A Systematic Review and Meta-Analysis of Healing Outcomes in Pediatric Lateral Humerus Condyle Fractures Treated with K-Wire Pin Fixation
Keywords:
Sagittal Balance, Lumbar Lordosis, Pelvic tilt, Spinal Alignment, X-ray
Abstract
Sagittal balance refers to the equilibrium between external forces acting on the spine, particularly gravity, and the body's response to maintain an upright position with minimal muscular energy expenditure. Disruption of this balance can lead to sagittal imbalance, which is linked to poor clinical outcomes in conditions such as adult scoliosis and degenerative spondylolisthesis. The sedentary lifestyle, especially in office workers who spend significant time sitting, makes understanding spinal alignment changes in various positions crucial. This study aims to assess the differences in lumbopelvic sagittal balance in standing, upright sitting, and relaxed sitting positions in a healthy population. This analytical study used a case series approach with 25 healthy subjects aged 18-40. X-ray images were taken in three positions: standing, upright sitting, and relaxed sitting. Parameters including lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), and PI-LL mismatch were measured using RadiAnt DICOM Viewer. Data were analyzed using ANOVA to compare the sagittal balance parameters across different positions. differences were found in LL, SS, PT, and PI-LL mismatch between positions (p < 0.05). LL was highest in standing and lowest in relaxed sitting. PT increased significantly in relaxed sitting, while SS was highest in standing. PI did not show significant changes across positions. Lumbopelvic sagittal balance varies significantly between standing and sitting positions, highlighting the need to consider sitting postures in spinal assessments. These findings provide valuable insights for spine surgery planning and postural assessments.
References
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Birkett, N., Al-Tawil, K. and Montgomery, A. (2020b). Functional Outcomes Following Surgical Fixation of Paediatric Lateral Condyle Fractures of the Elbow - A Systematic Review. Orthopedic Research and Reviews, 12, pp.45–52. [Online]. Available at: doi:10.2147/ORR.S215742.
Cho, Y. J., Kang, S. H. and Kang, M. H. (2023). K-wire versus screws in the fixation of lateral condyle fracture of humerus in pediatrics: a systematic review and meta- analysis. BMC Musculoskeletal Disorders, 24 (1), p.649. [Online]. Available at: doi:10.1186/s12891-023-06780-5.
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Gilbert, S. R. et al. (2016). Screw versus pin fixation with open reduction of pediatric lateral condyle fractures. Journal of Pediatric Orthopaedics B, 25 (2), pp.148–152. [Online]. Available at: doi:10.1097/BPB.0000000000000238.
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53
Correction. Clinics in Orthopedic Surgery, 13 (1), pp.110–116. [Online]. Available at: doi:10.4055/cios20003.
Justus, C. et al. (2017). Closed and Open Reduction of Displaced Pediatric Lateral Condyle Humeral Fractures, a Study of Short-Term Complications and Postoperative Protocols. The Iowa Orthopaedic Journal, 37, pp.163–169.
Kamath, A. T., Roy, S. and Pai, D. (2023). Paediatric condylar trauma – primary management considerations – A review. Journal of Oral Biology and Craniofacial Research, 13 (2), pp.236–242. [Online]. Available at: doi:10.1016/j.jobcr.2023.01.011.
Koo, K. O. T., Tan, D. M. K. and Chong, A. K. S. (2013). Distal Radius Fractures: An Epidemiological Review. Orthopaedic Surgery, 5 (3), pp.209–213. [Online]. Available at: doi:10.1111/os.12045.
Li, J. et al. (2020). Biodegradable pins for lateral condylar fracture of the humerus with an early delayed presentation in children: a retrospective study of biodegradable pin vs. Kirschner wire. BMC musculoskeletal disorders, 21 (1), p.735. [Online]. Available at: doi:10.1186/s12891-020-03774-5.
Li, W. C. and Xu, R. J. (2012). Comparison of Kirschner wires and AO cannulated screw internal fixation for displaced lateral humeral condyle fracture in children. International Orthopaedics, 36 (6), pp.1261–1266. [Online]. Available at: doi:10.1007/s00264-011-1452-y.
Lindsay, S. E. et al. (2022). The Pin: An Orthopaedic Transformation. Journal of the Pediatric Orthopaedic Society of North America, 4 (2), p.448. [Online]. Available at: doi:10.55275/JPOSNA-2022-0039.
Marcheix, P.-S. et al. (2011). Distal humerus lateral condyle fracture in children: when is the conservative treatment a valid option? Orthopaedics & traumatology, surgery & research: OTSR, 97 (3), pp.304–307. [Online]. Available at: doi:10.1016/j.otsr.2010.10.007.
Martins, T., Tiwari, V. and Marappa-Ganeshan, R. (2024). Pediatric Lateral Humeral Condyle Fractures. In: StatPearls. Treasure Island (FL): StatPearls Publishing. [Online]. Available at: http://www.ncbi.nlm.nih.gov/books/NBK560664/ [Accessed 9 December 2024].
Matijasich, P. et al. (2023). Pediatric Medial Condyle of Humerus Fracture Dislocation: A Case Report. Cureus. [Online]. Available at: doi:10.7759/cureus.43942 [Accessed 9 December 2024].
Memon, N. et al. (2016). Inherited disorders of bilirubin clearance. Pediatric Research, 79 (3), pp.378–386. [Online]. Available at: doi:10.1038/pr.2015.247.
Miller, M. D. and Thompson, S. R. (2023). Miller’s Review of Orthopaedics, 8th Edition, 1 1. 1st ed. United Kingdom: Elsevier.
54
Ogawa, K. et al. (2022). Fracture-Separation of the Medial Humeral Epicondyle Caused by Arm Wrestling: A Systematic Review. Orthopaedic Journal of Sports Medicine, 10 (5), p.23259671221087606. [Online]. Available at: doi:10.1177/23259671221087606.
Okubo, H. et al. (2019). Epidemiology of paediatric elbow fractures: A retrospective multi-centre study of 488 fractures. Journal of Children’s Orthopaedics, 13 (5), pp.516–521. [Online]. Available at: doi:10.1302/1863-2548.13.190043.
Pabin Thapa et al. (2019). Comparison of Kirschner wires and Cannulated screw internal fixation for displaced lateral humeral condyle fracture in children. Asian Journal of Medical Sciences, 10 (6), pp.75–79. [Online]. Available at: doi:10.71152/ajms.v10i6.3486.
Pennington, R. G. C., Corner, J. A. and Brownlow, H. C. (2009). Milch’s classification of paediatric lateral condylar mass fractures: analysis of inter- and intraobserver reliability and comparison with operative findings. Injury, 40 (3), pp.249–252. [Online]. Available at: doi:10.1016/j.injury.2008.08.014.
Pribaz, J. R. et al. (2012). Lateral spurring (overgrowth) after pediatric lateral condyle fractures. Journal of Pediatric Orthopedics, 32 (5), pp.456–460. [Online]. Available at: doi:10.1097/BPO.0b013e318259ff63.
Prusick, V. W. and Muchow, R. (2023). Open Reduction and Pinning of Lateral Condyle Fractures. Journal of the Pediatric Orthopaedic Society of North America, 5 (1), p.632. [Online]. Available at: doi:10.55275/JPOSNA-2023-632.
Qi, Y. et al. (2021). Clinical value of MRI in evaluating and diagnosing of humeral lateral condyle fracture in children. Journal of Orthopaedic Surgery and Research, 16 (1), p.617. [Online]. Available at: doi:10.1186/s13018-021-02726-6.
Ranjan, R. et al. (2018). Management of Neglected Lateral Condyle Fracture of Humerus: A Comparison between Two Modalities of Fixation. Indian Journal of Orthopaedics, 52 (4), pp.423–429. [Online]. Available at: doi:10.4103/ortho.IJOrtho_319_16.
Saeed, W. and Waseem, M. (2024). Elbow Fractures Overview. In: StatPearls. Treasure Island (FL): StatPearls Publishing. [Online]. Available at: http://www.ncbi.nlm.nih.gov/books/NBK441976/ [Accessed 9 December 2024].
Sahu, R. L. (2018). Percutaneous K wire fixation in pediatric lateral condylar fractures of humerus: A prospective study. Revista Espan?ola de Cirugi?a Ortope?dica y Traumatologi?a (English Edition), 62 (1), pp.1–7. [Online]. Available at: doi:10.1016/j.recote.2017.11.001.
Shabtai, L. et al. (2020). Incidence, risk factors and outcomes of avascular necrosis occurring after humeral lateral condyle fractures. Journal of Pediatric Orthopedics. Part B, 29 (2), pp.145–148. [Online]. Available at: doi:10.1097/BPB.0000000000000698.
55
Shaerf, D. A., Vanhegan, I. S. and Dattani, R. (2018). Diagnosis, management and complications of distal humerus lateral condyle fractures in children. Shoulder & Elbow, 10 (2), pp.114–120. [Online]. Available at: doi:10.1177/1758573217701107.
Stein, B. E. et al. (2017). Cannulated Lag Screw Fixation of Displaced Lateral Humeral Condyle Fractures Is Associated With Lower Rates of Open Reduction and Infection Than Pin Fixation. Journal of Pediatric Orthopaedics, 37 (1), pp.7– 13. [Online]. Available at: doi:10.1097/BPO.0000000000000579.
Su, Y., Chen, K. and Qin, J. (2019). Retrospective study of open reduction and internal fixation of lateral humeral condyle fractures with absorbable screws and absorbable sutures in children. Medicine, 98 (44), p.e17850. [Online]. Available at: doi:10.1097/MD.0000000000017850.
Su, Y. and Nan, G. (2020). Treatment of medial humeral epicondyle fractures in children using absorbable self-reinforced polylactide pins. Medicine, 99 (17), p.e19861. [Online]. Available at: doi:10.1097/MD.0000000000019861.
Tejwani, N., Phillips, D. and Goldstein, R. Y. (2011). Management of lateral humeral condylar fracture in children. The Journal of the American Academy of Orthopaedic Surgeons, 19 (6), pp.350–358. [Online]. Available at: doi:10.5435/00124635-201106000-00005.
Thomas, D. P. et al. (2001). Three Weeks of Kirschner Wire Fixation for Displaced Lateral Condylar Fractures of the Humerus in Children: Journal of Pediatric Orthopaedics, 21 (5), pp.565–569. [Online]. Available at: doi:10.1097/01241398- 200109000-00002.
Thore?n, H. et al. (1997). An epidemiological study of patterns of condylar fractures in children. British Journal of Oral and Maxillofacial Surgery, 35 (5), pp.306–311. [Online]. Available at: doi:10.1016/S0266-4356(97)90401-0.
Vergara, A. D. N. and Fretes, A. N. (2023). Comparac?a?o entre fixac?a?o de fio de Kirschner liso e de parafusos canulados em fraturas deslocadas do co?ndilo lateral do u?mero em crianc?as. Revista Brasileira de Ortopedia, 58 (01), pp.149–156. [Online]. Available at: doi:10.1055/s-0042-1757307.
Vogel, G. et al. (2007). Fixation of humeral surgical neck fracture using contoured pins versus straight pins: a mechanical study. International Orthopaedics, 31 (6), pp.811–815. [Online]. Available at: doi:10.1007/s00264-006-0266-9.
Wang, Y. et al. (2023). Kirschner wire versus external fixation in the treatment of proximal humeral fractures in older children and adolescents: a comparative study. BMC Musculoskeletal Disorders, 24 (1), p.899. [Online]. Available at: doi:10.1186/s12891-023-07037-x.
Weiss, J. M. et al. (2009). A new classification system predictive of complications in surgically treated pediatric humeral lateral condyle fractures. Journal of
56
Pediatric Orthopedics, 29 (6), pp.602–605. [Online]. Available at: doi:10.1097/BPO.0b013e3181b2842c.
Wendling-Keim, D. S. et al. (2021). Lateral Condyle Fracture of the Humerus in Children: Kirschner Wire or Screw Fixation? European Journal of Pediatric Surgery, 31 (04), pp.374–379. [Online]. Available at: doi:10.1055/s-0040-1714656.
Westacott, D. J., Jordan, R. W. and Cooke, S. J. (2012). Functional outcome following intramedullary nailing or plate and screw fixation of paediatric diaphyseal forearm fractures: A systematic review. Journal of Children’s Orthopaedics, 6 (1), pp.75–80. [Online]. Available at: doi:10.1007/s11832-011- 0379-6.
Wu, K. et al. (2016). Diagnosis and Treatment of Anterior Tibial Plateau Fracture– Dislocation: A Case Series and Literature Review. The Journal of Knee Surgery, 30 (02), pp.114–120. [Online]. Available at: doi:10.1055/s-0036-1581136.
Afaque, S. F. and Singh, A. (2020). Outcome of Cancellous screw vs K wire fixation for management of neglected lateral condyle fracture of humerus in children. National Journal of Clinical Orthopaedics, 4 (4), pp.14–17. [Online]. Available at: doi:10.33545/orthor.2020.v4.i4a.240.
Awad, N., Sabry, H. and Elhadidy, M. (2023). Epidemiological study of the pediatric mandibular condylar fractures (the outcomes of the management); Retrospective Study. Advanced Dental Journal, 5 (2), pp.340–346. [Online]. Available at: doi:10.21608/adjc.2023.200959.1277.
Birkett, N., Al-Tawil, K. and Montgomery, A. (2020a). Functional Outcomes Following Surgical Fixation of Paediatric Lateral Condyle Fractures of the Elbow – A Systematic Review. Orthopedic Research and Reviews, Volume 12, pp.45–52. [Online]. Available at: doi:10.2147/ORR.S215742.
Birkett, N., Al-Tawil, K. and Montgomery, A. (2020b). Functional Outcomes Following Surgical Fixation of Paediatric Lateral Condyle Fractures of the Elbow - A Systematic Review. Orthopedic Research and Reviews, 12, pp.45–52. [Online]. Available at: doi:10.2147/ORR.S215742.
Cho, Y. J., Kang, S. H. and Kang, M. H. (2023). K-wire versus screws in the fixation of lateral condyle fracture of humerus in pediatrics: a systematic review and meta- analysis. BMC Musculoskeletal Disorders, 24 (1), p.649. [Online]. Available at: doi:10.1186/s12891-023-06780-5.
Cummings, J. L. et al. (2023). K-wire Versus Screw Fixation in Displaced Lateral Condyle Fractures of the Humerus in Children: A Multicenter Study of 762 Fractures. Journal of Pediatric Orthopedics, 43 (4), pp.e284–e289. [Online]. Available at: doi:10.1097/BPO.0000000000002348.
Ganeshalingam, R. et al. (2018). Lateral condylar fractures of the humerus in children: does the type of fixation matter? The Bone & Joint Journal, 100-B (3), pp.387–395. [Online]. Available at: doi:10.1302/0301-620X.100B3.BJJ-2017- 0814.R1.
Gilbert, S. R. et al. (2016). Screw versus pin fixation with open reduction of pediatric lateral condyle fractures. Journal of Pediatric Orthopaedics B, 25 (2), pp.148–152. [Online]. Available at: doi:10.1097/BPB.0000000000000238.
Jung, H.-G. et al. (2021). Comparison between Pin Fixation and Combined Screw Fixation in Proximal Chevron Metatarsal Osteotomy for Hallux Valgus Deformity
53
Correction. Clinics in Orthopedic Surgery, 13 (1), pp.110–116. [Online]. Available at: doi:10.4055/cios20003.
Justus, C. et al. (2017). Closed and Open Reduction of Displaced Pediatric Lateral Condyle Humeral Fractures, a Study of Short-Term Complications and Postoperative Protocols. The Iowa Orthopaedic Journal, 37, pp.163–169.
Kamath, A. T., Roy, S. and Pai, D. (2023). Paediatric condylar trauma – primary management considerations – A review. Journal of Oral Biology and Craniofacial Research, 13 (2), pp.236–242. [Online]. Available at: doi:10.1016/j.jobcr.2023.01.011.
Koo, K. O. T., Tan, D. M. K. and Chong, A. K. S. (2013). Distal Radius Fractures: An Epidemiological Review. Orthopaedic Surgery, 5 (3), pp.209–213. [Online]. Available at: doi:10.1111/os.12045.
Li, J. et al. (2020). Biodegradable pins for lateral condylar fracture of the humerus with an early delayed presentation in children: a retrospective study of biodegradable pin vs. Kirschner wire. BMC musculoskeletal disorders, 21 (1), p.735. [Online]. Available at: doi:10.1186/s12891-020-03774-5.
Li, W. C. and Xu, R. J. (2012). Comparison of Kirschner wires and AO cannulated screw internal fixation for displaced lateral humeral condyle fracture in children. International Orthopaedics, 36 (6), pp.1261–1266. [Online]. Available at: doi:10.1007/s00264-011-1452-y.
Lindsay, S. E. et al. (2022). The Pin: An Orthopaedic Transformation. Journal of the Pediatric Orthopaedic Society of North America, 4 (2), p.448. [Online]. Available at: doi:10.55275/JPOSNA-2022-0039.
Marcheix, P.-S. et al. (2011). Distal humerus lateral condyle fracture in children: when is the conservative treatment a valid option? Orthopaedics & traumatology, surgery & research: OTSR, 97 (3), pp.304–307. [Online]. Available at: doi:10.1016/j.otsr.2010.10.007.
Martins, T., Tiwari, V. and Marappa-Ganeshan, R. (2024). Pediatric Lateral Humeral Condyle Fractures. In: StatPearls. Treasure Island (FL): StatPearls Publishing. [Online]. Available at: http://www.ncbi.nlm.nih.gov/books/NBK560664/ [Accessed 9 December 2024].
Matijasich, P. et al. (2023). Pediatric Medial Condyle of Humerus Fracture Dislocation: A Case Report. Cureus. [Online]. Available at: doi:10.7759/cureus.43942 [Accessed 9 December 2024].
Memon, N. et al. (2016). Inherited disorders of bilirubin clearance. Pediatric Research, 79 (3), pp.378–386. [Online]. Available at: doi:10.1038/pr.2015.247.
Miller, M. D. and Thompson, S. R. (2023). Miller’s Review of Orthopaedics, 8th Edition, 1 1. 1st ed. United Kingdom: Elsevier.
54
Ogawa, K. et al. (2022). Fracture-Separation of the Medial Humeral Epicondyle Caused by Arm Wrestling: A Systematic Review. Orthopaedic Journal of Sports Medicine, 10 (5), p.23259671221087606. [Online]. Available at: doi:10.1177/23259671221087606.
Okubo, H. et al. (2019). Epidemiology of paediatric elbow fractures: A retrospective multi-centre study of 488 fractures. Journal of Children’s Orthopaedics, 13 (5), pp.516–521. [Online]. Available at: doi:10.1302/1863-2548.13.190043.
Pabin Thapa et al. (2019). Comparison of Kirschner wires and Cannulated screw internal fixation for displaced lateral humeral condyle fracture in children. Asian Journal of Medical Sciences, 10 (6), pp.75–79. [Online]. Available at: doi:10.71152/ajms.v10i6.3486.
Pennington, R. G. C., Corner, J. A. and Brownlow, H. C. (2009). Milch’s classification of paediatric lateral condylar mass fractures: analysis of inter- and intraobserver reliability and comparison with operative findings. Injury, 40 (3), pp.249–252. [Online]. Available at: doi:10.1016/j.injury.2008.08.014.
Pribaz, J. R. et al. (2012). Lateral spurring (overgrowth) after pediatric lateral condyle fractures. Journal of Pediatric Orthopedics, 32 (5), pp.456–460. [Online]. Available at: doi:10.1097/BPO.0b013e318259ff63.
Prusick, V. W. and Muchow, R. (2023). Open Reduction and Pinning of Lateral Condyle Fractures. Journal of the Pediatric Orthopaedic Society of North America, 5 (1), p.632. [Online]. Available at: doi:10.55275/JPOSNA-2023-632.
Qi, Y. et al. (2021). Clinical value of MRI in evaluating and diagnosing of humeral lateral condyle fracture in children. Journal of Orthopaedic Surgery and Research, 16 (1), p.617. [Online]. Available at: doi:10.1186/s13018-021-02726-6.
Ranjan, R. et al. (2018). Management of Neglected Lateral Condyle Fracture of Humerus: A Comparison between Two Modalities of Fixation. Indian Journal of Orthopaedics, 52 (4), pp.423–429. [Online]. Available at: doi:10.4103/ortho.IJOrtho_319_16.
Saeed, W. and Waseem, M. (2024). Elbow Fractures Overview. In: StatPearls. Treasure Island (FL): StatPearls Publishing. [Online]. Available at: http://www.ncbi.nlm.nih.gov/books/NBK441976/ [Accessed 9 December 2024].
Sahu, R. L. (2018). Percutaneous K wire fixation in pediatric lateral condylar fractures of humerus: A prospective study. Revista Espan?ola de Cirugi?a Ortope?dica y Traumatologi?a (English Edition), 62 (1), pp.1–7. [Online]. Available at: doi:10.1016/j.recote.2017.11.001.
Shabtai, L. et al. (2020). Incidence, risk factors and outcomes of avascular necrosis occurring after humeral lateral condyle fractures. Journal of Pediatric Orthopedics. Part B, 29 (2), pp.145–148. [Online]. Available at: doi:10.1097/BPB.0000000000000698.
55
Shaerf, D. A., Vanhegan, I. S. and Dattani, R. (2018). Diagnosis, management and complications of distal humerus lateral condyle fractures in children. Shoulder & Elbow, 10 (2), pp.114–120. [Online]. Available at: doi:10.1177/1758573217701107.
Stein, B. E. et al. (2017). Cannulated Lag Screw Fixation of Displaced Lateral Humeral Condyle Fractures Is Associated With Lower Rates of Open Reduction and Infection Than Pin Fixation. Journal of Pediatric Orthopaedics, 37 (1), pp.7– 13. [Online]. Available at: doi:10.1097/BPO.0000000000000579.
Su, Y., Chen, K. and Qin, J. (2019). Retrospective study of open reduction and internal fixation of lateral humeral condyle fractures with absorbable screws and absorbable sutures in children. Medicine, 98 (44), p.e17850. [Online]. Available at: doi:10.1097/MD.0000000000017850.
Su, Y. and Nan, G. (2020). Treatment of medial humeral epicondyle fractures in children using absorbable self-reinforced polylactide pins. Medicine, 99 (17), p.e19861. [Online]. Available at: doi:10.1097/MD.0000000000019861.
Tejwani, N., Phillips, D. and Goldstein, R. Y. (2011). Management of lateral humeral condylar fracture in children. The Journal of the American Academy of Orthopaedic Surgeons, 19 (6), pp.350–358. [Online]. Available at: doi:10.5435/00124635-201106000-00005.
Thomas, D. P. et al. (2001). Three Weeks of Kirschner Wire Fixation for Displaced Lateral Condylar Fractures of the Humerus in Children: Journal of Pediatric Orthopaedics, 21 (5), pp.565–569. [Online]. Available at: doi:10.1097/01241398- 200109000-00002.
Thore?n, H. et al. (1997). An epidemiological study of patterns of condylar fractures in children. British Journal of Oral and Maxillofacial Surgery, 35 (5), pp.306–311. [Online]. Available at: doi:10.1016/S0266-4356(97)90401-0.
Vergara, A. D. N. and Fretes, A. N. (2023). Comparac?a?o entre fixac?a?o de fio de Kirschner liso e de parafusos canulados em fraturas deslocadas do co?ndilo lateral do u?mero em crianc?as. Revista Brasileira de Ortopedia, 58 (01), pp.149–156. [Online]. Available at: doi:10.1055/s-0042-1757307.
Vogel, G. et al. (2007). Fixation of humeral surgical neck fracture using contoured pins versus straight pins: a mechanical study. International Orthopaedics, 31 (6), pp.811–815. [Online]. Available at: doi:10.1007/s00264-006-0266-9.
Wang, Y. et al. (2023). Kirschner wire versus external fixation in the treatment of proximal humeral fractures in older children and adolescents: a comparative study. BMC Musculoskeletal Disorders, 24 (1), p.899. [Online]. Available at: doi:10.1186/s12891-023-07037-x.
Weiss, J. M. et al. (2009). A new classification system predictive of complications in surgically treated pediatric humeral lateral condyle fractures. Journal of
56
Pediatric Orthopedics, 29 (6), pp.602–605. [Online]. Available at: doi:10.1097/BPO.0b013e3181b2842c.
Wendling-Keim, D. S. et al. (2021). Lateral Condyle Fracture of the Humerus in Children: Kirschner Wire or Screw Fixation? European Journal of Pediatric Surgery, 31 (04), pp.374–379. [Online]. Available at: doi:10.1055/s-0040-1714656.
Westacott, D. J., Jordan, R. W. and Cooke, S. J. (2012). Functional outcome following intramedullary nailing or plate and screw fixation of paediatric diaphyseal forearm fractures: A systematic review. Journal of Children’s Orthopaedics, 6 (1), pp.75–80. [Online]. Available at: doi:10.1007/s11832-011- 0379-6.
Wu, K. et al. (2016). Diagnosis and Treatment of Anterior Tibial Plateau Fracture– Dislocation: A Case Series and Literature Review. The Journal of Knee Surgery, 30 (02), pp.114–120. [Online]. Available at: doi:10.1055/s-0036-1581136.
Published
2025-04-30
How to Cite
Tom Lieven Stefan Kurniawan, Benny, & Heru Rahmadhany. (2025). A Systematic Review and Meta-Analysis of Healing Outcomes in Pediatric Lateral Humerus Condyle Fractures Treated with K-Wire Pin Fixation. International Journal of Health, Economics, and Social Sciences (IJHESS), 7(2), 895~901. https://doi.org/10.56338/ijhess.v7i2.7406
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