Background: In the pediatric population, reports of a concomitant lateral condyle fracture (LCF) of the humerus and an elbow dislocation are rare.
Methods: From 2007 to 2013, we identified a group of 12 children who presented to our institution with a concomitant LCF and an elbow dislocation. This subset of fractures (group 1), all of which were managed surgically, is the subject of the present report. Their outcome was compared with that of all LCFs that were treated surgically at our institution during the study period (group 2, n=179). The length of surgery, recovery of range of motion (ROM), lateral spur formation, and the presence or absence of neurological or vascular complications, pin-tract infection, loss of fixation, and avascular necrosis or nonunion of the lateral condyle were used to describe the outcome of the fracture.
Results: A concomitant elbow dislocation and LCF of the humerus was observed in 12 patients with a mean age of 5.5 years (range, 2 to 8), and a mean follow-up of 51 weeks. A posteromedial dislocation of the elbow was observed in most patients. The recovery of ROM appeared to be slower for patients with an associated elbow dislocation, but a full recovery of ROM was obtained in the long term. Lateral spur formation was seen in all fractures in group 1 and only in 72% of fractures in group 2 (P=0.02). A satisfactory outcome was observed in 92% of fractures in group 1 and in 88% of fractures in group 2 (P=0.58).
Conclusions: Concomitant LCF of the humerus and an elbow dislocation are rare. Satisfactory outcomes can be expected when prompt reduction of the elbow dislocation and timely anatomic reduction and fixation of the fracture is obtained. A delayed recovery of elbow motion is common among this population, but a full recovery of ROM can be expected in the long term.
Level of Evidence: Level II—retrospective.
*Orthopaedic Institute for Children
†Department of Orthopaedics, UCLA/Orthopaedic Hospital, David Geffen School of Medicine, UCLA, Los Angeles, CA
The authors declare no conflicts of interest.
Reprints: Mauricio Silva, MD, Orthopaedic Institute for Children, 403 W. Adams Boulevard, Los Angeles, CA 90007. E-mail: firstname.lastname@example.org.