Osteosynthesis for Nonunion of the Lateral Condyle of the Humerus

Young Wook Lim; Jae Woong Yoon; In Young Ok

doi:10.4055/jkoa.2010.45.4.307

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Lim, Yoon, and Ok: Osteosynthesis for Nonunion of the Lateral Condyle of the Humerus

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2010; 45(4): 307-313.

Published online: 9 August 2010

DOI: https://doi.org/10.4055/jkoa.2010.45.4.307

Osteosynthesis for Nonunion of the Lateral Condyle of the Humerus

Young Wook Lim, M.D., Jae Woong Yoon, M.D., In Young Ok, M.D.

Department of Orthopedic Surgery, The Catholic University of Korea School of Medicine, Seoul St. Mary's Hospital, Seoul, Korea.

Correspondence to: In Young Ok, M.D. Department of Orthopedic Surgery, The Catholic University of Korea School of Medicine, Seoul St. Mary's Hospital, 505, Banpo-dong, Seocho-gu, Seoul 137-701, Korea. TEL: +82-2-2258-2837, FAX: +82-2-535-9834, iyokped@catholic.ac.kr

Received 21 December 2009 Accepted 10 May 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Although nonunion of the lateral humeral condyle is a rare complication in children, it can result in a number of complications, and treatment is controversial. Our study shows the results of using osteosynthesis in patients whose lateral humeral condyle was not united.

Materials and Methods

We studies 16 patients (M : F=13 : 3; Age: 11.8±5.2 years) who were diagnosed with nonunion of the lateral humeral condyle and who underwent osteosynthesis. The mean period of nonunion was 56.2 months (5-132 months). Outcome measures were range of movement, bone union, functional score, and carrying angle and were assessed both before and after surgery.

Results

Bones of all patients were united within 3 months of the operation; there were no complications. After surgery, a decreased range of movement was observed for 3 of 16 patients. However, the functional index for all patients was improved. In other words, the range of movement could be reduced while the functional index was improved so that the deformity would be lessened.

Conclusion

Osteosynthesis was successful in repairing the nonunion of the humeral lateral condyle. Therefore, osteosynthesis is suggested for patients who have had no treatment for nonunion of lateral humeral condyle for a long time.

Keywords: nonunion of lateral condyle, osteosynthesis

Figures and Tables

Figure 1

Radiograph of the left elbow of a 8-year-old boy (case No. 1). He previously had performed the osteosynthesis of lateral condyle twice, but he could not obtain bony union. (A) Preoperative radiograph shows nonunion of the lateral condyle. (B) Preoperative CT scan shows nonunion of the lateral condyle. (C) Post operative radiograph shows that the fragment internally fixed with one threaded K-wire and one smooth K-wire and a graft from iliac bone. (D) Final follow-up (26 months after surgery) radiograph. Union of fracture and normal alignment are achieved.

Figure 2

Radiograph of the left elbow of a 7-year-old girl (case No. 2). (A) Preoperative radiograph and 3D CT scan show non union of the lateral condyle. (B) Postoperative radiograph show that the fragment is internally fixed with one threaded K-wire and two smooth K-wires and a graft from iliac bone. (C) Final follow-up (28 months after surgery) radiograph. Union of fracture is achieved, the inclination of distal humerus is increased on the lateral view, and cubitus valgus is improved. (D) On the clinical photo, cubitus valgus is improved.

Figure 3

Radiograph of the left elbow of a 14-year-old man (case No. 7). (A) Preoperative radiographs show nonunion of the lateral condyle (Milch type I). (B) Postoperative radiographs show that the fragment is internally fixed with two treaded K-wires and a graft from iliac bone. (C) Final follow-up (50 months after surgery) radiograph. Union of fracture and normal alignment are achieved.

Table 1

Pre-operative Data on the Patients Summary of Cases

Table 2

Post-operative Results of the Patients

Table 3

Broberg and Morrey Functional Index^*

^*The translation of total score to qualitative groups was as follows; 95 to 100 points, excellent; 80 to 94 points, good; 60 to 79 points, fair; 0 to 59 points, poor.

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