Journal of Pediatric Orthopaedics - 2026-05-22 - Journal Article
Multicenter Retrospective Study of Ultrasound-Assisted Closed Reduction and Percutaneous Pinning Versus Open Reduction for Pediatric Song Type V Lateral Condylar Humerus Fractures.
Liu F, Zhang Z, Zhang S, Liu Y, Hua Z, Fan J, Zhang Y
Topics
Key Takeaway
Ultrasound-assisted CRPP for Song Type V lateral condyle fractures achieved a 98.96% excellent/good rate versus 97.80% with ORIF, with operative time 16 minutes shorter (37 vs. 53 min), supporting equivalent outcomes with less surgical exposure.
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Summary
This multicenter retrospective study compared ultrasound-assisted CRPP versus ORIF for Song Type V lateral condyle humerus fractures in 187 pediatric patients. Operative time was significantly shorter in the CRPP group (37.07 vs. 53.09 min, P<0.05), while Baumann angle, shaft-condylar angle, lateral condylar overgrowth rates, and Flynn functional scores were equivalent at 12 months. Excellent/good outcomes were 98.96% (CRPP) versus 97.80% (ORIF), with no statistically significant difference.
Key Limitation
The retrospective design without defined allocation criteria makes it impossible to exclude that CRPP was selectively applied to more favorably displaced fractures, confounding the equivalence conclusion.
Original Abstract
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.