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find Author "LIAOChunlai" 1 results
  • TREATMENT OF NONUNION OF LATERAL HUMERAL CONDYLE FRACTURE COMBINED WITH CUBITUS VALGUS

    ObjectiveTo investigate the surgical procedures and results of nonunion of lateral humeral condyle fracture combined with cubitus valgus. MethodsBetween January 2006 and September 2011, 19 cases of nonunion of lateral humeral condyle fracture combined with cubitus valgus were treated with supracondylar closing wedge osteotomy, open reduction, autogenous bone grafting, and internal fixation. There were 11 males and 8 females, aged 14-28 years (mean, 21.6 years). The left side was involved in 7 cases, and the right side in 12 cases. The disease duration was 3-22 years (mean, 9 years). The osseous protuberance and enlargement were seen in the lateral condyle of all the cases, with cubitus valgus. Compared with the contralateral side, the angle of cubitus valgus deformity increased (34.00±7.68)° at the affected side. The elbow range of motion of flexion and extension was (117.35±19.77)° in the other 17 patients except 2 patients with joint stiff. Among them, 10 patients had limited mobility. Three patients had ulnar neuritis. ResultsAll the patients obtained primary healing of incision, and no surgery-related complication occurred. Nineteen patients were followed up 2-6 years (mean, 3.2 years). Bony union at lateral condylar fracture site and the supracondylar osteotomy site was achieved in all cases within 6 months postoperatively. In 3 patients with ulnar neuritis, the symptoms of nerve injury disappeared within 6 months. At last follow-up, the angle of cubitus valgus deformity increased (3.21±4.09)° at the affected side when compared with the contralateral side, showing significant difference when compared with preoperative angle (t=30.472, P=0.000). The range of motion of the elbow was 20° and 30° in 2 patients with joint stiff before operation; the elbow range of motion of flexion and extension was (117.64±15.72)° in the other 17 patients, showing no significant difference when compared with preoperative value (t=-0.180, P=0.859). According to the appearance of the elbow, range of motion, and complications, the overall results were classified as excellent in 9 patients, good in 8 patients, and poor in 2 patients; the excellent and good rate was 89.5%. ConclusionSupracondylar closing wedge osteotomy can correct the cubitus valgus deformity and improve the symptoms of ulnar neuritis. Open reduction, autogenous bone grafting, and internal fixation for nonunion of the lateral condyle can effectively stabilize the lateral condylar fracture and promote fracture healing.

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