Osteosynthesis for old, established non-union of the lateral condyle of the humerus.

Masada, Kazuhiro; Kawai, Hiroki; Kawabata, Hideyuki; Masatomi, Takashi; Tsuyuguchi, Yusuke; Yamamoto, Kōichi

doi:10.2106/00004623-199072010-00006

Cited by 89 publications

(58 citation statements)

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“…The repair of nonunion lateral humeral condyle remains controversial, especially those presenting with >1 cm of displacement [7,12,13,16,19]. The treatment of nonunion lateral humeral condyle with <1 cm of displacement is generally recommended, if care is taken to avoid damage to the vasculature of the lateral condylar fragment [8][9][10][11][12][13]16]. Jakob et al [6] stated that open reduction should not be performed more than three weeks after the injury, as the blood supply of the fragment is easily disturbed, leading to avascular necrosis of the fragment.…”

Section: Discussionmentioning

confidence: 99%

“…Flynn et al [1,2] stated that a nonunion lateral humeral condyle can be painful for athletes. Masada et al [8] reported that adults with lateral condyle nonunion often present with pain or lateral instability symptoms besides the cubitus valgus and tardy ulnar nerve symptoms; they recommended osteosynthesis of the lateral condyle only for patients with pain or instability symptoms. Avascular necrosis of the lateral condyle after late repair can lead to pain and decreased motion, making the children worse than they were before surgery.…”

Section: Discussionmentioning

confidence: 99%

“…This can result in osteonecrosis of the lateral condyle and decreased elbow motion [1][2][3][4][5][6]. Several authors have recommended operative treatment for selected patients, but there have been few reports of such treatment in children [8][9][10][11][12][13]. Other authors have not recommended operative intervention because the range of motion of the elbow may be decreased and the vascularity of the fragment may be jeopardised along with persistent nonunion [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Should we repair nonunion of the lateral humeral condyle in children?

Eamsobhana

Kaewpornsawan

2015

International Orthopaedics (SICOT)

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(1) We support osteosynthesis for children, not only for those who have pain but also for those who are less symptomatic. Good and excellent results by Mayo elbow performance score were found in all patients, and all nonunions were united with good range of motion. (2) Neglecting lateral condyle fracture in children more than 28 months will reduce Mayo performance score to below 89 points. (3) Cases presenting with AVN pre-operatively can still have good results and remodeling potential with congruency of the joint.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Should we repair nonunion of the lateral humeral condyle in children?

Eamsobhana

Kaewpornsawan

2015

International Orthopaedics (SICOT)

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“…8) As for the decrease of postoperative ROM in the current study, osteosynthesis of lateral epicondyle could be contributing factor. Kim et al 13) and Masada et al 22) suggested that osteosynthesis of the lateral condyle could lead to complications, including decreased elbow ROM by extensive soft tissue dissection and mobilization of the lateral condyle fragment. In this study, we performed condyle osteosynthesis to three patients who have pain in the lateral condyle.…”

Section: Discussionmentioning

confidence: 99%

Clinical Results of Supracondylar Dome Osteotomy for Cubitus Varus and Valgus Deformities in Adults

Gwark¹,

Im²,

Park³

2016

Clinics in Shoulder and Elbow

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Background: Cubitus varus and cubitus valgus deformities are common complications of distal humeral fractures in children. We evaluated the usefulness of supracondylar dome osteotomy as a treatment option for adults with cubitus varus or valgus deformity developed during childhood. Methods: Ten patients who had received supracondylar dome osteotomy and stabilization with plates to treat cubitus varus or valgus deformity between July 2006 and August 2013 were included in this study. Their mean age at the time of surgery was 36.50 ± 10.22 years. The mean follow-up duration was 54.80 ± 32.50 months. We evaluated humerus-elbow-wrist angles (HEWA), improvements in the lateral prominence index (LPI) or medial prominence index (MPI), Mayo elbow performance scores (MEPS), and overall results in accordance with the Banerjee criteria. Results: For the six patients with cubitus varus, the mean postoperative HEWA, mean correction angle, and mean improvement in LPI were 9.72° ± 3.95°, 27.67° ± 10.75°, and 6.92% ± 3.40%, respectively. For the four patients with cubitus valgus, the mean postoperative HEWA, mean correction angle, and mean improvement in MPI were 14.73° ± 2.97°, 11.55° ± 3.26°, and 11.33% ± 6.39%, respectively. There was no significant difference between postoperative and preoperative mean MEPS. The subjective ulnar nerve symptoms were alleviated in all patients. The overall results were excellent in six and good in four patients. Conclusions: This study suggests that supracondylar dome osteotomy with secure fixation using double plates may be useful in correcting cubitus varus or cubitus valgus deformity, yielding good functional outcomes in adults. (Clin Shoulder Elbow 2016;19(4):229-236)

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“…11 The literature contains a few reports of osteosynthesis in adults. 4,6,12 According to these reports, some patients had a good outcome after osteosynthesis; others experienced postoperative complications including failure of bony union and restriction of range of motion, particularly flexion range. However, we noticed 2 following points regarding operative *Reprint requests: Junichi Miyake, MD,…”

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confidence: 99%