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Trochlear Deformity Occurring After Distal Humeral Fractures: Magnetic Resonance Imaging and Its Natural Progression

Kim, Hui Taek M.D.*; Song, Moon Bok M.D.*; Conjares, Jesse Noel V. M.D.; Yoo, Chong Il M.D.*

Journal of Pediatric Orthopaedics: March-April 2002 - Volume 22 - Issue 2 - p 188-193

Eighteen children (mean age 50.7 months) with trochlear deformities occurring after and related to distal humeral fractures (12 Salter-Harris type 2, 5 supracondylar, 1 Salter-Harris type 4) were evaluated with serial radiographs. The carrying angle and range of motion were measured throughout the follow-up period (up to 13 years after trauma) after definitive treatment. Bony defects on the medial (17 patients) and central (1 patient) regions of the trochlea were observed at a mean of 3.4 months after the trauma. They also persisted up to 4 to 7 years (latest follow-up in an intermediate follow-up group) and eventually reossified by skeletal maturity (in a long-term follow-up group). Magnetic resonance imaging was performed on eight patients after a mean of 1.9 years from injury. Low signal intensity on T2 indicative of cartilage necrosis and an intact articular surface were found. Cubitus varus deformity, which developed in almost all patients, was observed to be nonprogressive after 3 to 4 years but persisted until maturity. Limitation of motion and late neuropathy were not seen.

Study conducted at Pusan National University Hospital, Pusan, Korea

From the *Pediatric Orthopaedic Unit, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan, Korea; and the †Department of Orthopaedics, College of Medicine, University of the Philippines, Manila, Philippines.

Address correspondence and reprint requests to Dr. H. T. Kim, Department of Orthopaedic Surgery, Pusan National University Hospital, 1Ga-10, Ami-Dong, Seo-Gu, Pusan, 602–739, Korea (e-mail:

© 2002 Lippincott Williams & Wilkins, Inc.