Management of lateral condyle fractures of the humerus in children

Author(s):  
Woo Jae Kim ◽  
Chang Park ◽  
Douglas Evans ◽  
Khaled Sarraf

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.

2021 ◽  
Vol 14 (5) ◽  
pp. e241725
Author(s):  
Bradley D Wiekrykas ◽  
Nancy Campbell ◽  
Dustin A Greenhill

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.


1999 ◽  
Vol 12 (4) ◽  
pp. 1034
Author(s):  
Dong Soo Kim ◽  
Kook Jin Chung ◽  
Jong Guk Ahn ◽  
Byung Hyun Jung ◽  
Yeol Bo Sung ◽  
...  

1994 ◽  
Vol 29 (2) ◽  
pp. 415 ◽  
Author(s):  
Hyung Ku Yon ◽  
Kwang Pyo Jeon ◽  
Kuk Whan Oh ◽  
Dae Eun Jung ◽  
Kyung Hoon Kang ◽  
...  

2017 ◽  
pp. 419-422
Author(s):  
Melvin C. Makhni ◽  
Eric C. Makhni ◽  
Eric F. Swart ◽  
Charles S. Day

2018 ◽  
Vol 12 (2) ◽  
pp. 117-122 ◽  
Author(s):  
C. Zale ◽  
Z. A. Winthrop ◽  
W. Hennrikus

Purpose The aim of this retrospective study is to report the rate of displacement of Jakob Type 1 lateral condyle fractures that were initially treated in a cast. Methods We performed a retrospective review of all patients that were treated for a non-displaced (Jakob Type 1 < 2 mm) lateral condyle fracture of the humerus at our institution between 2002 and 2015. Results A total of 59 patients were initially treated with casting. Five fractures displaced and were converted to a closed pinning treatment plan with a conversion rate of 8.5%. There was a mean of 13.2 days (4 to 21) between treatment by initial casting and closed pinning. Conclusion This study demonstrates an 8.5% displacement and conversion rate from cast treatment to closed pinning for initially non-displaced Jakob Type 1 lateral condyle fractures of the humerus. The internal oblique radiograph is most accurate to determine displacement. We recommend obtaining an internal oblique view at initial evaluation and at follow-up in the cast for lateral condyle fractures. To minimize movement at the fracture site, we recommend treating Jakob Type 1 lateral condyle fractures with a long arm cast with the elbow at 90° and the forearm in the supine position with a sling-loop design. Level of Evidence IV – retrospective therapeutic study


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