Fracture-separation of the Distal Humeral Epiphysis in Children

Abstract

We retrospectively reviewed twelve cases of the fracture-separation of the distal humeral epiphysis, which were treated during the period from 1989 to 1996. The incidence of this injury was about 3 % from 266 pediatric elbow fractures. Four cases were remained misdiagnosed as the lateral or medial humeral condylar fracture until the authors reviewed their radiographs. Though eleven fractures were extension type injury with typical posteromedial displacement, we identified a rare flexion type injury with anterolateral displacement. This case was a 12+7 year old boy, who was the oldest in our series. Cubitus varus deformity of more than 10 o developed in five patients, and cubitus rectus in two patients. One patient underwent osteotomy for the correction of cubitus varus deformity. We feel this injury is not uncommon as previously noted in the literature. The major problem of this fracture was the possibility of misdiagnosis. Whichever treament modality one may choose, careful evaluation of the carrying angle after reduction is mandatory to avoid residual cubitus varus deformity.