title: Deformity after internal fixation of fracture separation of the medial epicondyle of the humerus.
abstract: We reviewed 24 displaced fractures through the physis of the medial epicondyle of the distal humerus. One was a Salter-Harris type-II fracture-separation of the whole distal humeral epiphysis; the others involved only the medial epicondylar centre of ossification. Two cases had presented as pseudarthroses. One fracture had been treated closed in a plaster slab and 21 had had open reduction and internal fixation with sutures, Kirschner wires or Palmer nails. At 2 to 13 years later we found five types of deformity of the epicondyle: pseudarthrosis, an ulnar sulcus, a double-contoured epicondyle, hypoplasia or hyperplasia. Pseudarthrosis had developed after either no treatment, closed reduction and plaster, or open reduction and suturing. Hypoplasia followed nailing, as did a trend to varus tilting of the joint surface. One very young patient, with fracture-separation of the whole distal epiphysis treated by nailing, developed marked cubitus varus.
authors.affiliation: University Hospital of Bispebjerg, Copenhagen, Denmark.
authors.forename: S V
authors.initials: SV
authors.lastname: Skak
authors.forename: E
authors.initials: E
authors.lastname: Grossmann
authors.forename: P
authors.initials: P
authors.lastname: Wagn
mesh_terms: D000293:Adolescent; D001858:Bone Nails; D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000000981:diagnostic imaging; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D016916:Joint Deformities, Acquired / Q000209:etiology*; D008297:Male; D011542:Pseudarthrosis / Q000209:etiology; D011859:Radiography