Course: Medial humeral condyle fracture in a 2-year-old child with abnormal displacement and mechanism of injury: A Case Report
Medial humeral condyle fracture in a 2-year-old child with abnormal displacement and mechanism of injury: A Case Report
Adryan Tanujaya, Anak Agung Ngurah Ronny Kesuma
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.