Management of the supposed elbow dislocation in newborns

Area of Science:

• Pediatric Orthopedics
• Neonatal Trauma
• Radiology

Background:

• Newborn transphyseal distal humerus fractures are rare and frequently misdiagnosed as elbow dislocations.
• The absence of the lateral condyle ossification node contributes to diagnostic challenges.
• There is no established consensus on the diagnosis or management of these fractures.

Purpose of the Study:

• To analyze a series of newborns diagnosed with transphyseal distal humerus fractures.
• To evaluate diagnostic methods and therapeutic management strategies.
• To assess outcomes and complications in this rare pediatric fracture type.

Main Methods:

• Retrospective analysis of infants under 6 months treated between 2005 and 2020.
• Review of radiological examinations including X-ray, ultrasound, and MRI.
• Assessment of orthopedic and surgical treatment outcomes with a minimum 2-year follow-up.

Main Results:

• Nine newborns were included, with obstetrical trauma as the primary cause (8/9).
• Diagnosis was confirmed by radiography, ultrasound, or MRI.
• Six patients received conservative treatment, and three underwent surgical reduction; all achieved full functional recovery with minimal complications.

Conclusions:

• Transphyseal fractures of the distal humerus in newborns are rare and best managed conservatively.
• Complementary imaging is crucial for accurate diagnosis.
• Early diagnosis and appropriate management lead to favorable functional recovery.