Course: Medial humeral condyle fracture in a 2-year-old child with abnormal displacement and mechanism of injury: A Case Report

  • Article

    • 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

      ABSTRACT

      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.

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