Milch described two types of lateral condyle fractures (Figure 1). In Milch type I, the fracture extends through the ossification center of the capitellum and enters the joint lateral to the trochlear groove. In Milch type II, the fracture extends medially into the trochlear groove. The most widely used system (not identified by name) identifies three fracture patterns (Figure 2). In a type I fracture, the articular surface is intact and the fracture is nondisplaced and stable. In types II and III, the fracture enters the joint. Type II fractures are minimally displaced (2 to 3 mm); type III fractures are displaced >4 mm and may be rotated. (For additional discussion of these systems, see Milch,1 Jakob et al,2 Ogden,3 Herring,4 Wilkins et al,5 and McIntyre.6)



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