II. Epidemiology

  1. Second most common elbow Fracture in children
  2. Most common elbow physeal Fracture
  3. Age of onset typically 4 to 7 years old

III. Mechanism

  1. Fall on an outstretched hand
  2. Avulsion Fracture of lateral condyle at attachment of the wrist extensors (and lateral collateral ligament)

IV. Signs

  1. Lateral Elbow Pain, swelling and decreased range of motion

V. Management

  1. Initial Splinting
    1. Posterior splint with Forearm in neutral position and elbow at 90 degrees
  2. Definitive management
    1. Orthopedic referral in all cases
    2. Most cases require surgical management with ORIF
    3. Some non-displaced or minimally displaced Fractures may be managed with Casting
      1. Requires repeat XRay every 3-5 days for first 7-10 days to confirm Fracture remains nondisplaced
      2. Non-displaced Fractures can then be casted in a Long Arm Cast for 3 weeks

VI. Complications

  1. Growth arrest
  2. Nonunion or malunion
    1. Cubitus varus deformity
    2. Cubitus valgus deformity
      1. Risk of Ulnar Nerve palsy

VII. References

  1. Eiff (2012) Fracture Management for Primary Care, Saunders, Philadelphia, p. 265-6

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