You are here

Lateral Condyle of Humerus Fracture 812.42

Lateral Condyle Fracture xray

Lateral Condyle Fracture xray

Lateral Condyle Fracture crpp

Lateral Condyle Fracture crpp

ICD-9 Classification / Treatment
Etiology / Natural History Associated Injuries / Differential Diagnosis
Anatomy Complications
Clinical Evaluation Follow-up Care
Xray / Diagnositc Tests Review References

synonyms: lateral condyle fracture, pediatric lateral condyle fracture,

Lateral Condyle Fracture ICD-9

  • 812.42(closed), 812.52(open)

Lateral Condyle Fracture Etiology / Epidemiology / Natural History

  • 10%-20% of all pediatric elbow fractures (Mirsky EC, J Orhtop Trauma 1997;11:117-120)
  • lateral approach 5-6cm incision ; interval between brachioradialis and triceps (Badelon O, JPO 8;31:1988)
  • tardy ulnar nerve palsies occur usually occur 20 yrs after lateral condyle fracture

Lateral Condyle Fracture Anatomy

  • fall on outstretched arm with varus moment leads to avulsion of lateral condyle by the common extensor origin

Lateral Condyle Fracture Clinical Evaluation

  • Fall onto outstretched hand or direct blow.
  • Pain and swelling in the lateral elbow.
  • Document NV exam before and after any treatment.

Lateral Condyle Fracture Xray / Diagnositc Tests

  • A/P. lateral and oblique xrays
  • Consider arthrography to assess intra-particular extention of fracture and adequacy of reduction. (Marzo JM, JPO 1990;10:317-321)

Lateral Condyle Fracture Classification / Treatment (Jakob R, JBJS Br 1975;57:430-436)

  • Type 1 = nondisplaced; <2mm of fracture displacement.  Generally stable if fracture does not extend into joint. RX=long arm posterior mold for 5days.  XOP at 5 days.  If Fracture remains unchanged LAC.  F/U with XOP’s at 14 days.  Continue with every 14-21 day XOP’s/LAC until fracture union.  May require 8-12 weeks to achieve union.  If >12wks, consider surgical fixation.
  • Type 2=lateral displacement greater than 2mm, and the joint surface is usually disrupted.  Rx=CRPP (Mintzer CM, JPO 1994;14:462-465) If conpression is needed across Fracture site consider pushing on fragment with the chuck end of a 4.5mm drill placed over the iniial K-wire.  Also consider compression screw.  Confirm reduction with arthrogram.
  • Type 3 = significant displacement including radiocapitellar joint displacement.  Rx=see Type 2.
  • Open reduction via Kocher approach (tticeps-brachioradialis).  Avoid dissection posterior to lateral condyle to preserve blood supply to capitellum. 

Lateral Condyle Fracture Associated Injuries / Differential Diagnosis

Lateral Condyle Fracture Complications

  • nonunion, capitellar osteonecrosis, fishtail  deformity of the distal humerus, premature growth arrest of capitellar physis, progressive lateral overgowth and cubitus varus, lateral prominence of the distal humerus
  • excessive valgus of the elbow may lead to ulnar nerve palsy
  • nonunion may lead to elbow instability, pain, and apprehension.  Elbow ROM is typically well maintained.

Lateral Condyle Fracture Follow-up Care

  • LAC for 4-6 weeks.  K-wires are removed when there radiograhpic signs of union(3-6wks). 

Lateral Condyle Fracture Review References

Disclaimer

The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer