Posteromedial Dislocation of the Elbow with Lateral Condyle Fracture in Children

Cheng, Pen-Gang; Chang, Wei‐Ning; Wang, Matthew N.

doi:10.1016/s1726-4901(09)70033-4

Cited by 19 publications

(22 citation statements)

References 17 publications

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“…Regarding clinical outcomes, several authors have reported poor results for elbow dislocations involving LCFs (Table 2 ). Some patients had complications, including restricted ROM, [ 4 , 7 , 10 ] non- or malunion of the LCF, [ 7 ] and cubitus varus deformity. [ 32 ] Satisfactory outcomes following open reduction and internal fixation for LCFs have been reported following anatomical reduction of the articular surface and when adequate bone union of the LCFs was obtained.…”

Section: Discussionmentioning

confidence: 99%

“…Although open reduction and internal fixation through a posterolateral approach [ 14 , 34 ] or lateral approach (Kocher approach) [ 3 , 4 , 7 – 10 , 12 ] is the standard treatment for displaced LCFs, [ 13 ] these approaches are not appropriate for visualizing the fracture line on the capitellum (Milch type I LCFs). [ 30 , 31 ] Because the articular surface of the capitellum is present only on the anterior side, only an anterolateral approach permits restoration of joint congruity.…”

Section: Discussionmentioning

confidence: 99%

“…[ 2 – 12 ] Typical radiographs of elbow dislocations with LCF show that the elbow joint is dislocated posteromedially while the displaced lateral condyle is aligned with the radial head. [ 2 – 4 , 6 , 7 , 10 , 12 ]…”

Section: Introductionmentioning

confidence: 99%

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Posteromedial elbow dislocation with lateral humeral condylar fracture in children

Tomori

Nanno²,

Takai³

2018

Medicine

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Rationale:Posteromedial dislocations of the elbow with lateral humeral condylar fractures (LCFs) are uncommon, and only isolated cases have been reported in the English-language literature. Because of the complex radiolucent cartilaginous structures and late-appearing ossification centers, radiological diagnosis of elbow dislocations with LCF in children is challenging.Patient Concerns:We report three children with posteromedial elbow dislocation: two patients with Milch type I and one patient with Milch type II LCF.Diagnoses:In our report, radiographs showed only a small bone fragment, and arthrography or computed tomography were helpful diagnostic aids in cases 1 and 3. In contrast, the patient in case 2 was initially misdiagnosed as having an epiphyseal separation of the distal humerus, and open reduction and internal fixation through the posterior approach revealed Milch type II LCF.Interventions:In case 1 and 3, Milch type I LCFs, open reduction and internal fixation was performed through the posterolateral approach. On the other hand, in case 2, Milch type II LCF, open reduction and internal fixation was performed through the posterior approach.Outcomes:Poor reduction of Milch type I LCFs resulted in incongruity of the articular surface and poor cosmetic results in two patients. In case 2, Milch type II LCF, plain radiographs showed adequate healing without elbow deformity and the clinical result was excellent.Lessons:Because LCFs are intra-articular fractures, anatomical reduction is crucial for satisfactory outcomes. We promote awareness of this injury, especially posteromedial dislocation with Milch type I LCF. Preoperative evaluation is helpful for achieving satisfactory outcomes, and open reduction and internal fixation through an anterolateral approach might be most appropriate for Milch type I LCFs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Posteromedial elbow dislocation with lateral humeral condylar fracture in children

Tomori

Nanno²,

Takai³

2018

Medicine

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“…Fixation of small fragment helps restore integrity of important lateral ligament complex and thus is advisable (9). The similar method of treatment is applied by workers like Kirkos et al (3) and Cheng et al (10) in their series of four and three cases respectively. Other workers witnessed instability of reduction till the fixation of fractures was undertaken in (11,12).…”

Section: Discussionmentioning

confidence: 93%

Lateral condyle fracture with concomitant postero-medial elbow dislocation in a child: a case report

Dharmshaktu

2016

J Emerg Pract Trauma

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Simultaneous combination of fracture of the lateral condyle and postero-medial elbow dislocation is a rare event and limited to few reports or case series in the literature. Rarity of the injury also necessitates judicious diagnosis and appropriate management to ensure optimal functional outcome. Various authors have reported about the condition including the management which mostly includes surgical intervention. A report of one such injury pattern in an 8 years old male child with operative management and satisfactory outcome is presented to highlight the presence of this rare combination and adherence to standard treatment protocols to address them. The report is an addition to the limited resources available on similar fractures and highlights the importance of ruling out possible associated injuries in cases of elbow dislocations. A good fixation of lateral condyle fracture is instrumental to avoid late complications leading to poor functional outcome. The early and supervised rehabilitation also plays a role in ensuring successful return to activities of daily living.

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“…Las luxaciones de codo y las fracturas de cóndilo lateral son lesiones relativamente frecuentes en el codo pediátrico [1][2][3][4][5][6][7][8][9][10] . No obstante, la luxación posteromedial de codo asociada a una fractura de cóndilo externo del húmero es una lesión rara en la edad pediátrica, y de difícil diagnóstico inicial, debido a los múltiples núcleos de osificación que presenta el codo en la infancia [3][4][5][6][7][8] . De hecho, no existe literatura en español sobre estas lesiones, y los casos publicados en lengua inglesa son escasos 3,5,10 .…”

Section: Introductionunclassified

Lesión compleja del codo pediátrico: fractura de cóndilo externo asociada a luxación posteromedial de codo.

Daras-Ballester¹,

Jover-Jorge²,

Domenech-Fernández³

2020

Rev Esp Cir Osteoart

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Background and aim: External humeral condyle fracture associated with a posteromedial elbow dislocation is a very rare entity, of which there are very few cases published. Our objective is to present a complex case treated in our Hospital, the diagnosis, the treatment we chose, and the follow-up at 9 weeks after the intervention. Clinical case: 5-year-old boy with a posteromedial elbow dislocation associated with an external humeral condyle fracture, which was diagnosed by CT and treated surgically using an anterior approach over the elbow, open reduction, and osteosynthesis with K-wires. Results: clinical and radiological results 9 weeks after the intervention were excellent, presenting a Radiographic consolidation of the fracture and an excellent range of joint mobility. Conclusion: early diagnosis and surgical treatment through open reduction and osteosynthesis of the external condyle is the gold standard on treatment for these injuries, since a bad reduction leads to poor long-term results.

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Posteromedial Dislocation of the Elbow with Lateral Condyle Fracture in Children

Cited by 19 publications

References 17 publications

Posteromedial elbow dislocation with lateral humeral condylar fracture in children

Posteromedial elbow dislocation with lateral humeral condylar fracture in children

Lateral condyle fracture with concomitant postero-medial elbow dislocation in a child: a case report

Lesión compleja del codo pediátrico: fractura de cóndilo externo asociada a luxación posteromedial de codo.

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