The Journal of Bone and Joint Surgery, Vol 57, Issue 8 1087-1092, Copyright © 1975 by Journal of Bone and Joint Surgery, Inc
Prevention and treatment of non-union of slightly displaced fractures of the lateral humeral condyle in children. An end-result study
JC Flynn, JF Richards and RI Saltzman
In a ten-year study of the healing responses of thirty-one children with
fresh fractures of the lateral condyle of the humerus with less than four
millimeters of displacement, there were three patterns of healing.
Forty-nine per cent healed rapidly in six weeks with abundant callus and
periosteal new bone. Thirty-eight per cent healed slowly over eight to
twelve weeks, mostly by endosteal union with little callus. Thirteen per
cent had progressive displacement of the fragment in the plaster cast and
required surgery to prevent non-union. Those fractures that healed had two
millimeters or less of displacement of the fragment initially. Those that
did not heal had an average of three millimeters of initial displacement.
Established non-unions in good position that were symptomatic while the
elbow was still immature were salvaged by bone-grafting, sparing the physis
of the condylar fragment. The fragment united and grew with the elbow to
maturity, producing an excellent end result on long-term follow-up. When
the physeal plate of the ununited condylar fragment was absent, the
fragment could not grow with the elbow and the result of surgery was less
satisfactory.
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