J Korean Orthop Assoc.  2008 Feb;43(1):24-29. 10.4055/jkoa.2008.43.1.24.

Surgical Treatment of Late Presented Displaced Lateral Condylar Fracture of the Humerus in Children

• Bae KC
• Song KS
• Kang CH
• Min BW
• Cho CH
• Kong HS

• KMID: 2106412
• DOI: http://doi.org/10.4055/jkoa.2008.43.1.24

Abstract

PURPOSE: To determine whether late open reduction and internal fixation (ORIF) of a lateral condylar fracture (LCF) after 3 weeks is possible, and to determine the latest time for ORIF without a bone graft.
MATERIALS AND METHODS
Eight children underwent late ORIF (>3 weeks) of a displaced LCF (>2.5 mm) of the humerus between 3 weeks and 5 weeks after injury.
RESULTS
Clinically, results were excellent in 6 cases and good in 2 cases. There was no serious complication, including nonunion and avascular necrosis (AVN), though 2 cases had a slight fishtail deformity and mild carrying angle loss due to overgrowth of the lateral condyle fragment.
CONCLUSION
We believe that 3 weeks is too short to deny open reduction and anatomic reduction for fear of AVN of a late presented lateral condyle fracture of the humerus. The latest time for ORIF in late presented LCF in children is around 5 weeks, and surgical treatment may even be possible after greater delays.

Keyword

Lateral condyle fracture of the humerus; Late open reduction; Children

MeSH Terms

Child
Congenital Abnormalities
Humans
Humerus
Lifting
Necrosis
Transplants

Figure

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  Fig. 1 A 3-year-old child with a lateral condyle fracture of the humerus. Antero-posterior (A) & lateral (B) radiographs showing a displaced lateral condylar fragment with some callus at 5 weeks after injury.

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  Fig. 2 Postoperative antero-posterior (A) & lateral (B) radiographs of the same case. The fracture was reduced anatomically with open reduction and fixed with 2 smooth Kirshner's wires.

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  Fig. 3 Three year follow-up antero-posterior (A) & lateral (B) radiographs showing a small defect at the central portion of the distal articular surface - the so-called "fishtail appearance".

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