Displaced Elbow Lateral Condyle Fracture: Treatment with a Cannulated Screw

Abstract

Lateral condyle fractures of the elbow in children are relatively common. Typically classified as Salter-Harris IV injuries, they cross the distal humeral physis and may enter the elbow joint through the trochlea. When displaced, they must be anatomically reduced to avoid malalignment and minimize the potential for posttraumatic arthritis at the joint surface. This chapter discussed the indications for operative management of displaced lateral condyle fractures, the risks and benefits of fixation using cannulated screws versus percutaneous pins, and the typical postoperative management when using cannulated screws.

A 7-year-old boy fell from a jungle gym at school and injured his left arm. He had immediate pain, swelling at the elbow, and difficulty moving the arm. Radiographs in the emergency department revealed a displaced lateral condyle fracture. He was splinted and scheduled for open reduction with internal fixation. After a discussion of options with the family, the patient was given a general anesthetic, and an open reduction with internal fixation utilizing a 4.0 mm cannulated screw was performed. Postoperatively, the patient was maintained in a long arm cast for 6 weeks, followed by physical therapy to regain range of motion and strength for another 6 weeks. The patient healed the lateral condyle fracture well, and the cannulated screw was removed under a second anesthetic as an outpatient procedure about 6 months later.