Multicenter Retrospective Study of Ultrasound-Assisted Closed Reduction and Percutaneous Pinning Versus Open Reduction for Pediatric Song Type V Lateral Condylar Humerus Fractures

BACKGROUND: To evaluate the clinical efficacy of ultrasound-assisted closed reduction and percutaneous pinning (CRPP) compared with traditional open reduction and internal fixation (ORIF) in the treatment of Song type V lateral condylar humerus fractures (LCHFs) in children. METHODS: A multicenter retrospective study was conducted on 187 pediatric patients with Song type V LCHFs between August 2019 and August 2023. Among them, 96 patients underwent ultrasound-assisted CRPP, and 91 patients received ORIF. Operative time, number of intraoperative fluoroscopy exposures, fracture healing duration, and postoperative complications were compared between the 2 groups. Radiographic parameters-including the Baumann angle (BA) and shaft-condylar angle (SCA)-and functional outcomes assessed by the Flynn criteria were evaluated at 12 months postoperatively. RESULTS: The mean operative time was significantly shorter in the CRPP group (37.07±8.95 min) compared with the ORIF group (53.09±18.36 min; P<0.05). Lateral humeral condylar overgrowth was noted in 37 patients in the CRPP group and 40 in the ORIF group, with no statistical difference. At 12 months, radiographic parameters (BA and SCA) and Flynn functional scores showed no significant differences between groups. The excellent and good rate was 98.96% in the CRPP group and 97.80% in the ORIF group (P>0.05). CONCLUSION: Compared with traditional ORIF, ultrasound-assisted CRPP for Song type V LCHFs in children yields comparable clinical outcomes while significantly reducing operative time and avoiding surgical exposure. This technique facilitates minimally invasive treatment and warrants broader clinical adoption. LEVEL OF EVIDENCE: Level III.