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Review Question - QID 6899

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QID 6899 (Type "6899" in App Search)
Figures 9a and 9b show the radiographs of a 4-year-old child who sustained an elbow injury. What is the most likely complication resulting from this fracture if treated in a cast?
  • A
  • B

Elbow stiffness

44%

24/55

Nonunion

31%

17/55

Osteonecrosis

5%

3/55

Varus malunion from overgrowth

15%

8/55

Fishtail deformity

4%

2/55

  • A
  • B

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The radiographs show a lateral condyle fracture with 2 mm of displacement. As opposed to other pediatric elbow fractures, lateral condyle fractures have a higher incidence of nonunion. This may be due to minimal metaphyseal bone on the distal fragment, the intra-articular nature of the fracture, or from further displacement when treated nonsurgically. These fractures with 2 mm and greater of displacement should be treated with reduction and stabilization. Osteonecrosis and fishtail deformity may be seen in very rare cases of lateral condyle fractures. The incidence is certainly less than the rates of nonunion seen in nonsurgically treated fractures with 2 mm and greater of displacement. Varus malunion from overgrowth and elbow stiffness are more likely seen in fractures treated surgically.

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