Surgical outcomes for displaced lateral humeral condyle fractures in children: a retrospective study comparing two types of tension band wiring procedures and pinning

Displaced lateral humeral condylar fractures in children require anatomical reduction and rigid fixation because they are intraarticular fractures, and inappropriate treatment causes late complications. Although the tension band wiring technique can offer stronger stability for the fracture site than wires alone, subcutaneously buried wires require a second operation for removal. The purpose of this retrospective study was to compare surgical outcomes using buried tension band wiring (necessity of a second wire removal operation, group T-B), nonburied wires and buried strong suture material (wire removal at an outpatient clinic, group T-NB), and pinning (group P) at three institutions. Sixty-three patients were included in this study (24, 24, and 15 in the T-B, T-NB, and P groups, respectively). Clinical and radiological assessments were performed. Bony union was observed in all patients. There were no significant differences in the clinical outcomes regarding the range of elbow motion and the functional and cosmetic Flynn criteria. There was a significant difference in the number of operations under general anesthesia (2 ± 0 in group T-B, 1.1 ± 0.3 in group T-NB, 1 ± 0 in group P). Delayed union was observed in group P (0/24 in groups T-B and T-NB, and 6/15 in group P). Surgical site infection requiring surgical debridement occurred in two patients in the group T-NB. The three surgical techniques showed equivalent clinical results. The buried tension band wiring technique could be superior among the three techniques because it showed fewer complications, including delayed union and infection.