scholarly journals Neglected Lateral condyle Humerus Fractures: Current Concepts and Practices

Neglected lateral condyle fractures present varied and difficult challenges to the treating orthopaedic surgeon. They have the potential to cause long term problems like deformities, stiffness, instability and tardy ulnar nerve palsy. The treatment of lateral condyle non-unions depend on the presence or absence of deformity, the duration of non-union, skeletal maturity of the child and the presence or absence of ulnar nerve palsy. Accordingly the treatment ranges from conservative management in neglected fractures with no deformity and no ulnar nerve palsy at one end, Open/mini-open or closed in-situ fixation for established non-unions with instability and corrective osteotomy with fixation of non-union and ulnar nerve transposition at the other end. In this article, the authors have endeavoured to go through the various aspects of clinical presentations and treatment modalities for this difficult fracture. Keywords: Neglected lateral condyle fractures, Cubitus valgus, Tardy ulnar nerve palsy, Instability.

Author(s):  
Abhishek Vaish ◽  
Aamir Johar ◽  
Abhishek Vaish ◽  
Lalit Maini ◽  
Raju Vaishya

Introduction: Fracture of lateral condyle of humerus is known for nonunion, if not treated properly in children, often leads to a cubitus valgus deformity. For the late presenting cases with deformity and restricted range of motion, surgical management is often challenging, and an appropriate preoperative planning is required. Case Report: We report a case of an un-united fracture of the lateral condyle of the humerus in an adult with a cubitus valgus deformity with early tardy ulnar nerve palsy. He was treated by corrective osteotomy with bone grafting of the nonunion and internal fixation with contoured plates. A virtual preoperative surgical planning was done using 3D printing to define the exact location and direction of the osteotomy, plate contouring and likely place of screw placement to achieve full correction of the elbow deformity. Results: There was good correction of deformity, with union of the nonunion and osteotomy, at three months follows- up. At one year, there was complete recovery of ulnar nerve palsy with excellent function of the elbow and hand. Conclusion: 3D printing is effective in treating complex orthopedic cases and deformity correction. Virtual preoperative surgical planning on the computer and on a 3D model help to study the exact site of osteotomy, plate contouring and screw placement to achieve accurate correction of the deformity. Virtual preoperative planning and 3D printing help in reducing the surgical time and help to achieve desired correction of the deformity.


2006 ◽  
Vol 37 (01) ◽  
Author(s):  
F Paul ◽  
F Paul ◽  
FJ Dieste ◽  
T Ratzlaff ◽  
HP Vogel ◽  
...  

1984 ◽  
Vol 32 (4) ◽  
pp. 1195-1198
Author(s):  
A. Kawano ◽  
M. Kido ◽  
K. Shibata ◽  
A. Ohnishi ◽  
T. Mitsuyasu

2017 ◽  
Vol 9 (4) ◽  
pp. 542 ◽  
Author(s):  
Tamer Ahmed EL-Sobky ◽  
John Fathy Haleem ◽  
Hossam Moussa Sakr ◽  
Ahmad Saeed Aly

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