Dissolution of the Capitellum After Lateral Condylar Fracture of the Humerus in a Child: A Case Report

Lateral condyle fractures of the humerus are a common elbow injury sustained by pediatric patients. Complications from surgical intervention can include malunion, fishtail deformity, osteonecrosis, and avascular necrosis (AVN). AVN of the capitellum is a rare complication of lateral condyle fractures with very few cases reported in the current literature. Here we report the rare case of dissolution of the capitellum following closed reduction and percutaneous pinning for a lateral condylar fracture of the humerus of a six-year-old child performed at an outside hospital that was subsequently managed at our academic pediatric level 1 trauma center. Other than a long-arm cast, no specific intervention was provided as the patient remained neurovascularly intact and improved clinically. Through careful follow-up and conservative management, the patient regained the full range of motion of the elbow and clinical resolution of the fracture. The single posterior blood supply of the capitellum likely contributes to the pathophysiology of this condition and further supports the methodology of avoiding posterior soft tissue stripping during surgical correction of distal humerus fractures. We conclude that the prognosis of this condition is favorable and can be managed by conservative treatment.