Prospective 3-center study of 24 consecutive Jakob Stage 3 lateral condyle fractures in children (completely displaced and rotated) asking whether closed reduction and internal fixation with percutaneous Kirschner wires can replace open reduction as the initial treatment strategy.
When you encounter a completely displaced and rotated (Jakob Stage 3) lateral condyle fracture in a child, attempt closed reduction with percutaneous pinning first — it works in three-quarters of cases and avoids the soft-tissue risks of open surgery; accept <2 mm residual displacement on AP, internal oblique, and lateral views as your threshold, and have a low threshold to convert to ORIF if that target isn't met.
Prospective 3-center study of 24 consecutive Jakob Stage 3 lateral condyle fractures in children (completely displaced and rotated) asking whether closed reduction and internal fixation with percutaneous Kirschner wires can replace open reduction as the initial treatment strategy.
When you encounter a completely displaced and rotated (Jakob Stage 3) lateral condyle fracture in a child, attempt closed reduction with percutaneous pinning first — it works in three-quarters of cases and avoids the soft-tissue risks of open surgery; accept <2 mm residual displacement on AP, internal oblique, and lateral views as your threshold, and have a low threshold to convert to ORIF if that target isn't met.