J Korean Fract Soc.  2012 Apr;25(2):163-168. 10.12671/jkfs.2012.25.2.163.

Lateral Condylar Fracture of the Humerus in Children: Is the Closed Pinning Saticfactory?

• Song KS

• KMID: 2015462
• DOI: http://doi.org/10.12671/jkfs.2012.25.2.163

Abstract

No abstract available.

MeSH Terms

Humerus

Figure

• 

  Fig. 1 Milch classification.

• 

  Fig. 2 Jakob classification.

• 

  Fig. 3 Finnbogason classification.

• 

  Fig. 4 (A) Anteroposterior radiograph of the elbow, showing a Finnbogason type A fracture (stable). (B) Internal oblique radiograph of the same patient showing a Finnbogason type C (unstable) traversing the capitellum.

• 

  Fig. 5 Classification according to degree of displacement and fracture pattern.

• 

  Fig. 6 Algorithm of treatment. Closed reduction and internal fixation is suggested as first line treatment option for unstable fracture.

• 

  Fig. 7 (A) Anteroposterior radiograph showing a completely displaced fracture with rotation of the fracture fragment. Intra-operative (B) anteroposterior and (C) lateral radiographs from same patient showing reduction by pushing the fragment backward and medially with operator's thumb. Intra-operative (D) anteroposterior and lateral (E) radiographs showing final reduction of the fragment <2 mm of displacement with Kirschner wire. (F) Post-reduction aneteroposterior arthrogram showing fixation with three Kirschner wires, congruent reduction of the articular surface.

Reference

1. Badelon O, Bensahel H, Mazda K, Vie P. Lateral humeral condylar fractures in children: a report of 47 cases. J Pediatr Orthop. 1988. 8:31–34.

2. Bast SC, Hoffer MM, Aval S. Nonoperative treatment for minimally and nondisplaced lateral humeral condyle fractures in children. J Pediatr Orthop. 1998. 18:448–450.

3. Beaty JH, Kasser JR. Rockwood and Wilkins' fractures in children. 2001. 6th ed. Philadelphia: Lippincott Williams & Wilkins;592–610.

4. Canale ST. Campbell's operative orthopaedics. 2008. 11th ed. St. Louis: Mosby;1569–1575.

5. Conner AN, Smith MG. Displaced fractures of the lateral humeral condyle in children. J Bone Joint Surg Br. 1970. 52:460–464.

6. Crabbe WA. The treatment of fracture-separation of the capitular epiphysis. J Bone Joint Surg Br. 1963. 45:722–726.

7. Finnbogason T, Karlsson G, Lindberg L, Mortensson W. Nondisplaced and minimally displaced fractures of the lateral humeral condyle in children: a prospective radiographic investigation of fracture stability. J Pediatr Orthop. 1995. 15:422–425.

8. Flynn JC. Nonunion of slightly displaced fractures of the lateral humeral condyle in children: an update. J Pediatr Orthop. 1989. 9:691–696.

9. Flynn JC, Richards JF Jr. Non-union of minimally displaced fractures of the lateral condyle of the humerus in children. J Bone Joint Surg Am. 1971. 53:1096–1101.

10. Flynn JC, Richards JF Jr, Saltzman RI. Prevention and treatment of non-union of slightly displaced fractures of the lateral humeral condyle in children. An end-result study. J Bone Joint Surg Am. 1975. 57:1087–1092.

11. Foster DE, Sullivan JA, Gross RH. Lateral humeral condylar fractures in children. J Pediatr Orthop. 1985. 5:16–22.

12. Hardacre JA, Nahigian SH, Froimson AI, Brown JE. Fractures of the lateral condyle of the humerus in children. J Bone Joint Surg Am. 1971. 53:1083–1095.

13. Horn BD, Herman MJ, Crisci K, Pizzutillo PD, MacEwen GD. Fractures of the lateral humeral condyle: role of the cartilage hinge in fracture stability. J Pediatr Orthop. 2002. 22:8–11.

14. Jakob R, Fowles JV, Rang M, Kassab MT. Observations concerning fractures of the lateral humeral condyle in children. J Bone Joint Surg Br. 1975. 57:430–436.

15. Kamegaya M, Shinohara Y, Kurokawa M, Ogata S. Assessment of stability in children's minimally displaced lateral humeral condyle fracture by magnetic resonance imaging. J Pediatr Orthop. 1999. 19:570–572.

16. Launay F, Leet AI, Jacopin S, Jouve JL, Bollini G, Sponseller PD. Lateral humeral condyle fractures in children: a comparison of two approaches to treatment. J Pediatr Orthop. 2004. 24:385–391.

17. Marzo JM, d'Amato C, Strong M, Gillespie R. Usefulness and accuracy of arthrography in management of lateral humeral condyle fractures in children. J Pediatr Orthop. 1990. 10:317–321.

18. Milch H. Fractures and fracture-dislocations of humeral condyles. J Trauma. 1964. 4:592–607.

19. Mirsky EC, Karas EH, Weiner LS. Lateral condyle fractures in children: evaluation of classification and treatment. J Orthop Trauma. 1997. 11:117–120.

20. Noonan K. Resident review. Top five pediatric orthopedic conditions to diagnose in the emergency room. POSNA. 2011. 02. 5–6.

21. Rang M, Pring ME, Wenger DR. Rang's Children's Fractures. 2005. 3rd ed. Philadelphia: Lippincott William, and Wilkins;113–114.

22. Song KS, Kang CH, Min BW, Bae KC, Cho CH. Internal oblique radiographs for diagnosis of nondisplaced or minimally displaced lateral condylar fractures of the humerus in children. J Bone Joint Surg Am. 2007. 89:58–63.

23. Song KS, Kang CH, Min BW, Bae KC, Cho CH, Lee JH. Closed reduction and internal fixation of displaced unstable lateral condylar fractures of the humerus in children. J Bone Joint Surg Am. 2008. 90:2673–2681.

24. Water PM, Song KS. Latral condyle: Should We fix them all? Pediatric orthopaedic trauma: the cases for best treatment. Proceedings of the POSNA 2010 half daycourse. 2010. 2010 May 4; Waikoloa (HI): Pediatric Orthopedic Society of North America;43–46.

25. Song KS, Shin YW, Oh CW, Bae KC, Cho CH. Closed reduction and internal fixation of completely displaced and rotated lateral condyle fractures of the humerus in children. J Orthop Trauma. 2010. 24:434–438.

26. Thönell S, Mortensson W, Thomasson B. Prediction of the stability of minimally displaced fractures of the lateral humeral condyle. Acta Radiol. 1988. 29:367–370.

27. Vocke-Hell AK, Schmid A. Sonographic differentiation of stable and unstable lateral condyle fractures of the humerus in children. J Pediatr Orthop B. 2001. 10:138–141.

28. Wadsworth TG. Injuries of the capitular (lateral humeral condylar) epiphysis. Clin Orthop Relat Res. 1972. 85:127–142.