II. Epidemiology
- Second most common elbow Fracture in children (12 to 17% of Distal Humerus Fractures)
- Most common elbow physeal Fracture
- Age of onset typically 4 to 7 years old
III. Mechanism
- Fall on an outstretched hand
- Avulsion Fracture of lateral condyle at attachment of the wrist extensors (and lateral collateral ligament)
IV. Signs
- Lateral Elbow Pain, swelling and decreased range of motion
V. Imaging
- See Elbow XRay
- Differentiate Fracture lines from normal Growth Plates
- Evaluate for Salter-Harris Fractures
VI. Management
- Initial Splinting
- Posterior splint with Forearm in neutral position and elbow at 90 degrees
- Definitive management
- Orthopedic referral in all cases
- Most cases require surgical management with ORIF
- Some non-displaced or minimally displaced Fractures may be managed with Casting
- Requires repeat XRay every 3-5 days for first 7-10 days to confirm Fracture remains nondisplaced
- Non-displaced Fractures can then be casted in a Long Arm Cast for 3 weeks
VII. Complications
- Rarely associated with neurovascular injury (contrast with supracondylar Fractures)
- Growth arrest
- Nonunion or malunion
- Cubitus varus deformity
- Cubitus valgus deformity
- Risk of Ulnar Nerve palsy
VIII. References
- Broder (2023) Crit Dec Emerg Med 37(6): 20-2
- Eiff (2012) Fracture Management for Primary Care, Saunders, Philadelphia, p. 265-6