Lateral Condyle Fracture of the Humerus Among Children Attending a Pediatric Emergency Department

James, Vigil; Chng, Abigail Chin Chii; Ting, Francesca Lim May; Chan, Yiong Huak; Ganapathy, Sashikumar

doi:10.1097/pec.0000000000002032

Cited by 8 publications

(24 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fractures of the lateral condyle peak at 6 to 7 years after injuries with a direct impact or significant varus force exerted through an extended elbow 1,8 . Localized pain lateral to the humerus after trauma should increase suspicion for this injury in children because these may be easily missed initially.…”

Section: Five Pediatric Elbow Fractures Not To Missmentioning

confidence: 99%

“…Advanced imaging may be considered if needed to assess alignment 1 . There are several classification systems, including the Milch and Jakob classifications, currently being used to further define anatomic involvement and severity of displacement 5,8 .…”

Section: Five Pediatric Elbow Fractures Not To Missmentioning

confidence: 99%

“…These fractures notoriously lose position, and therefore, it is prudent to repeat imaging frequently over the first few weeks. Operative management is considered at a low threshold of only 2 mm of displacement or with fracture extension into the trochlear cartilage 3,5,8 . Complications occur more frequently in missed or late recognition of a lateral condylar fracture.…”

Section: Five Pediatric Elbow Fractures Not To Missmentioning

confidence: 99%

See 2 more Smart Citations

Prompt Recognition

Bolander

Post

2023

JBJS Journal of Orthopaedics for Physician Assistants

View full text Add to dashboard Cite

There is a wide range of traumatic elbow injuries that require prompt recognition and management. Fractures of the elbow are common in children; however, because of the complexity of radiographic evaluation in skeletally immature patients, diagnosis of pathology may be missed or misinterpreted, leading to delay in treatment and complications. Careful history and thorough physical examination and utilization of a systematic approach to radiographic evaluation will reduce the chance of a delayed or missed diagnosis. This article will provide an overview of 5 pediatric elbow injuries not to miss, including potential complications and unique considerations for each fracture type to avoid common pitfalls.

show abstract

Section: Five Pediatric Elbow Fractures Not To Missmentioning

confidence: 99%

Section: Five Pediatric Elbow Fractures Not To Missmentioning

confidence: 99%

Section: Five Pediatric Elbow Fractures Not To Missmentioning

confidence: 99%

See 1 more Smart Citation

Prompt Recognition

Bolander

Post

2023

JBJS Journal of Orthopaedics for Physician Assistants

View full text Add to dashboard Cite

show abstract

“…A lateral condyle fracture of the humerus is a common type of elbow injury. Because children under 10 years old have a large number of epiphysis at this location, and the lateral malleolus of humerus is used as the cartilage site, which destroys the overall robustness, it is prone to fracture, and the incidence rate of this disease is second to that of supracondylar fracture of humerus, accounting for 16.9% of patients with distal humerus fracture [1,2]. The main cause of the disease is indirect violence.…”

Section: Introductionmentioning

confidence: 99%

The recovery of upper limb function and postoperative pain in children with lateral humeral condyle fractures were examined retrospectively in relation to the effects of brachial plexus block given in conjunction with general anesthesia

Qiao

et al. 2023

J Orthop Surg Res

View full text Add to dashboard Cite

Objective To assess in retrospect the effects of brachial plexus block and general anesthesia on children with lateral humeral condyle fractures in terms of postoperative pain and return of upper limb function. Methods Randomly allocated to either the control group (n = 51) or the study group (n = 55) were children with lateral humeral condyle fractures who were admitted to our hospital between October 2020 and October 2021, depending on the surgical anesthetic technique used. The research group had internal fixation surgery with brachial plexus block in addition to anesthesia on the basis of the control group, whereas both groups of children underwent the procedure with general anesthesia alone. Postoperative pain degree, upper extremity functional recovery, occurrence of adverse reactions, etc. Results The study group had shorter mean times for surgery, anesthesia, propofol dose, return to consciousness, and extubation than the control group did at every measure of statistical significance. The T2 heart rate (HR) and mean arterial pressure (MAP) were both significantly lower than the pre-anesthesia HR and MAP, and the T1, T2, and T3 HR and MAP were all significantly lower in the study group compared to the control group (P < 0.05). The difference between the SpO2 values at T0 and T3 was not statistically significant (P > 0.05); the VAS scores at 4 h, 12 h, and 48 h after surgery were higher than those at 2 h after surgery, and reached the peak at 4 h after surgery; within 2 h, 4 h, and 12 h of surgery At 48 h, the study group had substantially lower VAS ratings than the control group (P < 0.05). Post-treatment Fugl–Meyer scale scores were considerably higher across the board compared to pre-treatment levels in both groups. When compared to the control group, individuals who participated in the flexion-stretching coordinated exercise and the separation exercise had significantly better ratings. Electrocardiogram, blood pressure, respiratory circulation, and hemodynamic parameters all remained within normal limits during the surgical procedure. The study group had a 9.09% reduced incidence of adverse events compared to the control group. 19.61% (P < 0.05). Conclusion When used in conjunction with general anesthesia, brachial plexus block can help children with lateral humeral condyle fractures regulate perioperative signs, maintain their hemodynamic level, lessen postoperative pain and unpleasant reactions, and improve the function of their upper limbs. Functional recovery, with high safety and effectiveness.

show abstract

“…There is general agreement that nondisplaced and minimally displaced (≤2 mm) lateral condyle fractures (Weiss type 1; Song 1-2) can be successfully treated with cast immobilization. However, reportedly up to 26% of minimally displaced lateral condyle fractures further displace despite immobilization [14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Less common than expected: late displacement after minimally displaced pediatric lateral condyle fractures of the elbow

Burkhart

Kolin

Fabricant

et al. 2023

Journal of Pediatric Orthopaedics B

View full text Add to dashboard Cite

The incidence of late displacement among pediatric lateral condyle fractures has been described as 1.3-26%. However, prior studies are limited by small cohort sizes. The aim of this study was to determine the rate of late displacement and delayed union among lateral condyle fractures following immobilization in a large cohort and to establish additional radiographic criteria to help surgeons choose between immobilization and operative fixation for minimally displaced fractures. We performed a dual-center retrospective study of patients with lateral condyle fractures between 1999 and 2020. Patient demographics, injury mechanism, time to orthopedic presentation, duration of cast immobilization, and complications following casting were recorded. There were 290 patients with lateral condyle fractures included. The initial management in 61% of patients (178/290) was nonoperative, of which four had delayed displacement at follow-up and two developed delayed union requiring surgery (failure in 6/178, 3.4%). The mean displacement on the anteroposterior view was 1.3 ± 1.1 mm and the lateral view was 0.50 ± 1.0 mm in the nonoperative cohort. In the operative cohort, the mean displacement on AP was 6.6 ± 5.4 mm and the lateral view was 5.3 ± 4.1 mm. Our analysis found the rate of late displacement in patients treated with immobilization was lower than previously reported (2.5%; 4/178). The mean displacement on the lateral film in the cast immobilization cohort was 0.5 mm, suggesting that necessitating near anatomic alignment on the lateral film to consider nonoperative management may lead to a lower incidence of late displacement than previously reported. Level of evidence: Level III, retrospective comparative study.

show abstract

Lateral Condyle Fracture of the Humerus Among Children Attending a Pediatric Emergency Department

Cited by 8 publications

References 27 publications

Prompt Recognition

Prompt Recognition

The recovery of upper limb function and postoperative pain in children with lateral humeral condyle fractures were examined retrospectively in relation to the effects of brachial plexus block given in conjunction with general anesthesia

Less common than expected: late displacement after minimally displaced pediatric lateral condyle fractures of the elbow

Contact Info

Product

Resources

About