Arthroscopy-Assisted Reduction for Jacob Type II Pediatric Humeral Lateral Condyle Fractures: A Clinical Efficacy Study

Zhikai Chen^*

• Orthopeadic Hospital of Liuyang County, Changsha, China

Background Minimally invasive approaches are being increasingly employed in pediatric orthopedic trauma surgery. Clinical practice has seen applications of minimally invasive techniques for fractures such as intercondylar eminence avulsion fractures, femoral shaft fractures, and humeral shaft fractures. However, open reduction remains the primary surgical approach for pediatric humeral lateral condyle fractures. Open reduction disrupts peripheral blood circulation and increases the risk of epiphyseal injury. Damage to the epiphysis may affect a child's growth and development; therefore, surgical approach selection requires careful consideration. Objective:To compare the efficacy of arthroscopic reduction versus open reduction for Jacob type II pediatric humeral lateral condyle fractures. Methods:A retrospective study was conducted on 60 pediatric patients with Jacob type II humeral lateral condyle fractures treated at Liuyang Orthopedics Hospital between January 2021 and June 2022. The cases were divided into 2 group based on surgical approach. The A-Group underwent arthroscopy-assisted reduction with Kirschner wire fixation, while the O-Group received open reduction with Kirschner wire fixation. Operative time, intraoperative blood loss volume, and incision length were compared between the two groups; Pre-and postoperative VAS pain scores, CRP levels, and ESR were compared; To assess whether arthroscopic reduction offers advantages over open reduction for pediatric humeral lateral condyle fractures, outcomes including the Mayo Elbow Performance Score (MEPS) and Baumann angle were evaluated at 3 months.Results:Incisions healed by first intention in both groups. No statistically significant difference was found in operative time between groups [P=0.632]. Incision length was significantly shorter in the A-Group [P=0.000]. Intraoperative bleeding was significantly less in the A-Group [P=0.012]. Both groups showed reduced VAS scores postoperatively, with significantly better scores in the A-Group (P=0.000). Postoperative CRP and ESR levels increased in both groups compared to preoperative values, but the O-Group demonstrated significantly greater increases (P<0.05). At 3 months postoperatively, the A-Group showed superior Mayo Elbow Performance Scores (P=0.013), while no significant difference was observed in Baumann angle measurements. Conclusion:Arthroscopic reduction for pediatric humeral lateral condyle fractures offers smaller incisions, reduced bleeding, attenuated inflammatory response, and is more conducive to postoperative functional recovery.