Fractures of the lateral condyle of the humerus in children : High risk of secondary dislocation with conservative treatment

Abstract

Fractures of the lateral condyle of the humerus in children are articular fractures with difficult diagnostics due to the incompletely ossified elbow joint. The aim of this study was to evaluate the method of treatment at initial presentation and to analyze the frequency of subsequent displacement during follow-up. Retrospective analysis of the frequency of primary fracture dislocation and subsequent displacement of fractures of the lateral condyle of the humerus in children under 16years of age between 2004 and 2021. Conventional radiographs in two planes at the time of the accident and in the follow-up after 5-7days were evaluated. Atotal of 285 fractures of the lateral condyle of the humerus were evaluated. The average age was 5.3years. Of the fractures 109 (38.3%) were directly surgically treated in cases of primary displacement and 176 fractures (61.7%) were not primarily displaced and were initially treated conservatively. During follow-up, subsequent displacement was evident in 46fractures (26.1%). Atotal of 130 fractures (45.6%) were treated conservatively and 155 fractures (54.4%) were treated surgically using open joint visualization and screw osteosynthesis or K‑wire osteosynthesis. Fractures of the lateral condyle of the humerus occur more frequently in acertain age group and require targeted radiological diagnostics. Nondisplaced fractures can be treated conservatively but essential radiological follow-up shows ahigh number of subsequent displacements, so that open surgical stabilization is often necessary.