Application of ultrasonography in managing minimally displaced or nondisplaced lateral humeral condyle fractures in children

Abstract

Objective To evaluate the significance of ultrasonic examination in determining the stability of minimally displaced or nondisplaced lateral humeral condyle fractures in children. Methods From January 2014 to March 2017, 35 children with minimally displaced or nondisplaced lateral humeral condyle fractures were reviewed. There were 13 girls and 22 boys with an age range of 19-120 months. Transverse cross-section ultrasonography and sagittal section ultrasonography of anterior elbow were used for determining whether or not cartilage hinge was intact. If intact, patients were immobilized in long-arm casts and plain anteroposterior and lateral radiographs were made after 1 week. If disrupted, closed reduction and percutaneous pinning and plain anteroposterior and lateral radiographs were made for 2-3 weeks. For immobilization in long-arm casts and surgical refusal, plain anteroposterior and lateral radiographs were made for 5-7 days. Results Cartilage hinges were intact (n=11) and disrupted (n=24). And 8/24 disrupted children rejected surgery and were immobilized in long-arm casts. Two of them became displaced after 1 week and there were 3 displacements after 2-3 weeks. For 11 intact and 16 operated children, there was no displacement. Conclusions Ultrasonic examination is simple, convenient, accurate and sedation-free for managing lateral humeral condyle fractures in children. It should be routinely applied for early stability evaluations of minimally displaced or nondisplaced lateral humeral condyle fractures in children. Key words: Humeral external condyle fracture; Ultrasonic diagnosis Cartilage hinge; Stability