Module 22, Pediatric Orthopaedist Level

A five year and six month old white male sustained a fall onto his outstretched right arm with immediate complaints of pain and swelling in his right elbow. The child was unable to move his arm secondary to pain. He was on the play ground and the fall was not witnessed. Physical examination revealed swelling, tenderness and crepitus over the lateral aspect of the elbow. The skin was intact and neurovascular examination of the right upper extremity was without deficits. The patient was taken to the operating room where under general anesthesia and tourniquet control, the fracture was exposed utilizing an anterolateral approach. Two diverging k-wires were placed across the fracture site.

Question 22A

It is important not to disturb the posterior vascular pedicle of the lateral condyle during the open reduction.

Question 22B

Post-operative immobilization should be in 90 degrees flexion for at least four weeks.

Question 22C

Cubitus Valgus is another complication from this fracture.

Question 22D

This fracture may produce a fish tail deformity with growth.

Question 22E

Cubitis varus occurs with supracondylar fractures not with this injury.