Biodegradable pins fixation for lateral condylar fracture of the humerus in children

Biodegradable pins are increasingly used in the treatment of lateral condylar fractures of the humerus (LCFH) in children, but the strength of the biodegradable pin is weaker than that of K-wire. However, to enhance the stability of LCFH fixed by biodegradable pins, absorbable tension band wiring is often combined with the application, yet high-quality comparative evidence verifying the clinical value of this auxiliary reinforcement remains lacking. This study aimed to compare and analyze whether auxiliary absorbable tension band wiring has clinical significance for Weiss type III LCFH and to clarify whether additional tension band fixation is clinically necessary in reducing postoperative complications and improving fracture stability. This study enrolled 96 children with Weiss type III LCFH admitted between January 2017 and September 2019. The patients were divided into 2 groups: A (fixed by 3 biodegradable pins alone, n = 45) and B (fixed by 3 biodegradable pins and combined with the application of absorbable figure-of-eight tension band wiring, n = 51). Preoperative, intraoperative, and postoperative indicators, including age, sex, operation time, intraoperative blood loss, fracture healing time, elbow functional recovery time, and postoperative complications, were compared between the 2 groups. Postoperative elbow function was assessed by using the Flynn grading system. All radiographic measurements and functional evaluations were performed by 2 calibrated orthopedic surgeons with excellent inter-rater reliability. Sample size calculations were performed before data collection to guarantee statistical validity. There were no significant differences in age, sex, injured side, preoperative fracture displacement, operation duration, intraoperative blood loss, fracture healing time, elbow functional recovery time, or Flynn functional grading (all P > .05). Complete fracture union was observed in all patients, and no adverse complications, such as wound infection, bone nonunion, osteonecrosis, or elbow deformity, occurred in either group. Absorbable tension band wiring reinforcement is not required after biodegradable pin fixation in the treatment of LCFH in children.