Displaced fractures of the medial humeral condyle in children.

Case Report on Cubitus Varus Deformity as a Complication of United Medial Condyle of Humerus Fracture- A Rare Fracture in Children

“…. [10], [11] Although falling directly on the point of the flexed elbow is implicated as mechanism of injury, [7], [10], [12], [13] yet in some series, [14], [15], [16] many patients sustained this injury when they fell on their outstretched arms implicating that this is an avulsion injury caused by a valgus strain at the elbow.…”

“…However, in younger children, in whom only the epicondyle is ossified, fracture of the medial condylar physis may be erroneously diagnosed as an isolated fracture of the medial epicondyle. [8], [9], [15] Whereas medial epicondyle fractures are often associated with elbow dislocations, usually posterolateral but with medial condylar physeal fractures, the elbow tends to subluxate posteromedially [8] because of the loss of trochlear stability.…”

“…Untreated displaced fractures usually result in non-union with cubitus varus deformity. [15], [21] These patients are at high risk for loss of motion, function, pain, and eventual arthrosis. Delayed union has been reported in patients treated with insecure fixation or simply placed in a cast.…”

“…Several investigators have reported subsequent avascular changes in the medial crista of the trochlea. [5], [15], [19] Both cubitus varus and valgus deformities have been reported in patients whose fractures united uneventfully. The valgus deformity appears to be caused by secondary stimulation or overgrowth of the medial condylar fragment.…”

“…[10] For displaced fractures, open reduction with internal fixation is the most often used treatment method. [5], [10], [14], [15], [19] [24]. The fracture fragment can be approached by a posteromedial incision that allows good exposure of both the fracture site and the ulnar nerve.…”