Pediatric and Adolescent T-type Distal Humerus Fractures

Abstract

Although fractures of the elbow are extremely common in pediatric patients, the T-type distal humerus fracture is rare and offers unique challenges. The mechanism of injury may be similar to the adult counterpart and is usually caused by a fall onto a flexed elbow or from a direct blow. Diagnosing these injuries may be difficult. They often resemble extension-type supracondylar fractures, yet the treatment algorithm is quite different. In younger patients, percutaneous pinning remains a viable option, but for older adolescents, open reduction and internal fixation provides stable fixation at the elbow and the most reliable restoration of the articular surface. Appropriate imaging, careful radiographic diagnosis, and choice of surgical technique are of paramount importance when treating young patients with this injury. Most pediatric and adolescent patients with T-type distal humerus fractures have results better than those of adults but often worse than other elbow fractures in this age group.

“Double X” Fixation for Rare and Particular Pediatric Supracondylar Humerus Fractures

“…The results are better than those obtained in adults, but often poorer than other elbow fractures in this age group [9].…”

“…The T-fracture is rare, offers unique challenges and the mechanism of production may be common to those of the adult [9]. In children under 8 years of age, the lesion is extremely rare.…”

“…In younger patients, CRPP remains a viable option, but for older adolescents, ORIF ensure stable elbow fixation and the most reliable restoration of the joint surface [9].…”

Comminuted intra articular fracture of distal radius: Outcome of Management with closed reduction and percutaneous pinning.

“…7 Closed reduction with percutaneous pinning remains globally a popular method for many years, the procedure is less invasive, in which the consultant have a choice of wide variety of pinning. 8 The benefits of this procedure are that it is a swift and technically less demanding in comparison to more complex forms of fixation and there is less destruction of soft tissues. 9 The drawbacks of this technique are the complications of pin-site infection, perfectness is less than open technique and the stability of fixation is also less in comparison to plating.…”

“…9 The drawbacks of this technique are the complications of pin-site infection, perfectness is less than open technique and the stability of fixation is also less in comparison to plating. 10 External fixation is a well known method and is populated by more than 25 brands of external fixators 8,11 , which achieve reduction and fixation without loss of position and acceptable functional results. 12 The likely complications of this procedure are re-displacement, pin-tract infection and late collapse.…”