title: Fishtail deformity following fracture of the distal humerus in children: historical review, case presentations, discussion of etiology, and thoughts on treatment.
abstract: Fishtail deformity is an uncommon complication of distal humeral fractures in children. This article reports four cases accompanied by premature closure of a portion of the distal humeral physis with resultant deformity, length retardation, decreased elbow motion, and functional impairment. The ages of the patients at time of injury ranged from 4 years 2 months to 6 years 1 month (average 5 years 4 months). The average length of follow-up was 9 years 9 months (range, 3 years 5 months to 18 years 10 months). The cause of the arrest is multifactorial and may be due to a gap in reduction of an intracondylar fracture, avascular necrosis of the epiphysis, or central premature physeal arrest (bar formation) without a fracture gap or avascular necrosis. If identified in a young child, surgical closure of the medial and lateral portion of the physis may prevent the deformity from progressing and would not cause significant additional humeral length discrepancy.
authors.affiliation: Mayo Clinic/Mayo Foundation, 200 First Street, SW, Rochester, MN 55905, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Nwakama
authors.forename: H A
authors.initials: HA
authors.lastname: Peterson
authors.forename: W J
authors.initials: WJ
authors.lastname: Shaughnessy
mesh_terms: D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006810:Humeral Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D016059:Range of Motion, Articular