Anatomic reduction of old displaced lateral condylar fractures of the humerus in children via a posterior approach with olecranon osteotomy.
OBJECTIVE
We questioned the principle of treatment of late lateral condylar fracture of a pediatric elbow. We report the results of treating this condition using a different approach.


METHODS
We treated six children with type 3 late lateral condylar fractures. The average age was 4.5 years old. The time delay from injury to surgery averaged at 3.8 months. All the displaced lateral condyles were Milch type 2 with significant rotation away from the trochlea. The articular anatomic reduction of the lateral condyles was achieved via ulnar osteotomy in all six cases. We fixed both the fracture and the osteotomy with Kirschner wires buried under the skin. No strenuous passive physical therapy was needed.


RESULTS
All lateral condylar fractures and ulnar osteotomies were united within 3 months. Five out of six children had regained full range of motion and symmetric carrying angles at the latest follow-up 2 to 11 years later. Complications included transient physeal change and lateral bump.


CONCLUSIONS
Based on our results, we recommend olecranon osteotomy via a posterior approach as one of the options in treating late cases of type 3 lateral condylar fracture of the elbow with significant displacement in children.
Yang
Wen-E
WE
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan, China. yangwene@adm.cgmh.org.tw
Shih
Chun-Hsiung
CH
Lee
Zhon-Liau
ZL
Chang
Chia-Hsien
CH
Chen
Wen-Jer
WJ
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006810:Humeral Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D007223:Infant; D008297:Male; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D016059:Range of Motion, Articular