Elbow Fracture in Children: Types, Diagnosis and Treatment

Elbow fracture in children includes two important fractures that occur around the elbow joint. One of these is the fracture of the lateral condyle of humerus and the other is the Supracondylar fracture. Here on this page we will learn about the fracture of lateral condyle of humerus. Supracondylar fracture can be seen by clicking here.

Lateral condyle elbow fracture in children occurs by falling on the hand with a force that tends to wedge open the elbow joint. The lateral collateral ligament of the elbow joint becomes taut and pulls the lateral condyle of the elbow along with it as the force continues to act, resulting in the fracture. See the red arrows in the graphic. They show the direction of the force.

Classification of this elbow fracture in children is on the degree of separation of the bone fragments.

• Type 1 are undisplaced or minimally displaced fractures are those with less than 2mm gap between the fractured bone parts.
• Type 2 are displaced fractures with greater than 2mm gap.
• Type 3 are displaced fractures along with rotation of the bone fragment.

Symptoms include pain, swelling and inability to move the elbow joint following injury. In undisplaced fractures the symptoms are mild whereas in displaced fractures they are more severe. There may be a delay in diagnosis of undisplaced fractures because the symptoms are mild. This may result in the fracture being labelled as a elbow sprain.

Diagnosis is confirmed by taking a x ray of the elbow joint. A x ray of the opposite normal elbow may be required for comparison in very young children, because the bone is mainly cartilaginous and does not give a clear picture on x rays.

Treatment depends upon the classification of the fracture.

• Type 1 fractures are treated by immobilization of the fracture in a plaster splint.
• Type 2 fractures are treated surgically. Stainless steel pins are used to stabilize the fracture under fluoroscopy.
• Type 3 fractures are also treated surgically. A incision is given over the elbow. The fracture is exposed and aligned in proper position and stabilized with stainless steel wires.

The above x rays show a Type 2 fracture. The red arrows show the fractured condyle.

Many complications can occur after this fracture. They include the following

• The fracture may fail to unite or there can be considerable delay in healing of the fracture. Failure to unite is called non-union. Many times this non-union can remain asymptomatic or may result in some weakness when performing unusual and demanding activities. It can also result in increasing deformity of the elbow joint called as cubitus valgus.
  In cubitus valgus the forearm and hand is shifted more outward as compared to normal. If this deformity is progressive then it can cause paralysis of the ulnar nerve.
• Some children may develop the opposite deformity called cubitus varus in which the forearm and hand are shifted inwards more than normal.
• Excessive bone formation may occur around the elbow joint causing limitation of motion.
• Avascular necrosis or death of bone tissue following disruption of blood supply to the lateral condyle may develop. This usually occur when during surgery extensive dissection is required to align the fracture.

Frequently Asked Questions

How long does the fracture take to heal?

How can complications be prevented?

I hope the information provided was helpful. If you have any query you can ask me at the contact me page.

This page was last updated on 11th February 2009.

Another important elbow fracture in children is Supracondylar Fracture

Other causes of elbow pain...

Tennis elbow

Golfers elbow

Olecranon bursitis

Olecranon Fracture

Radial Head Fracture

Elbow dislocation

Pulled elbow

Little leaguer's elbow

Elbow Joint Anatomy

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