Lateral condyle fracture humerus by Dr Bipul Borthakur

1. LATERAL CONDYLE hUMERus
FRACTURE
DR. BIPUL BORTHAKUR
PROFESSOR
DEPARTMENT OF ORTHOPAEDICS, SMCH

2. ANATOMY
 Lateral condyle of the humerus is a
large, tuberculated eminence located at
the distal part of humerus.
 It extends medially to form main part of
lower articular end of humerus.
 It gives attachment to:
 Radial collateral ligament
 Supinator
 Forearm extensors.

3. LATERAL CONDYLE
HUMERUS FRACTURE
 Comprises 17% of distal humerus fractures
 Peak age is 6 years
 It is Salter – Harris type IV physeal injury

4. MECHANISM OF INJURY
 Fall on the extended upper extremity
with additional varus force (Push off
theory)
 Avulsion injury due to pull of strong
wrist extensors

5. CLINICAL PRESENTATION
 Pain
 Swelling
 Restriction of movement
 Skin changes or wound
 Bony crepitus

6. CLASSIFICATION
 MILCH
 Type I – fracture line lateral to the
trochlea & into the capitellar-trochlear
groove
 It represents a Salter-Harris type IV
fracture
 Type II – fracture line extends into the
apex of the trochlea
 More common
 It represents a Salter-Harris type II
fracture
 Elbow is unstable

7. DISPLACEMENT
 Displacement of the fracture fragments in two planes.
1. Vertical
2. Horizontal

8. LATERAL CONDYLE
FRACTURE
 INVESTIGTAIONS:
 Plain radiograph of elbow – AP and lateral view
 The size of the condyle in x-ray is much smaller
than the actual size.

9. TREATMENT
 Undisplaced fracture – above elbow slab
or cast with elbow at 90deg flexion and
wrist extended for 2 weeks, followed by
physiotherapy.
 Displaced fracture – open reduction and
internal fixation with pins or screws and
limb immobilized for 3-4weeks; followed
by physiotherapy.

10. COMPLICATION
 Non-union – neglected fracture with rotation and
displacement of the condyle
 Valgus deformity of elbow, tardy ulnar nerve palsy
 Malunion
 Growth arrest
 Elbow stiffness

11. THANK
YOU