Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 3 Issue 12

Surgical Treatment in Fractures of the Lateral Humeral Condyle in Children: When and Which Surgery

Sudhir Shankar Babhulkar*, Sushrut Babhulkar and Amol Yashwantrao Patil

Sushrut Hospital Research Centre and PGI Orthopaedics, Nagpur, India

*Corresponding Author: Sudhir Shankar Babhulkar, Professor, Sushrut Hospital Research Centre and PGI Orthopaedics, Nagpur, India.

Received: November 10, 2020; Published: November 27, 2020

×

Abstract

Background: To optimize the treatment for lateral condyle humerus fracture and define surgical indications.

Material and Methods: 36 patients evaluated with an average follow up of 3 years. All 36 patients had fresh injuries. Internal rotation view with antero-posterior and lateral view is essential. Arthrography, ultrasound or MRI may be required. Type I injury treated partly conservatively and mostly by percutaneous fixation in situ. Type II by closed reduction and fixation after confirming the intact cartilaginous hinge by arthrography and Type III by open reduction.

Result: Type I had excellent results. In type II 8 had excellent and 10 patients had good results. Out of 8 Type III fresh cases 2 had excellent and 5 had good results, 1patient had fair outcome.

Conclusion: Type I injury should be treated by percutaneous fixation to avoid chances of displacement. Type II injuries after confirming the intact cartilaginous hinge can be dealt without open reduction. Type III injury requires open reduction and perfect anatomical fixation. Prognosis of type III injury should be informed in advance to parents. Follow up for loss of carrying angle and development of ulnar neuritis is necessary.

Keywords: Lateral Condyle Humerus; Open Reduction; Ulnar Nerve; Nonunion; Arthrography

×

References

  1. Milch H. “Fractures and fracture dislocations of the humeral condyles”. Journal of Trauma 4 (1964): 592-607.
  2. Flynn JC., et al. “Prevention and treatment of non-union of slightly displaced fractures of the lateral humeral condyle in children: An end-result study”. Journal of Bone and Joint Surgery8 (1975): 1087-1092.
  3. Landin LA. “Fracture patterns in children: Analysis of 8,682 fractures with special reference to incidence, etiology and secular changes in a Swedish urban population 1950-1979”. Acta Orthopaedica Scandinavica 202 (1975): 1-109.
  4. Tejwani N., et al. “Management of Lateral Humeral Condylar Fracture in Children”. Journal of the American Academy of Orthopaedic Surgeons 19 (2011): 350-358.
  5. Stimson L. “A Practical Treatise on Fractures and Dislocations”. Philadelphia, PA, Lea Brothers and Co, (1900).
  6. Milch H. “Fractures of the external humeral condyle”. Journal of the American Medical Association 8 (1956): 641-646.
  7. Jakob R., et al. “Observations concerning fractures of the lateral humeral condyle in children”. Journal of Bone and Joint Surgery. British4 (1975): 430-436.
  8. Song KS., et al. “Internal oblique radiographs for diagnosis of nondisplaced or minimally displaced lateral condylar fractures of the humerus in children”. Journal of Bone and Joint Surgery1 (2007): 58-63.
  9. Marzo JM., et al. “Usefulness and accuracy of arthrography in management of lateral humeral condyle fractures in children”. Journal of Pediatric Orthopaedics3 (1990): 317 321.
  10. Yates C and Sullivan JA. “Arthrographic diagnosis of elbow injuries in children”. Journal of Pediatric Orthopaedics1 (1987): 54-60.
  11. Hausman MR., et al. “Arthroscopically-assisted treatment of pediatric lateral humeral condyle fractures”. Journal of Pediatric Orthopaedics7 (2007): 739-742.
  12. Perez Carro L., et al. “Arthroscopic-assisted reduction and percutaneous external fixation of lateral condyle fractures of the humerus”. Arthroscopy10 (2007): 1131-1134.
  13. Jon A Hardacre., et al. “Fractures of lateral condyle of the humerus in children”. Journal of Bone and Joint Surgery 6 (1973): 1083-1095.
  14. Pirker ME., et al. “Subsequent displacement of initially nondisplaced and minimally displaced fractures of the lateral humeral condyle in children”. Journal of Trauma6 (2005): 1202-1207.
  15. Rutherford A. “Fractures of the lateral humeral condyle in children”. Journal of Bone and Joint Surgery6 (1985): 851-856.
  16. Kamegaya M., et al. “Assessment of stability in children’s minimally displaced lateral humeral condyle fracture by magnetic resonance imaging”. Journal of Pediatric Orthopaedics5 (1999): 570-572.
  17. Vocke-Hell AK and Schmid A. “Sonographic differentiation of stable and unstable lateral condyle fractures of the humerus in children”. Journal of Pediatric Orthopaedics B2 (2001): 138-141.
  18. Conner AN and Smith MG. “Displaced fractures of the lateral humeral condyle in children”. Journal of Bone and Joint Surgery3 (1970): 460-464.
  19. Speed J and Macey H. “Fractures of humeral condyles in children”. Journal of Bone and Joint Surgery 15 (1933): 903-919.
  20. Horn BD., et al. “Fractures of the lateral humeral condyle: Role of the cartilage hinge in fracture stability”. Journal of Pediatric Orthopaedics1 (2002): 8-11.
  21. Song KS., et al. “Closed reduction and internal fixation of displaced unstable lateral condylar fractures of the humerus in children”. Journal of Bone and Joint Surgery12 (2008): 2673-2681.
  22. Skak SV., et al. “Deformity after fracture of the lateral humeral condyle in children”. Journal of Pediatric Orthopaedics B2 (2001): 142-152.
  23. Gay JR and Love JG. “Diagnosis and treatment of tardy paralysis of the ulnar nerve: Based on a study of 100 cases”. Journal of Bone and Joint Surgery4 (1947): 1087-1097.
×

Citation

Citation: Sudhir Shankar Babhulkar., et al. “Surgical Treatment in Fractures of the Lateral Humeral Condyle in Children: When and Which Surgery".Acta Scientific Orthopaedics 3.12 (2020): 68-74.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is February 15, 2023.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US