Management of chronic neglected lateral condyle elbow non-union in adults: functional results of a cohort study and a proposed treatment algorithm.
To evaluate surgical treatment of symptomatic non-union of lateral condylar elbow fractures in adults.



In this retrospective cohort study, 11 consecutive adult patients were surgically treated for symptomatic non-union of the lateral humeral condyle. Milch type I fracture non-unions (n = 3) were treated with medial closing wedge osteotomy and ulnar nerve transposition, while type II equivalents (n = 8) were treated with non-union fixation and bone grafting. Age at injury, age at referral, pre-operative symptoms, and pre-operative functional data (Modified An and Morrey functional rating index) were collected.



Eleven patients (average age 20 years old) with varying symptoms attributable to non-union were surgically treated at a mean of 15.8 years following the initial fracture. Post-operative complications included one superficial infection and 17one radial nerve temporary neuropraxia. Pain, ulnar neuritis, and functional outcomes (Modified An and Morrey, mean 7.1 point improvement) improved significantly. However, the combined range of motion decreased by a mean of 11.4°.



Our treatment algorithm for adults with chronic neglected and symptomatic non-union of the lateral humeral condyle improved functional outcomes in this cohort.
Department of Orthopedic Trauma, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China.
Mao Qi
MQ
Gong
Medical Center, Tsinghua University, Beijing, 100084, China.
Xiao Wen
XW
Huang
Department of Orthopedic Trauma, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China.
Cheng
C
Wang
Department of Orthopedic Trauma, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China.
Ye Jun
YJ
Zha
Department of Orthopedic Trauma, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China.
Ying
Y
Li
Department of Orthopedic Trauma, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China.
Li Dan
LD
Zhang
Department of Orthopedic Trauma, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China. jxy0845@sina.com.
Xie Yuan
XY
Jiang
Department of Orthopedic Trauma, Beijing Jishuitan Hospital, No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035, China.
Man Yi
MY
Wang
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D002908:Chronic Disease; D015331:Cohort Studies; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008297:Male; D010027:Osteotomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D014459:Ulnar Nerve / Q000601:surgery; D055815:Young Adult
Adults; Non-union lateral humeral condyle; Open reduction; Osteotomy; Ulnar nerve transposition