Pediatric humeral condyle fractures

Condylar and epicondylar fractures differ from other pediatric upper extremity fractures because of the anatomy and ossification of the distal humerus. These fractures are prone to nonunion,and initial deformities do not remodel well. Radiographic diagnosis and severity are difficult to determine, and adjunct studies, particularly arthrography and MRI, often are needed. The correlation of an intact cartilaginous hinge and subsequent fracture stability has helped identify fractures at risk for displacement and nonunion,prompting closer follow-up or more aggressive initial treatment. Although many humeral condylar fractures can be treated successfully with cast immobilization, operative treatment often is warranted. Specific treatment recommendations continue to evolve. The general trend is toward treating more fractures and nonunions with surgical fixation while using less invasive techniques.