Coupon Accepted Successfully!


Fracture Lateral Condyle Humerus

This is a transphyseal intraarticular injury usually involving immature skeleton of children & adolescent.
Age group of Lateral condyle fracture humerus: 5-15 yrs.

  1. Mechanism
    1. Fall on outstretched arm with
    2. Varus stress (mostly) that “Pulls off” (avulses) lateral condyle
    3. Valgus force (rarely) in which radial head directly pushes off the lateral condyle.
  2. Milch Classification of Fracture Lateral Condyle Humerus
    Milch type I (Salter Harris type IV)
    1. Less common type
    2. Fracture running through the secondary ossification centre of capitullum and entering the joint lateral to capitulotrochlear groove Cause growth defect.
  1. Milch type II (Salter Harris type II )
    1. Commonest
    2. Fracture starting in metaphysis and running along the physis of lateral condyle into trochlear i.e. fracture extends medial to capitulotrochlear groove.
    3. Make ulnar — hurneral (elbow) joint unstable.
  1. Although these fractures may be either Salter Harris type IV & type II injury fracture treatment guidelines follow those of type IV injury: open reduction & internal fixation of displaced intra – articular fractures with the potential for mild growth disturbance of distal humeral physis.
  2. Delayed union/nonunion is most frequent problematic comnplication.
  3. The most common sequela of nonunion with displacement is the development of progressive cubitus valgus defomity. Malunited lateral condylar fractures cause cubitus varus.
Cubitus valgus
  1. Cubitus varus/Lateral spur formation pseudo-varus is the most commnonly reported complication following malunited lateral condyle fracture.
  2. Tardy ulnar nerve palsy is a late complication of progressive cubitus valgus deformity occuring in lateral condylar fractures.
  1. Growth (physical) arrest, avascular necrosis & fishtail deformity are other rare complications.
  1. Tardy Ulnar Nerve Palsy
    1. Tardy ulnar nerve palsy is a late complication of fracture lateral condyle after the development of cubitus valgus more common than cubitus varus.
    2. The symptoms are usually gradual in onset and may appear years after injury. Motor loss occur first, with sensory changes developing somewhat later.
  2. Anterior transposition of ulnar nerve is most commonly used procedure.

Test Your Skills Now!
Take a Quiz now
Reviewer Name