Medial humeral condyle fracture in a 2-year-old child with abnormal displacement and mechanism of injury: A Case Report

Authors

  • Adryan Tanujaya Medical Doctor, Department of Orthopaedic and Traumatology, Wangaya General Hospital, Denpasar, Bali
  • Anak Agung Ngurah Ronny Kesuma 2Orthopaedic and Traumatology Surgeon, Department of Orthopaedic and Traumatology, Wangaya General Hospital, Denpasar, Bali

DOI:

https://doi.org/10.31282/joti.v5n1.86

Keywords:

Medial Condyle Humerus, Pediatric, Osteosynthesis, Proximal Displacement

Abstract

Fractures of the medial humeral condyle are considered a rare injury of a pediatric elbow injury, accounting
for only 1-2% of pediatric elbow fractures. The current mechanism of injury describes the fracture to be caused
by direct trauma at the point of the flexed elbow or by an avulsion injury due to a valgus strain of the elbow
upon falling with an outstretched arm. We report a case of early presentation of an atypical injury mechanism,
as well as proximal displacement of the medial condyle fracture fragment (Kilfoyle Type III) in a 2-year-old child
treated with open reduction internal fixation (ORIF) with a 3-month follow-up period. The patient was treated
with ORIF using 2 Kirschner wires and presented with a periosteal reaction. The implants were maintained for
3 months, allowing full extension and 90 active flexions of elbow movement after removal. The direction of the
shearing force upon injury could explain the proximal displacement of the fracture; however, the absence of
rupture of the surrounding tendons upon exploration contradicts the possibility and hence remains unknown. In
conclusion, treatment with ORIF using 2 Kirschner wires is sufficient to reduce the medial humeral condyle
fracture; however, the risk of developing elbow stiffness as a complication is still present, as shown in this case.

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References

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Additional Files

Published

2022-04-25