title: Paediatric lateral humeral condyle fractures: internal oblique radiographs alter the course of conservative treatment.
abstract: BACKGROUND
  At first presentation of paediatric humeral lateral condyle fractures, radiological methods such as computerised tomography, ultrasonography, magnetic resonance imaging, arthrography, and internal oblique radiography are used to determine stability. Very few studies show which radiological method should be used to evaluate displacement at follow-up for conservatively treated patients. This study aimed to show that internal oblique radiography is a simple, effective method to determine the subsequent development of fracture displacement in patients with an initially non-displaced or minimally displaced fracture.
  
  
  METHODS
  In this retrospective study, 27 paediatric patients with non-displaced or minimally displaced (<2 mm) humerus lateral condyle fracture were evaluated by elbow anteroposterior radiograph. The degree of fracture displacement was evaluated by anteroposterior then by internal oblique radiographs. The first follow-up was made between the 5th and 8th day and thereafter at intervals of 7-10 days.
  
  
  RESULTS
  Of the 27 patients identified with non-displaced or minimally displaced (<2 mm) fracture from the initial anteroposterior radiograph, 16 were accepted as displacement >2 mm as a result of the evaluation of the internal oblique radiography and underwent surgery. At follow-up, 2 of 11 patients were defined with displacement from anteroposterior and internal oblique radiographs and 4 from the internal oblique radiographs and underwent surgery. Conservative treatment was applied to 5 patients.
  
  
  CONCLUSIONS
  Internal oblique radiography is the best imaging showing subsequent fracture displacement in initially non-displaced or minimally displaced humerus lateral condyle fractures. At the first week follow-up, anteroposterior and particularly internal oblique radiographs should be taken of conservatively treated patients.
authors: Department of Orthopedics and Traumatology, Umraniye Training and Research Hospital, Istanbul, Turkey, drtuhan@hotmail.com.
authors: Tuhan
authors: T
authors: Kurtulmuş
authors: Necdet
authors: N
authors: Sağlam
authors: Gursel
authors: G
authors: Saka
authors: Cem Coşkun
authors: CC
authors: Avcı
authors: Meriç
authors: M
authors: Uğurlar
authors: Mehmet
authors: M
authors: Türker
mesh_terms: D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000000981:diagnostic imaging*; D005260:Female; D017102:Fracture Healing; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy*; D007103:Immobilization; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy*; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D000092464:Elbow Injuries
references: J Pediatr Orthop. 1989 Nov-Dec;9(6):691-6
references: 2600178
references: J Pediatr Orthop. 2002 Jan-Feb;22(1):8-11
references: 11744845
references: J Pediatr Orthop. 1995 Jul-Aug;15(4):449-53
references: 7560032
references: J Pediatr Orthop. 1995 Jul-Aug;15(4):422-5
references: 7560027
references: J Orthop Trauma. 2010 Jul;24(7):434-8
references: 20577074
references: J Pediatr Orthop. 1988 Jan-Feb;8(1):31-4
references: 3335619
references: J Pediatr Orthop. 2012 Jun;32 Suppl 1:S5-9
references: 22588104
references: Acta Radiol. 1988 May-Jun;29(3):367-70
references: 2968111
references: J Pediatr Orthop. 1990 May-Jun;10(3):317-21
references: 2355073
references: Clin Orthop Relat Res. 1972;85:127-42
references: 5036913
references: J Comput Assist Tomogr. 2005 Nov-Dec;29(6):842-6
references: 16272862
references: J Bone Joint Surg Am. 1975 Dec;57(8):1087-92
references: 1201992
references: J Bone Joint Surg Br. 1975 Nov;57(4):430-6
references: 1104630
references: J Pediatr Orthop B. 2001 Apr;10(2):123-30
references: 11360778
references: J Pediatr Orthop. 1998 Jul-Aug;18(4):448-50
references: 9661850
references: J Bone Joint Surg Am. 2007 Jan;89(1):58-63
references: 17200311
references: J Bone Joint Surg Br. 1970 Aug;52(3):460-4
references: 5455077
references: J Pediatr Orthop B. 2001 Apr;10(2):138-41
references: 11360780
references: J Pediatr Orthop. 2002 May-Jun;22(3):394-8
references: 11961463
references: J Pediatr Orthop. 1985 Jan-Feb;5(1):16-22
references: 3884662
references: J Trauma. 2005 Jun;58(6):1202-7
references: 15995471
references: Orthop Traumatol Surg Res. 2011 May;97(3):304-7
references: 21478066
references: J Bone Joint Surg Am. 1971 Sep;53(6):1083-95
references: 5092798
references: J Bone Joint Surg Am. 1985 Jul;67(6):851-6
references: 4019532
references: J Am Acad Orthop Surg. 2011 Jun;19(6):350-8
references: 21628646
references: J Pediatr Orthop. 1999 Sep-Oct;19(5):570-2
references: 10488852
references: J Pediatr Orthop. 2004 Jul-Aug;24(4):385-91
references: 15205620