(1) +/- one year, varies between boys and girl. C-R-I-T-O-E to remember age of ossification. CTE-R-O-I to remember age of fusion (capitellum, trochlea and external (lateral) epicondyle fuse together at puberty. Together they fuse to the distal humerus between the ages of 14-16 years old)
Fracture line is lateral to trochlear groove (less common, elbow is stable as fracture does NOT enter trochlear groove)
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Technique guide are not considered high yield topics for orthopaedic standardized exams including the ABOS, EBOT and RC.
A 9-year-old child is on follow-up for a lateral condyle fracture of the distal humerus. AP radiographs are taken on the date of injury and at 6 weeks postoperatively, shown in Figures A and B respectively. Which of the following statements is true?
The final range of motion of the elbow is not influenced by the size of the lateral spur.
Lateral spurring is common in patients treated surgically because of surgical disruption of the overlying periosteum.
Younger patients are more likely to develop larger spurs compared with older patients because of greater growth potential.
The size of the lateral spur is independent of the amount of initial fracture displacement.
Arthroscopic or open trimming of the lateral spur is recommended to prevent late cubitus varus tarda.
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A 7-year-old with a history of an elbow injury treated conservatively presents for evaluation of ongoing elbow pain. The coronal alignment of her elbows in extension is symmetric. On physical examination, she has full, but painful range of motion of her elbow. She has tenderness at the lateral elbow. She is able to cross her fingers without difficulty. A radiograph is shown in Figure A. What is the best definitive treatment plan for this patient?
Observation with splinting
Osseous fragment excision
Internal fixation of the nonunion
Ulnar nerve decompression
A 36-year-old male presents for evaluation of left hand weakness. A current clnical photograph of his hand is shown in Figure A. His medical history is significant for the elbow injury shown in Figure B, which was treated non-operatively twenty-eight years previously. Current radiographic evaluation of the patients elbow will most likely reveal what deformity?
Avascular necrosis of the lateral fragment
Fishtail deformity of the distal humerus
Fracture nonunion and a normal carrying angle
Nonunion following a pediatric lateral condyle fracture has been associated with which of the following?
Ulnar nerve palsy
Radial nerve palsy
Parsonage Turner syndrome
A 6-year-old boy presents to the emergency room after a fall from his bicycle with an isolated left elbow injury. A radiographic series is obtained and the fracture line is only appreciated on the internal oblique view. The greatest distance between the humerus and the fracture fragment is measured to be 2 mm. The patient's mother is strongly opposed to operative intervention and he is placed in a cast. However, the resident explains to her that this injury has the highest rate of nonunion about the elbow and that close follow-up will be necessary. Which of the following injuries is described in this scenario?
Medial condyle fracture
Lateral condyle fracture
Radial neck fracture
Supracondylar humerus fracture
An 8-year-old boy falls on his right upper extremity and presents to the emergency room with the radiographs shown in Figures A and B. He has exquisite tenderness to palpation along the lateral aspect of his elbow. What additional radiographic view will likely demonstrate the maximum degree of fracture displacement?
External oblique radiograph
Internal oblique radiograph
Anteroposterior in maximum flexion
Anteroposterior in maximum extension
Lateral in maximum extension
A 7-year-old girl undergoes open reduction internal fixation of a displaced humeral lateral condyle fracture. Dissection around which portion of the fracture fragment should be avoided to protect its blood supply?
A 6-year-old girl is referred for the elbow injury seen in Figure 2. What is the most appropriate treatment?
Immobilization in a long arm cast for 3 weeks
Immobilization in a long arm cast for 8 weeks
Open reduction and immobilization in a long-arm cast for 3 weeks
Open reduction and internal fixation with smooth pins or cannulated screw
Open reduction and internal fixation with plate and screw construct
Figure A shows the radiograph of a 6-year-old girl after a fall on the playground. What is the most appropriate course of action?
Observation with treatment in a sling
Closed reduction and long arm casting
Closed reduction percutaneous pinning with k-wires
Open reduction internal fixation with k-wires
Open reduction with plate fixation