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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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The radius is longer of the two bones that make up the human antebrachium or forearm. At the proximal end, the radius articulates with the capitulum of the humerus and the radial notch of the ulna to form the elbow joint. At the distal end, the radius articulates with the ulna via the ulnar notch, forming the distal radioulnar joint. Distally, the radius also attaches to the carpal wrist bones (scaphoid and lunate) to form the radiocarpal joint.
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Nine muscles are involved in arm movements. Two of these, the pectoralis major and latissimus dorsi, originate from the axial skeleton and are called axial muscles. The other seven originate from the scapula and are called the scapular muscles.
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The subclavian artery transitions into the axillary artery as it exits the chest and enters the axillary region. This artery is critical for supplying blood to the shoulder area, including the head of the humerus, through the humeral circumflex arteries. As the vessel continues into the upper arm or brachium, it becomes the brachial artery. This artery plays a key role in vascularizing the brachial region and bifurcates at the elbow into several branches. These branches include the deep...
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Transphyseal Distal Humerus Fracture.

Joshua Abzug1, Christine Ann Ho, Todd F Ritzman

  • 1Assistant Professor, Director of Pediatric Orthopaedics, Director of University of Maryland Brachial Plexus Clinic, Deputy Surgeon-in-Chief of Maryland Children's Hospital, Department of Orthopaedics, University of Maryland Medical System, Baltimore, Maryland.

Instructional Course Lectures
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PubMed
Summary

Transphyseal distal humerus fractures in young children require prompt diagnosis. Surgical management involves closed reduction and percutaneous pinning, with potential complications like cubitus varus addressed by osteotomy.

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Area of Science:

  • Pediatric Orthopedics
  • Pediatric Trauma Surgery

Background:

  • Transphyseal distal humerus fractures are uncommon injuries in children under 3 years old.
  • These fractures often result from birth trauma, nonaccidental trauma, or minor falls.
  • Early and accurate diagnosis is critical for optimal patient outcomes.

Purpose of the Study:

  • To review the diagnosis, management, and complications of transphyseal distal humerus fractures in pediatric patients.
  • To highlight key radiographic findings and surgical techniques for this specific fracture pattern.

Main Methods:

  • Review of clinical presentations and radiographic findings.
  • Description of surgical techniques including arthrogram-assisted reduction and percutaneous pinning.
  • Discussion of common complications and their management.

Main Results:

  • Radiographic assessment, noting forearm-humerus misalignment, aids diagnosis.
  • Surgical treatment commonly utilizes closed reduction and percutaneous pinning.
  • Cubitus varus, medial condyle osteonecrosis, and growth arrest are frequent complications.

Conclusions:

  • Prompt diagnosis and appropriate surgical intervention are essential for managing transphyseal distal humerus fractures.
  • Awareness of potential complications guides long-term management strategies.
  • Corrective osteotomy can effectively address malunion deformities like cubitus varus.