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LATERAL HUMERAL CONDYLE FRACTURES IN CHILDREN



Abstract

Fracture of the lateral humeral condyle accounts for approximately 15% of all elbow fractures in children.

We studied 68 fractures of the lateral humeral condyle, which were treated surgically over a period of six years during 1994 to 2000. There were 49 boys and 19 girls. The average age was 6,5 years (2,5 – 13 years). All cases were treated with open reduction and internal fixation with two divergent K-wires for safer stabilisation of the fracture. Subsequently a cast was applied for 4–6 weeks to the radiological union of the fracture, where the K-wires were removed.

The patients were evaluated with clinical and radiological criteria. Sixty-five cases were classified as Milch type II fractures and three were Milch type I fractures. According to the Jacob classification, which records the degree of displacement, 23 cases were type II fractures and 45 cases were type III fractures. The mean follow up was 4 years (2–8 years). Analysis of the postoperative radiographs showed that radiological union was achieved in all cases. The mean time to radiological union of the fracture was 4,5 weeks (3–8 weeks). At latest follow up we observed abnormalities of the shape of the distal humerus due to overgrowth of the lateral humeral condyle in 40% of the cases. In 4 patients we observed pseudocubitus varus due to overgrowth of the lateral humeral condyle and in 3 patients we observed mild cubitus varus (< 5°). Clinically in all cases there was painless free movement of the elbow.

We conclude that satisfactory anatomical reduction of the fracture gives good clinical results. The radiological abnormalities observed seem not to play an important role in the final result.

The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.