Transphyseal Injury of Distal Humerus: A Commonly Missed Diagnosis in Neonates

Малик, Сергей Васильевич; Khopkar,; Cs, Korday; Ss, Jadhav; Ar, Bhaskar

doi:10.7860/jcdr/2015/11619.6715

Cited by 9 publications

(12 citation statements)

References 8 publications

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“…The manifestation of a dislocated elbow is very similar to that of a physeal fracture of the distal humerus. The main difference is the fact that the relationship between the medial and lateral condyles of the humerus and the olecranon is maintained in a physeal fracture of the distal humerus, even after injury; however, in elbow dislocations, the relationship of the medial and lateral condyles and olecranon appears to be disrupted[ 5 , 8 , 9 , 16 - 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the physeal fracture can be distinguished from dislocation of the elbow and humeral lateral condyle fractures. Nevertheless, it is often difficult to identify the injury in this way when the swelling is severe[ 5 , 8 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Some researchers have proposed that callus formation at the ends of a physeal fracture of the distal humerus in the neonate begins to form on the fifth day after the injury. Reduction is not recommended when the fracture is older than 5 d[ 5 , 21 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous fixation of neonatal humeral physeal fracture: A case report and review of the literature

Tan

Wang

Yao

et al. 2020

WJCC

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BACKGROUND Neonatal distal humeral physeal fractures are rare and difficult to diagnose. Thus, missed diagnoses and delayed healing are possible. Few studies have reported surgical treatment, because a callus may develop at the fracture site 5 d after the fracture, resulting in difficult reduction, and reduction of the limb may cause further physeal injury. Other surgical challenges include the provision of adequate anesthesia and complexity of the operation. However, without appropriate reduction and fixation, a varus elbow deformity may develop. Manual reduction and percutaneous pin fixation are ideal treatment options. CASE SUMMARY A 4-day-old neonate with left elbow pain accompanied by limited movement for 4 d was admitted, and diagnosed with delayed physeal fracture of the distal humerus based on physical examination, ultrasonography, and magnetic resonance imaging. The patient was treated by manual reduction combined with percutaneous pin fixation under arthrography. Postoperatively, the reduction was successful. The upper limbs could have been lifted and the fingers could have been moved freely on the second day after the operation. CONCLUSION The techniques of manual reduction and percutaneous pin fixation, to treat neonatal distal humeral physeal fractures, are safe and reliable.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Percutaneous fixation of neonatal humeral physeal fracture: A case report and review of the literature

Tan

Wang

Yao

et al. 2020

WJCC

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“…Meticulous clinical examination can differentiate between elbow dislocation and distal humeral physeal separation 5 6. Thus, it is essentially a clinical–radiological diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Late presented case of distal humerus epiphyseal separation in a newborn

Mane

Challawar

Shah³

2016

BMJ Case Reports

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The incidence of traumatic bone injuries occurring during birth is rare (1 per 1000 live births). Of all long bone fractures, the humerus is one of the commonest bones to be involved. However, distal humeral epiphyseal separation is rare and has seldom been written up in case reports and small case series. It warrants some critical assessment and appropriate attention. This injury is sometimes missed as it is difficult to diagnose at initial presentation. It may be mistaken for dislocation of the elbow, osteomyelitis, septic arthritis or brachial plexus injury, owing to lack of movement of the upper limb. Knowledge of its clinical and radiological findings will enable the treating physician to diagnose it at the appropriate time. Masterful observation is adequate treatment for this condition, and leads to a better clinical and radiological outcome. Timely diagnosis with an optimistic prognosis will prevent unnecessary parental apprehension.

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“…Transepiphyseal Fracture of Distal Humerus ( TFDH ) or epiphysiolysis of distal humerus is a rare injury seen in children younger than three years of age [1]. It is the least commonest of all physeal injuries representing 3.9% of them in this age group [2]. The reported incidence of this injury is 1:35000 births [3].…”

Section: Introductionmentioning

confidence: 99%

Transepiphyseal separation of distal humerus: A case report and review of literature

Dhar¹

2020

Open J Trauma

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Transphyseal Injury of Distal Humerus: A Commonly Missed Diagnosis in Neonates

Cited by 9 publications

References 8 publications

Percutaneous fixation of neonatal humeral physeal fracture: A case report and review of the literature

Percutaneous fixation of neonatal humeral physeal fracture: A case report and review of the literature

Late presented case of distal humerus epiphyseal separation in a newborn

Transepiphyseal separation of distal humerus: A case report and review of literature

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