• Ömer Naci Ergin, Mehmet Demirel, Fatih Şentürk, Serkan Bayram, and Fuat Bilgili.
• Department of Orthopaedics and Traumatology, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey.
• Ulus Travma Acil Cer. 2020 Jan 1; 26 (1): 137-143.

BackgroundThe rationale behind the decision-making on which type of fixation to use in displaced medial epicondyle fractures is not well elucidated. This study aims to compare the long-term clinical and radiographic outcomes of internal fixation with either Kirschner wires (K-wires) or cannulated screws in children with displaced medial epicondyle fractures.MethodsIn this study, 42 consecutive children who underwent surgical treatment for medial epicondyle fractures displaced more than 5 mm were categorized into two groups as follows: group A, 22 children undergoing fixation with K-wires and group B, 20 children undergoing fixation with a screw. The mean age was nine (median, 10.5; range, 6-14) years in group A and 15 (16, 10-17) in group B. The overall follow-up was 10 (median, 10; range, 5-15) years. To assess patients' clinical outcomes, the Mayo Elbow Performance Scores (MEPS) were used in addition to the elbow range of motion (ROM) at the last follow-up. During the radiographic assessment, possible deformities secondary to the epicondyle fracture were examined on final follow-up radiographs.ResultsThe main MEPS were 95 (median, 95; range, 85-100) and 93 (94, 85-100) in groups A and B, respectively (p=0.18). In ROM, no significant differences were observed (p=0.43). In the radiographic assessment, one patient from each group developed a fibrous union, and one from each group had hypoplasia. There was no significant relationship between the deformity and fixation type (p=0.34, χ2 test).ConclusionTwo smooth K-wires for younger children and screw fixation for children near skeletal maturity may provide favorable clinical and radiological outcomes at long-term follow-up, with low morbidity and radiographic deformity.

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