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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