence: Level II—systematic review of level-II or level-I studies with inconsistent results.