(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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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
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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 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 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?
HPI - This patient had a fall and sustained a lateral condyle fracture which was treated in a peripheral hospital with cast immobilization.
She is now 14 months post injury.
No ulnar nerve symptoms at the moment.
Her primary complaint is a significant elbow deformity.
How would address this problem surgically?
HPI - h/o fall in the park a week before presentation.was treated in a slab in another hospital.
How would you treat this fx now that it is seven days old?
HPI - The patient had a history of a fall in childhood that was treated nonoperatively by the village bone setter. Patient went about his life with deformity but no limitation to his work.
Then 7 months ago the patient fell again and developed acute pain in his right elbow. Patient did not seek immediate treatment.
Three months after the fall, he returned to his native country and surgery was performed. (see Postop Procedure 1 films).
He now presents with persistent pain and hardware prominence.
Do you think the large lateral condyle fragment represents an acute nonunion (from fall 7 months ago) or a chronic nonunion from his pediatric lateral condyle fx?