Transphyseal Fracture of the Distal Humerus

Area of Science:

• Pediatric Orthopedics
• Pediatric Traumatology
• Pediatric Radiology

Background:

• Transphyseal fractures of the distal humerus are uncommon injuries in children under three years old.
• These fractures can result from birth trauma, nonaccidental trauma, or low-height falls.
• Accurate diagnosis is critical for effective management and preventing long-term complications.

Purpose of the Study:

• To review the diagnostic methods for transphyseal distal humerus fractures in young children.
• To discuss the surgical management and common complications associated with these injuries.
• To highlight treatment options for correcting residual deformities such as cubitus varus.

Main Methods:

• Diagnosis is often aided by identifying forearm-humerus misalignment on plain radiography.
• Surgical management frequently involves arthrography to delineate the fracture.
• Treatment typically employs closed reduction and percutaneous pinning, similar to techniques used for supracondylar humerus fractures.

Main Results:

• The most frequent complication is cubitus varus, stemming from malunion, osteonecrosis of the medial condyle, or growth arrest.
• A corrective lateral closing wedge osteotomy can be performed to restore the normal carrying angle.

Conclusions:

• Early recognition of forearm-humerus malalignment on radiographs is key for diagnosing transphyseal distal humerus fractures.
• Surgical intervention with closed reduction and percutaneous pinning is the standard treatment.
• Management of complications, particularly cubitus varus, is crucial for functional recovery and optimal elbow alignment.