Current Concepts in the Treatment of Lateral Condyle Fractures in Children

Joshua M. Abzug, MD; Karan Dua, MD; Scott H. Kozin, MD; Martin J. Herman, MD

Disclosures

J Am Acad Orthop Surg. 2020;28(1):e9-e19. 

In This Article

Postoperative Management

The postoperative course is similar to that described for closed reduction and fixation. Kirschner wires left exposed are removed in an office setting at 4 weeks after surgery; a cast is then reapplied for an additional 2 to 4 weeks. Some recommend that the wires should remain longer and not be removed until callus formation is seen on all radiographs, which typically occurs at the 6-week postoperative visit.[22] There can be apprehension from the child and/or family members about removing the Kirschner wires in an outpatient setting, but a recent study showed that children only reported mild pain when the wires were removed (average of two on the Wong-Baker FACES scale).[23] Administration of oral pain medication before wire removal does not markedly reduce pain.[24] Active ROM can be resumed after cast removal, but heavy lifting and contact sports should be limited for an additional 4 to 6 weeks.[25]

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