Although fractures of the elbow are extremely common in pediatric patients, the T-type distal humerus fracture is rare and offers unique challenges. The mechanism of injury may be similar to the adult counterpart and is usually caused by a fall onto a flexed elbow or from a direct blow. Diagnosing these injuries may be difficult. They often resemble extension-type supracondylar fractures, yet the treatment algorithm is quite different. In younger patients, percutaneous pinning remains a viable option, but for older adolescents, open reduction and internal fixation provides stable fixation at the elbow and the most reliable restoration of the articular surface. Appropriate imaging, careful radiographic diagnosis, and choice of surgical technique are of paramount importance when treating young patients with this injury. Most pediatric and adolescent patients with T-type distal humerus fractures have results better than those of adults but often worse than other elbow fractures in this age group.

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Pes cavus is defined as an abnormal elevation of the medial longitudinal arch of the foot. More than two-thirds of patients with pes cavus are found to have an underlying neurologic diagnosis driving a muscle imbalance within the foot. Expedient clinical diagnosis of underlying pathology is paramount to facilitate proper neuraxial imaging studies and a referral to pediatric neurology. Non-operative management is rarely sufficient and is typically indicated only in cases of mild deformity. Surgical management hinges heavily on physical and radiographic examination findings including the Coleman block test, which can help to determine the need for soft tissue or bony reconstruction. The goal of treatment in pes cavus is to obtain a painless, plantigrade, and supple foot.