Post-traumatic fishtail deformity of distal humerus—is there a risk for refracture?

Abstract

We present the case of fishtail deformity of distal humerus in a 13-year-old boy presenting with a refracture 8 years after the original surgically treated lateral condyle fracture. This unusual incomplete vertical fracture of distal humerus starting at the apex of fishtail was treated non-surgically and went on to union but refractured yet again 12 months later. This also went on to full healing with conservative treatment, however the fishtail deformity persists. We discuss the possibility that fishtail deformity reflects an inherent weakness in the distal humerus. We suggest that children and parents should be warned about the potential risk for refracture, particularly if they participate in contact sports.

Is biodegradable pin a good choice for lateral condylar fracture of humerus in children

“…Avascular necrosis and physeal arrest is a challenging situation usually following ORIF for neglected LCF, and there was no case of AVN in our study, possibly due to careful dissection and limited soft tissue stripping during the surgery. Fishtail deformity is a late manifestation of LCF healing, [ 28 , 29 ] and as shown in the result, the BP degradation in vivo did not increase its incidence. Lateral condylar prominence is postulated to result from fracture stimulation to lateral condyle and remodeling.…”

Treatment of Adult Distal Humerus Fracture with Fishtail Deformity

“…Radiographic changes may develop as early as 7 months to 4 years after injury depending on the age of the patient 3 . Long-term outcomes are limited to case series and case reports and range from no pain to ongoing pain beyond 1-year follow-up 4,5 . Nearly all cases report loss of motion at the final follow-up 6 .…”