Transphyseal Distal Humerus Fracture.

Instr Course Lect

Assistant 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.

Published: July 2016

Transphyseal distal humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal distal humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the humerus on plain radiographs may aid in the diagnosis of a transphyseal distal humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar humerus fractures are employed. Cubitus varus caused by a malunion, osteonecrosis of the medial condyle, or growth arrest is the most common complication encountered in the treatment of transphyseal distal humerus fractures. A corrective lateral closing wedge osteotomy can be performed to restore a nearly normal carrying angle.

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