Observations Concerning Fractures of the Lateral Humeral Condyle in Children

Abstract

From an anatomical study and clinical review of fractures of the lateral humeral condyle in children, the following conclusions are drawn. The mechanism of injury is a violent varus force with the elbow in extension, the condyle being avulsed. by the lateral ligament and the extensor muscles. If the fracture is incomplete, with an intact hinge of pre-osseous cartilage medially, the fragment will not be displaced. If the fracture is complete the fragment may be displaced, and open reduction with internal fixation is mandatory. The results of open reduction more than three weeks after the fracture are no better than those of no treatment at all, and may kill the lateral condylar fragment by damaging its blood supply. The major problem of a neglected fracture is tardy ulnar nerve palsy; to avoid this, immediate anterior transposition of the nerve is recommended, operation for the fracture itself being of no benefit.

Left-side dominance of upper extremity fracture in children

“…This hand was "free" in 1 16 cases 'and involved in some activity or other in 7 cases; only in these 7 children (all right-handed) could the occupation of either hand have led to the use of the other hand for protection. Jakob et al 1975, Landin 1983, Landin and Danielsson 1986, Thonell et al 1988. The greater frequency of left-sided fractures in our material resulted mainly because the children favored their lett hand to protect themselves when they fell.…”

Outcome of lateral humeral condylar mass fractures in children associated with elbow dislocation or olecranon fracture

“…Alternatively, the leverage of the olecranon may fracture the medial condyle though medial epicondylar fractures are probably avulsion injuries through pull of the medial collateral ligament. Applying Jakob's classification [10] to this series, eight were type I and were managed nonoperatively. The six type II and six type III cases were treated operatively.…”

“…Both the growth plate and articular surface should be anatomically aligned. A missed or inadequately treated LCM fracture can lead to nonunion, malunion, recurrent dislocation, abnormalities in the carrying angle, prominence of the lateral humeral condyle, progressive cubitus valgus deformity, and tardy ulnar palsy [8][9][10]12].…”

“…LCM fractures have been classified in relation to the degree of displacement and rotation of the fracture fragment [10]. Stage I fractures have less than 2 mm displacement and an intact articular surface.…”

Exposed versus buried wires for fixation of lateral humeral condyle fractures in children: A comparison of safety and efficacy

“…Fractures of the lateral humeral condyle are a common childhood injury typically caused by a fall onto an extended arm with a varus force [1]. Undisplaced fractures may be treated conservatively with casting, but displaced fractures have a high incidence of nonunion, and fractures with more than 2 mm of displacement require operative fixation [2][3][4][5].…”