OUTCOME OF OPERATIVE MANAGEMENT OF NEGLECTED LATERAL CONDYLAR FRACTURE IN CHILDREN

BACKGROUND: Fracture lateral Condyle of Humerus is the 2nd commonest fracture in childrenaround the Elbow joint. It is called the Fracture of necessisity. It is famous for its complications likeN/U, M/U & growth arrest with elbow Deformity. These are Intra articular fractures caused by fall withvarus force on the elbow. It is most common at the age of 6-7 years. Its management is controversialespecially in late, neglected cases.OBJECTIVE: To determine the outcomes of open reduction and internal fixation of lateral condylarfractures of humerus in children presented between 3 and 9 weeks.MATERIALS AND METHODS: It was descriptive case study of 27 patients presented with more than3 weeks of fracture and displacement of more than 2 mm from September 2013 to March 2015 admittedthrough OPD at Orthopedics Unit of Saidu Teaching Hospital Swat, Department of Orthopedics, KhyberTeaching Hospital Peshawar and Department of Orthopedics and Spine Surgery Ghurki Trust TeachingHospital Lahore. Detailed history, clinical examination and investigations were done after properconsent. Pre operative diagnosis was made on antero posterior and lateral views of plan x rays. Fractureswere managed with open reduction and internal fixation and were followed regularly on OPD basis andoutcome was documented using Hardacre criteria. The results were analyzed using SPSS 17.0.RESULTS: There were 27 patients with mean age of 7±2.7years.66.7% were male and 33.3 % werefemale .55.6% of patients involved non dominant hand while remaining dominant hand.14 patientswere initially managed by bone setters,7 managed by parents as home remedies,2 missed by physicianand 4 displaced in cast.77.78% of patients presented between 3-5 weeks shows excellent result, between5-7 weeks 33.33% shows good results,55.56% shows excellent and 11.11% shows poor results ,between7-9 weeks ,11.11% shows excellent, 44.44% shows good and poor results..CONCLUSION: Open reduction and internal fixation is good option for patients presented after 3weeks having excellent results up to 7 weeks .Moreover it can be done even after weeks, but the rate ofcomplications increases as time passes more.KEY WORDS: Lateral condylar fracture, children, Open reduction and internal fixation.