Journal of Musculoskeletal Trauma

Fracture-Separation of the Distal Humeral Epiphysis in Young Children: Hyoun Oh Cho, Kyoung Duck Kwak, Byung Yong Kim, Su Min Sohn, Pill Whan Oh; J Korean Soc Fract 1999;12(2):365-371. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.365

Abstract PDF: We have reviewed seven cases of fracture-separation of the distal humeral epiphysis, two of which were initially misdiagnosed as a fracture of the lateral condyle and one as a fracture of the supracondyle. The four cases were treated by closed reduction and cast immobilization, and three cases by open reduction and internal fixation. The one case with conservative treatment had cubitus varus, other were good result. To distinguish the fracture-separation from a fracture of lat. condyle and from a dislocated elbow is impossible using clinical signs alone. For reducing misdiagnosis, it is important to consider age and there could be need further evaluation such as arthrogram, USG, CT and MRI.

Fracture-separation of the Distal Humeral Epiphysis in Children: Yeo Hon Yun, Jong Keon Oh; J Korean Soc Fract 1998;11(4):977-984. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.977

Abstract PDF: We retrospectively reviewed twelve cases of the fracture-separation of the distal humeral epiphysis, which were treated during the period from 1989 to 1996. The incidence of this injury was about 3 % from 266 pediatric elbow fractures. Four cases were remained misdiagnosed as the lateral or medial humeral condylar fracture until the authors reviewed their radiographs. Though eleven fractures were extension type injury with typical posteromedial displacement, we identified a rare flexion type injury with anterolateral displacement. This case was a 12+7 year old boy, who was the oldest in our series. Cubitus varus deformity of more than 10 developed in five patients, and cubitus rectu intwo patients. One patient underwent osteotomy for the in the literature. The major problem of this fracture was the possibility of misdiagnosis. Whichever reament modality onr may choose, careful evaluation of the carrying angle after reduction is mandatory to avoid residual cubitus varus deformity.

Fracture-Separation of The Distal Humeral Epiphysis: Hak Yeong Jeong, Seung Wook Yang, Jae Woong Shim, Seung Joon Shin, Jeong Tae Kim; J Korean Soc Fract 1998;11(3):650-657. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.650

Abstract PDF: A fracture-separation of the distal humeral epiphysis in children is an extremely rare injury and presents problems in diagnosis, radiographic interpretation and management. From June 1992 to December 1996, Authors experienced the 5 cases of Salter - Harris type II injury of the distal humeral epiphysis at Department of Orthopedic Surgery, Pusan Maryknoll General Hospital. The patient were followed up from one year nine months to three years four months. The two cases were treated by closed reduction and percutaneous K-wire fixation and the three cases by open reduction and internal fixation with K-wires. There were 4 cases of complication seldom reported following fracture-separation of the distal humeral epiphysis. This complications consist of 4 dissolutions of trochlea, which is one, frank avascular necrosis of trochlea. In 3 cases with open reduction developed the cubitus varus & dissolution of trochlea. We speculate that this complications results from avascular necrosis of distal end of humerus. Attention to change of carrying angle and radiographic change of distal humeral end are important in detection of complication & evaluation of etiology of dissolution of distal humeral end.

Fracture-SeFaration Involving the Entire Distal Humeral Epiphysis in a Young Child(Salter-Harris type I injury): A Case Report: Jong Ho Jang, Seung Gyun Cha, Kyoung Hoon Kim, Jeon Oh Kang; J Korean Soc Fract 1996;9(3):674-677. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.674

Abstract PDF: Fracture-separation of the distal humeral epiphysis is a rare injury, frequently misdiagnosed as a fracture of the lateral humeral condyle, a supracondylar fracture of the humerus or a dislocation of the elbow. Roentgenographic evaluation reveals posteromedial displacement of the distal epiphysis. Single contrast arthrography is performed in order to confirm diagnosis. Treatment is first directed toward prompt recognition of the injury. A manipulative closed reduction is usually recommended. We experienced a case of fracture-separation involving the entire distal humeral physis treated by closed reduction and percutaneous pinning. The result was excellent.

Frarture-Separation of the Distal Humeral Epiphysis in Children: Dong Wo Lee, Se Dong Kim; J Korean Soc Fract 1994;7(1):72-78. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.72

Abstract PDF: We have reviewed thirteen cases of fracture-separation of the distalk humeral epiphysis, one of which was initially misdiagnosed as a fracture of the lateral condyle. There were some difficulties in making the correct diagnosis. The injury must be distinguished from anelbow dislocation and a fracture of the lateral humeral condyle. All thirteen patients revealed posteromedial displacement of the distal humeral epiphysis on initial x-rays nine patients were treated by colosed reduction and cast Immobilizatlon, and four patients by open reduction and internal fixation All nine patients with conservative treatment had slight cubitus varus under 5 degrees. Two patients with operative treatment had significant deformities of the elbow, one 25 degrees of valgus and one 20 degrees of varus. In treatment of these injuries, accurate evaluation of the state of reduction is important but difficult to obtain. We got acceptable results with conservative treatment.

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