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JBJS Essent Surg Tech 2020 Oct-Dec;10(4). Epub 2020 Nov 19.

Children's Hospital Los Angeles, Los Angeles, California.

Background: Lateral condylar fractures of the humerus are the second most common elbow fracture seen in pediatrics, behind supracondylar humeral fractures. All practicing orthopaedic surgeons should be able to identify and treat these injuries appropriately, as the intra-articular and transphyseal nature of this fracture pattern contributes to the relatively high complication rate. Treatment has evolved with time as classification systems better characterize the different types of lateral condylar fractures, aiding in decision-making for management. Read More

Zhongguo Gu Shang 2021 May;34(5):437-41

The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang, China.

Objective: To explore clinical effectiveness and safety of ultrasound-guided closed reduction and K-wires internal fixation in treating of Kilfoyle Ⅱand Ⅲ medial condylar fracture of humerus in children.

Methods: Clinical data of 32 children with medial condylar fracture of humerus treated with closed reduction and internal fixation with K-wires under the guidance of ultrasound were retrospectively analyzed from January 2014 to August 2019, including 23 males and 9 females, age ranged from 3.2 to 12. Read More

Indian J Orthop 2021 Jun 8;55(3):539-548. Epub 2021 Mar 8.

Department of Paediatric Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, 16 Shivajinagar, Pune, 411005 India.

TRASH lesions are a group of special injuries around the elbow resulting from high energy trauma that are routinely missed at initial presentation because of seemingly normal X-rays. These are a group of osteochondral injuries having a high propensity for surgical intervention and usually have poor outcomes if not treated adequately. Prompt diagnosis warrants a high index of suspicion even when a radiograph appears to be normal with a disproportionately swollen elbow in a child. Read More

Int Orthop 2021 04 27;45(4):1065-1070. Epub 2020 Sep 27.

School of Medicine, University of Belgrade, Belgrade, 11000, Serbia.

Intracondylar T-type fractures of distal humerus represent a rare condition in paediatric population with unknown incidence since the literature is limited to case reports or case series. The main purpose of this article is to provide a comprehensive review of the current literature about the incidence and diagnostic modalities, as well as to evaluate all treatment options with results and complications. Review of the literature identified nine institutional reports in the period between 1984 and 2015, involving a total of 135 children and adolescents. Read More

Int Orthop 2020 07 27;44(7):1417-1426. Epub 2020 May 27.

Department of Orthopaedics, PGIMER Chandigarh, 162 K Block Mdh Pgimer, Chandigarh, 160012, India.

Purpose: Cubitus varus deformity occurs in children as a late consequence of supracondylar fracture of the distal humerus. Different types of corrective osteotomies have been described, but a gold standard has not yet been established. The aim of this study is to report the clinical, radiological, and cosmetic outcome of the modified reverse step-cut osteotomy technique. Read More

Injury 2021 Mar 28;52 Suppl 1:S25-S30. Epub 2020 Feb 28.

Department of Traumatology, University of Szeged, Hungary.

Introduction: Positive role of ultrasound in the diagnosis of pediatric elbow injuries were confirmed by many papers but no comprehensive, standardized method has been developed for daily clinical practice. The aim of our prospective diagnostic study was to prove the efficacy of a five point sonographic point of care method for detecting different pediatric elbow fractures or dislocations.

Methods: Between 2016 January and 2017 March 365 children (age 1-14) with suspected closed elbow injury were enrolled in our study. Read More

Bull Hosp Jt Dis (2013) 2019 12;77(4):250-255

Background: Supracondylar humerus fractures account for two thirds of all hospitalizations for elbow injuries in children. A prevailing assumption exists regarding whether treatment quality varies by surgeon training background. This study compares radiographic outcomes of pediatric supracondylar humerus fractures treated by fellowship trained pediatric orthopedists (PO) and non-pediatric orthopedists (adult traumatologists, AT) with regard specifically to ability to obtain and maintain an operative closed reduction. Read More

Int Orthop 2018 03 1;42(3):619-624. Epub 2018 Feb 1.

The First Affiliated Hospital of Nanchang University, Nanchang, China.

Purpose: The purpose of this study was to compare the surgical findings and clinical outcomes of the lateral condylar fractures of the humerus with or without posteromedial elbow dislocation in children.

Methods: Between January 2013 and June 2016, a total of 21 Milch type II humeral condylar fractures were treated with open reduction and internal fixation. The average follow-up was 2. Read More

Medicine (Baltimore) 2017 Feb;96(6):e6085

Department of Orthopaedic Surgery, Nippon Medical School Hospital, Tokyo, Japan.

Rationale: Intercondylar fracture of the distal humerus is an extremely rare injury in children, especially in those under 8 years of age. To our best knowledge, there have been 55 reported cases of this fracture type in children in the English literature, 12 of which involved children under 8 years of age.

Patient Concerns: We report a case of intercondylar fracture of the distal humerus in a7-year-old boy fell in a gymnasium, injuring his left elbow. Read More

Radiographics 2016 Oct;36(6):1672-1687

From the Department of Radiology, Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104 (J.D., N.A.C.); Department of Radiology, Stanford University Medical Center, Palo Alto, Calif (D.J.); and Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa (N.A.C.).

Increased physical activity in childhood has resulted in a large number of sports-related injuries. Although there is overlap between the sports-related injuries seen in pediatric and adult patients, important differences exist in the injury patterns of pediatric patients. These differences are related to the continuous changes in the developing skeleton and its relationship with adjacent soft tissues. Read More

Int Orthop 2017 Jan 5;41(1):157-164. Epub 2016 Sep 5.

Department of Orthopedic Trauma, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China.

Purpose: To evaluate surgical treatment of symptomatic non-union of lateral condylar elbow fractures in adults.

Methods: In this retrospective cohort study, 11 consecutive adult patients were surgically treated for symptomatic non-union of the lateral humeral condyle. Milch type I fracture non-unions (n = 3) were treated with medial closing wedge osteotomy and ulnar nerve transposition, while type II equivalents (n = 8) were treated with non-union fixation and bone grafting. Read More

Injury 2016 Oct 24;47(10):2071-2076. Epub 2016 Aug 24.

Department of Orthopedic Surgery, Juntendo University, Tokyo, Japan.

Introduction: Previous reports have questioned whether an orthogonal or parallel configuration is superior for distal humeral articular fractures. In previous clinical and biomechanical studies, implant failure of the posterolateral plate has been reported with orthogonal configurations; however, the reason for screw loosening in the posterolateral plate is unclear. The purpose of this study was to evaluate biomechanical properties and to clarify the causes of posterolateral plate loosening using a humeral fracture model under axial compression on the radial or ulnar column separately. Read More

Res Vet Sci 2016 Jun 31;106:143-8. Epub 2016 Mar 31.

Department of Clinical Sciences, Small Animal Surgery Service, Faculty of Veterinary Medicine, University of Liège, Belgium. Electronic address:

Distal humeral fractures are common fractures especially in immature small breed dogs. The pathogenesis is still unknown. For this study, a three- dimensional bone model of the canine elbow was created and finite element analysis performed in order to determine the relationship between fracture type and bone interactions. Read More

Orthop J Sports Med 2016 Mar 16;4(3):2325967116635515. Epub 2016 Mar 16.

Kaiser Permanente of Los Angeles, Los Angeles, California, USA.

Background: The frequency of osteochondritis dissecans (OCD), a disorder of the subchondral bone and articular cartilage, is not well described.

Purpose: To assess the frequency of pediatric OCD lesions that progress to surgery based on sex, joint involvement, and age.

Study Design: Descriptive epidemiology study. Read More

J Pak Med Assoc 2015 Nov;65(11 Suppl 3):S202-4

Department of Surgery, Aga Khan University Hospital, Karachi.

Objective: To compare iatrogenic ulnar nerve injury in lateral entry pin fixation versus medial and lateral entry pin fixation in the treatment of supracondylar fractures of the humerus in children. Measurement of clinical parameters in terms of elbow range of motion and postop radiographic alignment was also targeted.

Methods: The retrospective cohort study was conducted at Aga Khan University Hospital, Karachi, and comprised data of paediatric patients who underwent closed reduction and percutaneous pin fixation for the treatment of displaced extension type supracondylar fractures of the humerus between July 2007 and June 2012. Read More

Indian J Orthop 2015 Sep-Oct;49(5):523-8

Department of Orthopaedics, Bhattacharyya Orthopaedics and Related Research Centre, Narayanpur, P.O.; R-Gopalpur, Kolkata, India.

Background: The condyles of the distal humerus have characteristic orientation in reference to the diaphysis. Anatomical reduction of the articular surface in intraarticular fractures of adult distal humerus does not always restore preinjury functional status. The purpose of this study was to determine the outcome of treating these fractures with technique of condylar orientation precontoured plating. Read More

Pediatr Radiol 2016 Jan 28;46(1):61-6. Epub 2015 Jul 28.

Department of Pediatric Orthopedics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Background: The three most common elbow fractures classically reported in pediatric orthopedic literature are supracondylar (50-70%), lateral condylar (17-34%), and medial epicondylar fractures (10%), with fractures of the proximal radius (including but not limited to fractures of the radial neck) being relatively uncommon (5-10%). Our experience at a large children's hospital suggests a different distribution.

Objective: Our goals were (1) to ascertain the frequency of different elbow fracture types in a large pediatric population, and (2) to determine which fracture types were occult on initial radiographs but detected on follow-up. Read More

AJR Am J Roentgenol 2015 Feb;204(2):W192-8

1 Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Riley Hospital for Children, 705 Riley Hospital Dr, Rm 1053, Indianapolis, IN 46202.

OBJECTIVE. Distal humeral epiphyseal separation is rare and often misdiagnosed. The purpose of this study was to summarize an experience with radiography and ultrasound of distal humeral epiphyseal separation. Read More

Pediatr Radiol 2015 Jun 20;45(6):814-9. Epub 2014 Dec 20.

Department of Radiology, Division of Pediatric Imaging, Massachusetts General Hospital, 55 Fruit St., Boston, MA, 02114, USA.

Background: Concavity in the central portion of the distal humerus is referred to as fishtail deformity. This entity is a rare complication of distal humeral fractures in children.

Objective: The purpose of this study is to describe imaging features of post-traumatic fishtail deformity and discuss the pathophysiology. Read More

Vet Comp Orthop Traumatol 2014 26;27(3):179-85. Epub 2014 Feb 26.

Andy Moores, BVSc DSAS(Orth) Dip ECVS MRCVS, Anderson Moores Veterinary Specialists, Bunstead Barns, Poles Lane, Hursley, Winchester, Hampshire, United Kingdom, Phone: + 44 1962 767920, Fax: + 44 1962 775909, E-mail:

Objective: To report the use of a 4.5 mm shaft screw for the management of humeral condylar fractures (HCF) and incomplete ossification of the humeral condyle (IOHC) in dogs, and to assess risk factors for complications.

Methods: Dogs with HCF or IOHC that were managed with a 4. Read More

Vet Surg 2014 Feb 6;43(2):155-65. Epub 2014 Jan 6.

Fitzpatrick Referrals, Eashing, United Kingdom.

Objective: To compare radiographic elbow arthrosis with arthroscopic cartilage pathology in Labrador retrievers with elbow osteoarthritis secondary to medial coronoid process (MCP) disease.

Study Design: Retrospective epidemiological study.

Animals: Labrador retrievers (n = 317; 592 elbow joints). Read More

Orthopedics 2012 Jun;35(6):e823-8

Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Gyeonggi-do, Seoul, Korea.

The purpose of this study was to evaluate the effectiveness of supracondylar lateral closing-wedge osteotomy of the humerus in children and the postoperative remodeling of the lateral condylar prominence. Lateral closing-wedge osteotomy for cubitus varus deformity was performed in 52 children. In all cases, medial translation for decreasing lateral condylar prominence or transposition of the ulnar nerve was not performed. Read More

Vet Comp Orthop Traumatol 2010 9;23(6):468-71. Epub 2010 Sep 9.

Veterinary Specialists of Alaska, 3330 Fairbanks Street, Anchorage, Alaska 99503, USA.

A five-month-old male, German Shorthaired Pointer dog was presented for severe, bilateral, thoracic-limb-lameness, with elbow swelling, pain, and crepitus. Radiography and computed tomography confirmed bilateral incomplete ossification of the humeral condyles (IOHC), with a non-displaced incomplete fracture of the left medial epicondylar crest and condylar deformity, characterised by enlargement of the trochleas with extension of the disto-medial aspect of the bone below the normal elbow joint level, and a deformed proximo-medial aspect of the ulna and radius. Transcondylar lag screws were placed bilaterally in an attempt to prevent fracture. Read More

J Bone Joint Surg Br 2010 May;92(5):668-71

Centre for Hand and Upper, Limb Surgery, Wrightington Hospital, Hall Lane, Appley Bridge, Lancashire WN6 9EP, UK.

This is a retrospective review of the results of the Acclaim total elbow replacement in 11 older patients aged > or = 65 years with primary osteoarthritis of the elbow, with a mean follow-up of 57.6 months (30 to 86.4). Read More

Clin Calcium 2008 Sep;18(9):1332-8

Tokyo Metropolitan Rehabilitation Hospital, Department of Orthopaedics and Rheumatology.

Fractures of the distal humerus around the elbow joint are most often in supracondylar or condylar lesion. This article described the diagnosis, classification, treatment, progress, side-effect, after-treatment and rehabilitation of fractures of supracondylar, lateral condyle and medial epicondyle of the humerus in child, and also described these of supracondylar, epicondylar fractures of the humerus in adult. Physical therapy should include active and active-assisted exercises for joint mobilization as soon as soft tissue healing permits. Read More

Vet Surg 2008 Apr;37(3):226-31

Institute of Comparative Medicine, Faculty of Veterinary Medicine, Glasgow, Scotland, UK.

Objectives: To describe computed tomographic (CT) features of canine elbows with incomplete ossification of the humeral condyle (IOHC) and investigate co-existing incongruence in the elbow joint.

Study Design: Case control study.

Animals: Dogs with IOHC (n=20; 38 elbows) and 25 normal elbows. Read More

J Bone Joint Surg Am 2006 Sep;88 Suppl 1 Pt 2:191-201

Department of Orthopaedic Surgery, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan, Republic of China.

Background: Open reduction, autogenous bone-grafting, and internal fixation for the treatment of established nonunion of the lateral condyle associated with a cubitus valgus deformity has a high rate of complications. As a consequence, we developed a new technique that includes in situ compression fixation of the lateral condylar nonunion and a dome-shaped supracondylar osteotomy of the distal aspect of the humerus through a single posterior incision.

Methods: Eight consecutive patients were treated with the new surgical technique between 1994 and 2000. Read More

Oper Orthop Traumatol 2005 Feb;17(1):51-65

Abteilung für Kinderorthopädie, Krankenhaus Hautepierre, Louis-Pasteur-Universität, Strassburg, Frankreich.

Objective: Improvement of stability of internal fixation of epiphyseo-metaphyseal fractures in children with an implant characterized by its small diameter, easy utilization and its versatility. It avoids the drawbacks of screw fixation particularly in respect to the growth plate.

Indications: Potentially all epiphyseo-metaphyseal fractures in children. Read More

J Bone Joint Surg Am 2005 Jul;87(7):1456-63

Department of Orthopaedic Surgery, Kaohsiung Medical College, 100 Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan, Republic of China.

Background: Open reduction, autogenous bone-grafting, and internal fixation for the treatment of established nonunion of the lateral condyle associated with a cubitus valgus deformity has a high rate of complications. As a consequence, we developed a new technique that includes in situ compression fixation of the lateral condylar nonunion and a dome-shaped supracondylar osteotomy of the distal aspect of the humerus through a single posterior incision.

Methods: Eight consecutive patients were treated with the new surgical technique between 1994 and 2000. Read More

Injury 2005 Feb;36 Suppl 1:A35-43

Department of Pediatric Surgery, St. Hedwig's Hospital, Clinical Centre Barmherzige Brüder, Regensburg, Germany.

Articular fractures in children are rare and occur mainly in the elbow and ankle joint. Condylar fractures of the humerus, olecranon fractures, medial malleolar, and transitional fractures of the distal tibia are the commonest, though there is an increasing incidence of avulsion fractures of the intercondylar tibial eminence. Conservative treatment is recommended in articular displacements of less than 2 mm, but dislocation of more than 2 mm is a commonly accepted indication for surgery. Read More