Paediatric lateral humeral condyle fractures: internal oblique radiographs alter the course of conservative treatment

  • Tuhan Kurtulmuş
  • Necdet Sağlam
  • Gursel Saka
  • Cem Coşkun Avcı
  • Meriç Uğurlar
  • Mehmet Türker
Original Article

DOI: 10.1007/s00590-013-1294-y

Cite this article as:
Kurtulmuş, T., Sağlam, N., Saka, G. et al. Eur J Orthop Surg Traumatol (2014) 24: 1139. doi:10.1007/s00590-013-1294-y
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Abstract

Introduction

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.

Materials and 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.

Keywords

Conservative treatmentInternal oblique radiographyLateral condyle fracturePaediatric elbow

Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  • Tuhan Kurtulmuş
    • 1
  • Necdet Sağlam
    • 1
  • Gursel Saka
    • 1
  • Cem Coşkun Avcı
    • 1
  • Meriç Uğurlar
    • 1
  • Mehmet Türker
    • 2
  1. 1.Department of Orthopedics and TraumatologyUmraniye Training and Research HospitalIstanbulTurkey
  2. 2.Department of Orthopedics and TraumatologyKirikkale UniversityKırıkkaleTurkey