Effect of minimally invasive surgery guided by arthrography on surgical progress, postoperative recovery and long-term prognosis of lateral humeral condyle fractures in children: a retrospective cohort study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: In recent years, arthrography-assisted fixation techniques have become more common in pediatric orthopedic surgery because they provide real-time intraoperative assessment of fracture alignment and overall joint congruency. This study aimed to descriptively analyze outcomes in two groups of patients: patients with Jakob type IIA lateral humeral condyle fractures (LHCF) treated with closed reduction and internal fixation (CRIF) using intraoperative arthrography (arthrography group, AG); and patients with Jakob type IIB LHCF treated with open reduction and internal fixation (ORIF) (control group, CG). Caution is used when interpreting outcomes due to the differences in fracture severity. Methods: A total of 190 pediatric patients diagnosed with Jakob type II LHCF and treated between 2021 and 2023 were analyzed retrospectively. Jakob type IIA fractures (n=101) underwent CRIF with assistance from arthrography, and Jakob type IIB fractures (n=89) underwent ORIF. The outcomes evaluated included operation time (OT), intraoperative blood loss (IBL), length of hospitalization (LOH), pain (Visual Analog Scale; VAS), elbow function (Mayo Elbow Performance Score; MEPS), complications, and long-term prognosis. Postoperative imaging was obtained to confirm anatomic reduction. Results: The AG had significantly shorter OT, less IBL, and less LOH than the CG (P<0.05), along with lower VAS scores on postoperative day 1 and higher MEPS on day 28. Long-term functions were similar between groups, and the rate of complications was similarly low, with a lower rate of poor prognosis in the AG. As the differences in severity of fracture between groups were intrinsic reasons for differences between the groups, they can be followed descriptively and cannot imply the superiority of treatment. Conclusions: Arthrography-assisted CRIF may be a safe and feasible method to assist with treating some selected Jakob type IIA LHCF and offers some short-term reductions in pain. These findings are limited in their ability to be interpreted due to retrospective design, failures of group comparability, and no objective imaging confirmation, so caution should be taken into account. Further prospective controlled studies are warranted to validate these results.
Source: Translational Pediatrics
Institutions: Xi'an Honghui Hospital, Xi'an Jiaotong University
Language: English
Subfield: Rehabilitation
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7128802348
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