- See:
Pediatric
Elbow Injuries
- Discussion:
- most frx involving total distal humeral physis occur before age 6 or 7;
- in an infant less than one year of age, whose elbow is swollen 2nd to
trauma or suspected trauma, frx involving
the entire distal humeral physis should always be
suspected;
-
Radiographs:
- proximal radius and ulna maintain anatomical relationship to each other
but are displaced posterior and medially
in relation to distal humerus;
- distinguish between DHPS and
elbow dislocation:
- in
elbow dislocation proximal radius & ulna usually are displaced
posterolaterally & relationship
between proximal
radius & lateral condyle epiphysis is disrupted;
- in physeal separation displacement is usually posterior & medial;;
- arthrogram is helpful in cases in which ossification centers are not
present;
- Management:
- infants: closed reduction and casting (elbow flexed);
- children: closed reduction and percutaneous pinning (lateral pins);
- arthrogram may help confirm adequacy of the reduction;
- delayed diagnosis: after 5-6 days manipulation may increase the risk of
AVN;
Fracture separation of the distal humeral physis in the newborn.
Radiographic diagnosis of fracture-separation of the entire distal humeral
epiphysis.
Fracture-separation of the distal humeral epiphysis.
Physeal fractures of the distal humerus: avoiding the pitfalls. Wilkins KE.
Instructional Course Lectures. 35:83-93, 1986.
Epiphyseal separation of the distal end of the humerus with medial displacement.
Fracture-separation of the distal humeral epiphysis in young children.
Fracture separation of the distal humeral epiphysis. JC DeLee et al. JBJS Vol
62-A. 1980. p 46-51.
Fracture separation of the distal humeral epiphysis in children younger than
three years old.
Distal humeral epiphyseal separation.