Pediatric elbow Fracture Discussion

The majority of pediatric elbow fractures involve the distal humerus. Common varieties include fractures of the medial epicondyle, medial humeral condyle, lateral humeral condyle, T-shaped intraarticular fractures, fracture-separation of the distal humeral epiphysis and supracondylar fractures. Growth disturbance and obvious deformity are significant potential problems with any pediatric distal humeral fracture. With early treatment, prognosis is good for most medial epicondylar and medial condylar fractures, although 1 in 10 can be expected to develop tardy ulnar nerve palsy. Lateral condylar fractures are less predictable, with at least 1 in 10 resulting in deformity, awkward loss of motion or tardy ulnar nerve palsy. Supracondylar fractures are associated with the most dramatic early complications, including compartment syndrome, Volkmann's contracture, and an average of 1 in 10 incidence of median or ulnar nerve injury. Poor results including stiffness, angulation, myositis ossificans, nerve dysfunction and pain may follow appropriate treatment of even nondisplaced fractures, and prognosis is always guarded.

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