Lateral Condylar Fractures Of Humerus In Children Following Varus Malunion Of Supracondylar Fracture

摘要

Not much is written about lateral condylar fractures of humerus in children following a united supracondylar fracture except for a few case reports and series. We present a series of 7 such cases. There were 5 boys and 2 girls and left side was involved in 5 cases and right in 2. Lateral condylar fracture occurred at an average of about 2.72 years after sustaining initial supracondylar fracture. In all cases fresh fracture was treated by open reduction and k-wire fixation. The varus deformity required a second stage corrective osteotomy in 4 of 7 patients for cosmetic reasons. Further research is needed and special stress needs to be given to the biomechanics of occurrence of lateral condylar fracture following supra condylar fracture. Introduction There is not much literature available regarding lateral condylar fracture following a united supracondylar fracture of humerus in children. In past some light on this topic has been showered by Herrin and Fitch (1) who reported one case, David’s et al (2) reported 6 such cases and Takahara et al (3) added 9 more to the list. We over a period of 5 years from beginning 2003 to ending 2008 collected data Of patients who had sustained a lateral condylar fracture following a united supracondylar fracture. Our study adds 7 more cases to the limited resource of knowledge we have about these fractures Material and methods From 2003 to 2008, we collected data of patients who had sustained a lateral condylar fracture subsequent to a united supracondylar fracture (Table 1). We had a total of 7 cases, 5 boys and 2 girls. Left side was involved in 5 cases and right in 2. The age at which patients suffered supracondylar fracture ranged from 4 to 8 years with an average of 5.85 years. Out of 7 patients, 4 had a type III supracondylar fracture and 3 had a type II fracture using Gartland classification (4). All type II fractures and 2 type III fractures were managed by closed reduction and long arm slab while as 2 type III fracture were managed by closed reduction and percutaneous pinning. All patients united in some varus deformity with carrying angle ranging from 0 to -15 degrees with a mean of -9.14 degrees (Figure 1,2,3,4). Lateral condylar fracture occurred due to fall in all patients at an age range of 7 to 11 years with an average of 8.57 years. So lateral condylar fracture occurred at an average of about 2.72 years after sustaining initial supracondylar fracture. The lateral condylar fracture was classified on the basis of displacement and confirmed intraoperatively. All patients were treated by open reduction and k wire fixation.