Paediatric lateral condyle fracture with a posterolateral elbow dislocation: an atypical injury in a preadolescent

2021 ◽  
Vol 14 (5) ◽  
pp. e241725
Author(s):  
Bradley D Wiekrykas ◽  
Nancy Campbell ◽  
Dustin A Greenhill
Keyword(s):  
Functional Limitations ◽  
Elbow Dislocation ◽  
Distal Humerus ◽  
Fracture Dislocation ◽  
Lateral Condyle ◽  
Elbow Fracture ◽  
Rare Injury ◽  
Lateral Condyle Fracture ◽  
Carrying Angle ◽  
Condyle Fracture

Paediatric lateral condyle fractures of the distal humerus are common but a concomitant elbow dislocation is rare. Typically, paediatric orthopaedic surgeons will treat lateral condyle fractures with pin or metaphyseal single-screw fixation and supplementary immobilisation for several weeks. These techniques sacrifice the early stability and mobilisation necessary to avoid stiffness after a complex elbow fracture-dislocation. We present an 11-year-old boy who sustained a traumatic posterolateral elbow dislocation with lateral condyle and coronoid fractures. Due to advanced skeletal age, both paediatric and adult treatment principles were applied to this rare injury. After initial closed reduction, open reduction and internal fixation of the distal humerus lateral condyle with divergent partially threaded compression screws was performed. Motion was initiated in 2 weeks and the patient regained almost full motion by 3 months. At 1.5-year follow-up, the affected limb carrying angle was unaffected and the patient had no functional limitations.

scholarly journals Early Versus Late Removal of Internally Fixated Kirschner’s Wires for Displaced Lateral Condyle Fracture of Humerus in Children

2018 ◽  
Vol 12 (1) ◽  
pp. 229-235
Author(s):  
Hari Prasad Sapkota ◽  
Poojan K Rokaya ◽  
Mangal Rawal ◽  
Dhan Bahadur Karki ◽  
Deoman Limbu
Keyword(s):  
Internal Fixation ◽  
Scoring System ◽  
Distal Humerus ◽  
Lateral Condyle ◽  
Lateral Condyle Fracture ◽  
Carrying Angle ◽  
Condyle Fracture ◽  
Late Group ◽  
Radiological Union

Introduction: Lateral condyle fracture of the distal humerus is the second most common paediatric elbow fracture. Unstable, rotated and displaced (>2 mm) fractures are managed with open reduction and internal fixation with Kirschner’s wires or screws. Debate persists as for how long the Kirschner’s wires should be placed in situ after internal fixation. We aimed to compare the functional and radiological outcome after early versus late removal of internally fixated Kirschner’s wires for displaced lateral condyle fracture of distal humerus. Methods: Children that underwent early (3-4 weeks) or late (5-7 weeks) removal of Kirschner’s wire after open reduction and internal fixation for displaced lateral condyle fracture of humerus were observed for a period of minimum 6 months. Time to radiological union, carrying angle, range of motion was assessed and compared between early and late group. Functional outcome was compared using the Dhillon scoring system. Results: We report the outcome of 40 cases (20 cases in each early and late group). Radiological union was achieved in all the cases of both group at 12 weeks follow up. The mean loss of carrying angle was statistically insignificant (p = 0.394) between the early and late group. There was no significant difference between the early and late group in relation to arc of motion at 12 weeks (p=0.724) and 6 months (p=0.638) follow up. Using the Dhillon scoring system, there was 100% excellent Dhillon score in early group, 80% excellent and 20% good Dhillon score in late group. Functional outcome was statistically insignificant between the two groups (p = 0.106) Conclusion: Early removal of internally fixated K-wires for displaced lateral condyle fracture of humerus in children showed similar radiological and functional results to late removal.

Elbow Dislocation and Articular Fracture of the Distal Humerus

2010 ◽  
Vol 2 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Thierry G. Guitton ◽  
Andrew D. Duckworth ◽  
Margaret M. Mcqueen ◽  
Peter Kloen ◽  
David Ring
Keyword(s):  
Medial Collateral Ligament ◽  
Articular Surface ◽  
Present Report ◽  
Elbow Dislocation ◽  
Distal Humerus ◽  
Fracture Dislocation ◽  
Elbow Fracture ◽  
Collateral Ligament ◽  
Articular Fracture

Background The present report describes subluxation and dislocation of the elbow with articular fracture of the distal humerus and injury to the medial collateral ligament, a type of elbow fracture-dislocation about which little is available in the literature. Methods Twenty-two patients with subluxation or dislocation of the elbow (with injury to the medial collateral ligament) and a fracture of the distal humerus articular surface (capitellum/trochlea) were identified. Seventeen patients had a minimum of 12 months follow-up and eight patients returned for a long-term follow-up at a median of 36 months (range 12 months to 154 months) after injury. Results Nine patients had one or more subsequent surgeries. Seven patients had surgery to address complications and two had a planned implant removal. The final median arc of elbow flexion was 120° (range 100° to 145°) and the median arc of forearm rotation was 175° (range 150° to 180°). The median Broberg and Morrey score was 88 points (range 63 points to 100 points) and the median Disabilities of the Arm Shoulder and Hand score was 9 points (range 1 point to 43 points). Discussion Some elbow dislocations and subluxations are associated with osteochondral fractures of the distal humeral articular surface.

A Clinical Study of Lateral Condyle Fracture of Distal Humerus in Children

1988 ◽  
Vol 23 (4) ◽  
pp. 1039
Author(s):  
Bong Yeol Lim ◽  
Hee Young Cheong ◽  
Byung Ryoung Yoo ◽  
Dong Bai Shin
Keyword(s):  
Clinical Study ◽  
Distal Humerus ◽  
Lateral Condyle ◽  
Lateral Condyle Fracture ◽  
Condyle Fracture

Management of lateral condyle fractures of the humerus in children

2021 ◽  
pp. 1-6
Author(s):  
Woo Jae Kim ◽  
Chang Park ◽  
Douglas Evans ◽  
Khaled Sarraf
Keyword(s):  
Nerve Palsy ◽  
Growth Arrest ◽  
Definitive Treatment ◽  
Lateral Condyle ◽  
Elbow Fracture ◽  
Lateral Condyle Fracture ◽  
Ulnar Nerve Palsy ◽  
Paediatric Fracture ◽  
Condyle Fracture ◽  
High Index Of Suspicion

Lateral condyle fracture of the humerus is the second most common paediatric elbow fracture and is often missed, which can result in severe consequences including malunion, growth arrest and tardy ulnar nerve palsy. The difficulty in managing this fracture stems from a lack of awareness and the often subtle findings on radiographs. Patients can also present with quite vague symptoms; clinicians who do not have a high index of suspicion may not investigate beyond the initial clinical assessment and could miss vital cues. This article provides a guide to managing this common paediatric fracture, from initial presentation to definitive treatment, and discusses the complications that can ensue if managed incorrectly.

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