Med Epicondyle/Lat Condyle Fractures

Question 1

What the operative indications for medial epicondyle fractures?

Answer 1

Absolute:

1) incarcerated fragment in the joint
2) open fracture

Relative:

1) ulnar nerve dysfunction
2) injury in high level athlete
3) > 5-15mm displacement

Question 2

What technique can be used to close reduce medial epicondyle fractures?

Answer 2

Robert’s technique:

placing valgus stress on the elbow, supinating the forearm, and extending the wrist and fingers.

Question 3

What leads to a medial epicondyle fracture?

Answer 3

Valgus stress leading to tension overpull by the flexor-pronator mass; >50% are a/w elbow dislocations

Question 4

What is the fracture classification of lateral condyle fractures?

Answer 4

Milch:
Type I- lateral to trochlear groove
Type II- fracture involves trochlear groove

Question 5

What is the best view to evaluate a pediatric lateral condyle fracture?

Answer 5

Internal oblique

Question 6

What are indications for CRPP of lateral condyle fractures?

Answer 6

1)

Question 7

What are indications for ORIF of lateral condyle fractures?

Answer 7

1) >2mm displacement
2) articular incongruity
3) non-union
Use direct lateral approach; do not dissect posteriorly

Question 8

What must be avoided during ORIF of lateral condyle fractures?

Answer 8

Posterior dissection of the lateral condyle; prevent AVN

Question 9

Nonunion following a pediatric lateral condyle fracture has been associated with which of the following?

Answer 9

Ulnar nerve palsy from cubitus valgus deformity

Question 10

Missed lateral condyle fractures can result in what condition?

Answer 10

non-union or malunion leading to cubitus valgus deformity

Question 11

What is common with lateral condyle fracture regardless of treatment?

Answer 11

Lateral spurring (50%); final ROM not influenced by the size of the spur