Current Pediatric Research

Background: Lateral spurring is frequently observed after lateral condyle fractures of the humerus in children. Despite its frequent recognition, few previous studies have defined this phenomenon, explored a correlation with any fracture or treatment characteristics, nor assessed its clinical significance.

Methods: Information of 146 lateral condyle fractures in children from June 2015 to September 2021 were retrospectively analyzed and a database was established. Lateral spurring was defined as a bony overgrowth over the lateral aspect of the lateral condyle resulting in imaging irregularity on radiography. Univariable and multivariable logistic regression analyses were used to identify independent risk factors for lateral spurring, and a Receiver Operating Characteristic (ROC) curve was used to assess the impact of independent risk factors.

Results: Among the 146 fractures identified, 6.6% were treated with cast immobilization, 93.4% with open reduction and internal fixation, and none with closed reduction and percutaneous pinning. In total, 110 (75.3%) patients developed a lateral spur, age was identified as an independent risk factor for lateral spurring (P<0.001), and the Area Under the ROC Curve (AUC) was 0.806(95% Confidence Interval (CI) 0.729-0.883, P<0.001). At age 61.5 months, the Youden index reached its maximum with a sensitivity of 86.1% and specificity of 65.5%, Patients with age less than 61.5 months had a higher lateral spurring, the Relative Prevalence (RP) was 1.70.

Conclusions: The development of lateral spurring closely correlates with patient age, the incidence of lateral spurring decreases with age, the incidence of lateral spurring was higher in patients younger than 61.5 months. The presence of a lateral spur after an LCF of the humerus does not influence the function or the appearance of the elbow.

Level of Evidence: Level ?— retrospective study.

Author(s): Tao Liu1, Chuan Dong2, Wu Wen3, Nan Li3

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