Lateral humeral condyle fractures: diagnosis, classification, management and complications

Abstract

INTRODUCTION: Lateral condyle fractures (LCF) of the distal humerus are one of the more common skeletal injuries in the pediatric population. The mean age of patients with these fractures is 6 years. In the majority of the cases, the diagnosis is based on clinical and radiographic examination. The most recent classifcation divides these fractures according to degree of displacement and stability. EVIDENCE ACQUISITION: A literature search was performed using Pubmed and Scopus database, until June 2020. Inclusion criteria were studies regarding lateral humeral condyle fractures in pediatric patients. Case reports were excluded. EVIDENCE SYNTHESIS: Most of the studies in literature are retrospective with contrasting opinions and conclusions on diagnosis, classifcation and management. CONCLUSIONS: Regarding the diagnosis and classifcation, the stability of the fracture remains in some cases diffcult to ascertain and MRI can be helpful in identifying the integrity of the articular cartilage and hence fracture stability. Displaced or unstable fractures are preferably treated by closed reduction and percutaneous pinning, while fractures that have rotation of the condylar fragment need to be treated surgically. ORIF can be performed by using different approaches, and the methods of fxation are K-wires or screws. The main factors associated with long-term results are quality of reduction and timing of treatment. The most serious complications are cubitus varus, nonunion, AVN of the condylar fragment and ulnar nerve palsy.