Is Computed Tomography Necessary for Diagnostic Workup in Displaced Pediatric Medial Epicondyle Fractures?
This study aimed to compare the treatment outcomes and complications between operatively and nonoperatively treated medial epicondyle fractures with displacement of >5 mm as accurately measured on three-dimensional computed tomography (3D CT). We retrospectively reviewed 77 patients who had isola...
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doaj-7aafbe232c7c4611b626bb8641b23d3f2020-11-25T04:09:09ZengMDPI AGDiagnostics2075-44182020-11-011095795710.3390/diagnostics10110957Is Computed Tomography Necessary for Diagnostic Workup in Displaced Pediatric Medial Epicondyle Fractures?Sungmin Kim0Hyun Woo Kim1Kun-Bo Park2Kee-Bum Hong3Hoon Park4Department of Orthopaedic Surgery, Chonnam National University Hospital and Medical School, College of Medicine, Gwangju 61469, KoreaDivision of Pediatric Orthopaedic Surgery, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Pediatric Orthopaedic Surgery, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, KoreaDepartment of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, KoreaThis study aimed to compare the treatment outcomes and complications between operatively and nonoperatively treated medial epicondyle fractures with displacement of >5 mm as accurately measured on three-dimensional computed tomography (3D CT). We retrospectively reviewed 77 patients who had isolated medial epicondylar fractures with displacement of >5 mm. The mean age at injury was 11.4 years. Patients were assigned to one of two groups: 21 patients treated nonoperatively and 56 patients treated surgically. Additionally, patients treated operatively were divided into two subgroups according to fixation method; 31 patients underwent internal fixation with K-wires and 25 patients underwent internal fixation with a screw. Radiological and functional outcomes were compared among the three groups. Although the bony union rate was significantly higher in patients treated operatively compared to patients treated non-operatively (96.4% vs. 23.8%, <i>p</i> < 0.001), there were no significant differences in functional outcomes between the two groups. In the nonoperative group, three patients underwent osteosynthesis for symptomatic nonunion. There were no significant differences in radiological and functional outcomes between the two subgroups divided by fixation method. In a pediatric medial epicondylar fracture with a displacement of >5 mm as accurately measured on 3D CT, despite the difference in union rate, there was no difference in functional outcomes between operative and nonoperative treatment. Performing CT only to measure the fracture displacement in obviously displaced medial epicondylar fracture is not considered as a part of the “necessary” diagnostic workups.https://www.mdpi.com/2075-4418/10/11/957medial epicondylefracturecomputed tomography |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sungmin Kim Hyun Woo Kim Kun-Bo Park Kee-Bum Hong Hoon Park |
spellingShingle |
Sungmin Kim Hyun Woo Kim Kun-Bo Park Kee-Bum Hong Hoon Park Is Computed Tomography Necessary for Diagnostic Workup in Displaced Pediatric Medial Epicondyle Fractures? Diagnostics medial epicondyle fracture computed tomography |
author_facet |
Sungmin Kim Hyun Woo Kim Kun-Bo Park Kee-Bum Hong Hoon Park |
author_sort |
Sungmin Kim |
title |
Is Computed Tomography Necessary for Diagnostic Workup in Displaced Pediatric Medial Epicondyle Fractures? |
title_short |
Is Computed Tomography Necessary for Diagnostic Workup in Displaced Pediatric Medial Epicondyle Fractures? |
title_full |
Is Computed Tomography Necessary for Diagnostic Workup in Displaced Pediatric Medial Epicondyle Fractures? |
title_fullStr |
Is Computed Tomography Necessary for Diagnostic Workup in Displaced Pediatric Medial Epicondyle Fractures? |
title_full_unstemmed |
Is Computed Tomography Necessary for Diagnostic Workup in Displaced Pediatric Medial Epicondyle Fractures? |
title_sort |
is computed tomography necessary for diagnostic workup in displaced pediatric medial epicondyle fractures? |
publisher |
MDPI AG |
series |
Diagnostics |
issn |
2075-4418 |
publishDate |
2020-11-01 |
description |
This study aimed to compare the treatment outcomes and complications between operatively and nonoperatively treated medial epicondyle fractures with displacement of >5 mm as accurately measured on three-dimensional computed tomography (3D CT). We retrospectively reviewed 77 patients who had isolated medial epicondylar fractures with displacement of >5 mm. The mean age at injury was 11.4 years. Patients were assigned to one of two groups: 21 patients treated nonoperatively and 56 patients treated surgically. Additionally, patients treated operatively were divided into two subgroups according to fixation method; 31 patients underwent internal fixation with K-wires and 25 patients underwent internal fixation with a screw. Radiological and functional outcomes were compared among the three groups. Although the bony union rate was significantly higher in patients treated operatively compared to patients treated non-operatively (96.4% vs. 23.8%, <i>p</i> < 0.001), there were no significant differences in functional outcomes between the two groups. In the nonoperative group, three patients underwent osteosynthesis for symptomatic nonunion. There were no significant differences in radiological and functional outcomes between the two subgroups divided by fixation method. In a pediatric medial epicondylar fracture with a displacement of >5 mm as accurately measured on 3D CT, despite the difference in union rate, there was no difference in functional outcomes between operative and nonoperative treatment. Performing CT only to measure the fracture displacement in obviously displaced medial epicondylar fracture is not considered as a part of the “necessary” diagnostic workups. |
topic |
medial epicondyle fracture computed tomography |
url |
https://www.mdpi.com/2075-4418/10/11/957 |
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