lateral condylar fracture

Question 1

Age

Answer 1

children

Question 2

mechanism

Answer 2

FOOSH with elbow extended into varus

Question 3

classification

Answer 3

Type 1 : fracture through capitulo trochlear groove , resembles (salter harris type 4 )
is uncommon
Type 2 : fracture through trochlea , resembles ( salter harris type 4 )
is common

Question 4

Presenting complaints

Answer 4

Pain
Swelling
Deformity
Restricted movement

Question 5

Xray

Answer 5

AP , lateral and oblique view

Question 6

Treatment

Answer 6

Undisplaced
Displaced

Question 7

Undisplaced

Answer 7

Above elbow slab for 2 weeks
90 degree elbow flexion , neutral forearm , wrist extension

Question 8

Displaced

Answer 8

Moderate : Close reduction ( by extending elbow and pressing ) and k wire fixation
Severe : ORIF
And then above elbow cast for 3 to 4 weeks

Question 9

Complications

Answer 9

MALUNION = CUBITUS VALGUS DEFORMITY
TARDY ULNAR NERVE PALSY
NON UNION
MYOSITIS OSSIFICANS
PHYSEAL GROWTH ARREST
OSTEOARTHRITIS

Question 10

CUBITUS VALGUS

Answer 10

Imrproper or failed reduction
Lateral side ceases to grow and medial side continues to grow which ultimately causes valgus deformity
tt : supracondylar osteotomy
also can be associated with tardy ulnar nerve palsy

Question 11

TARDY ULNAR NERVE PALSY

Answer 11

As ulnar nerve lies behind the medial epicondyle , there may be friction neuritis during extension and flexion of elbow which may cause tingling and numbness sensation .Can be treated by transpositioning of ulnar nerve from behind the epicondyle to anterior of epicondyle