In Situ Late Metaphyseal Osteosynthesis for the Fractures of the Lateral Humeral Condyle in Children

Kun Bo Park; Seung Whan Lee; Hyun Woo Kim; Hui Wan Park; Ki Seok Lee

doi:10.12671/jkfs.2008.21.2.151

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Park, Lee, Kim, Park, and Lee: In Situ Late Metaphyseal Osteosynthesis for the Fractures of the Lateral Humeral Condyle in Children

Original Article

Journal of the Korean Fracture Society 2008; 21(2): 151-156.

Published online: 30 April 2008

DOI: https://doi.org/10.12671/jkfs.2008.21.2.151

In Situ Late Metaphyseal Osteosynthesis for the Fractures of the Lateral Humeral Condyle in Children

Kun Bo Park, M.D., Seung Whan Lee, M.D., Hyun Woo Kim, M.D., Hui Wan Park, M.D., Ki Seok Lee, M.D.

Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

Address reprint requests to: Ki Seok Lee, M.D. Department of Orthopaedic Surgery, Yonsei University College of Medicine, 250, Seongsanno (134, Sinchon-dong), Seodaemun-gu, Seoul 120-752, Korea. Tel: 82-2-2228-2180, Fax: 82-2-363-1139, leeks@yuhs.ac

(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

To evaluate the efficacy of the in situ late osteosynthesis for slightly displaced fractures of the lateral humeral condyle.

Materials and Methods

From 2000 to 2004, 12 patients (8 boys and 4 girls) were managed with in situ late osteosynthesis for fractures of the lateral humeral condyle. The average age at the time of operation was 6 years 1 month (1 year 7 months~9 years 1 month), and the mean amount of fragment displacement was 3.3 mm (2.0~4.5 mm). The operative procedure included curettage and in situ fixation of the fragment.

Results

Bony union was achieved in all cases after avg. 48 months (33~73 months) follow-up assessment. According to the score system of Dhillon et al, 7 patients had excellent, 3 had good, 2 had fair results. None of the patients developed avascular necrosis or premature closure of the epiphysis.

Conclusion

We suggest that in situ fixation is an effective method for the late treatment of slightly displaced fracture of the lateral humeral condyle.

Keywords: Lateral humeral condyle, Nonunion, Delayed union, Osteosynthesis

Figures and Tables

Fig. 1

Measurement of the displacement in the anteroposterior, lateral and both oblique view. In this case, the displacement in the internal oblique view was selected.

Fig. 2

Anteroposterior radiographs of the left elbow (No. 7).

(A) At the age of 5 years and 9 months, nonunion of the lateral condyle fracture at 3 months after injury was noted.

(B) At follow-up, the elbow show normal alignment without any signs of avascular necrosis. But, the lateral prominence was noted.

Fig. 3

Anteroposterior radiographs of the left elbow (No. 5).

(A) At the age of 4 years and 5 months, he already had a fishtail deformity, as well as cubitus valgus deformity before operation.

(B) At the time of the most recent follow-up, the physis of the lateral condylar fragment is still open and there was no progression of the cubitus valgus deformity.

Table 1

Score system for the outcome of lateral humeral condyle fractures in children

Functional grading (points): excellent 6, good 5, fair 4, poor <4, Overall grading (points): excellent 9, good 7~8, fair 5~6, poor <5.

Table 2

Patient data

^*OR: Open reduction, ^†CR: Closed reduction.

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