A randomized controlled trial comparing outcomes of K wire removal at 3weeks vs. 6weeks of lateral condyle fractures of humerus in children

Anand Shankar; Santosh Kumar; Raju Rijal; Shiv Raj Paneru; Reetesh Roshan

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ORIGINAL ARTICLE

Year : 2020 \| Volume : 6 \| Issue : 1 \| Page : 70-74

A randomized controlled trial comparing outcomes of K wire removal at 3weeks vs. 6weeks of lateral condyle fractures of humerus in children Anand Shankar¹, Santosh Kumar², Raju Rijal³, Shiv Raj Paneru⁴, Reetesh Roshan⁵ ¹ Assistant Professor, Dept. of Orthopaedics, NMCH, Jamuhar, Sasaram, India ² Professor & Head, Dept. of Orthopaedics, IGIMS, India ³ Professor, B.P. Koirala Institute of Health Sciences, Dharan, Nepal, India ⁴ Assistant Professor, Dept. of Orthopaedics, B.P. Koirala Institute of Health Sciences, Dharan, Nepal, India ⁵ PG Student, Dept. of Orthopaedics, IGIMS, India Correspondence Address: Santosh Kumar Prof. & Head Dept. of Orthopedics, IGIMS, Patna India Source of Support: None, Conflict of Interest: None

Background & objectives: Lateral condyle humerus fractures are the most common distal humeral epiphyseal fracture. They are usually associated with relatively high rate of complications and the results of non-operative management are not always good. So a randomised controlled trial comparing outcomes of K-wire removal at three weeks vs. six weeks for lateral condyle fractures of humerus in children was done. Methods: All patients aged one to fourteen years with traumatic fractures of the lateral condyle fracture of humerus presenting to the Department of Orthopaedics, BPKIHS giving written consent for the trial were included and randomised in two groups. Fractures duration more than seven days old were excluded. Cases taken were put and randomized according to random excel number generation. After open reduction and internal fixation the k-wire removed at three weeks in one group and at six weeks in another group. The clinic radiological outcomes were evaluated and noted for infection and radiological union. The collected data were evaluated and various statistical tests applied. P value of less than 0.05 was taken as significant. Results: We found statistically significant difference in comparison of union with different age groups (p<0.05). Other parameters were statistically not significant. Three patients developed skin infection, one in group A and two in group B . Three patients did not show radiological union at the expected time of k-wire removal two in group A one in group B and all the cases were above ten years of age. Conclusion: Our study has shown that fracture of lateral condyle of humerus united earlier than 6 weeks and shows no significant difference in short term outcome of K-wire and back slab removal at 3 weeks or at 6 weeks regarding union and infection.



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