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Explain
analyse_media
Reading File
Finding Sources
Searching PubMed
"Humeral Fractures"[MeSH Terms] AND pediatric
Searching the Web
pediatric lateral humeral condyle fracture fall extended elbow varus mechanism
Reading File
Correct answer: B. Fracture of the lateral condyle of the humerus.
Why?
A child falls on an outstretched hand while the elbow is extended and forced into varus.
- Varus stress means the forearm is pushed toward the midline relative to the arm.
- This opens the lateral side of the elbow and creates a traction or avulsion force at the lateral distal humerus.
- The wrist extensor muscles and lateral soft-tissue attachments pull on the lateral condylar fragment, causing a lateral humeral condyle fracture.
This is a common pediatric elbow injury, typically in children aged about 4 to 6 years. Campbell's Operative Orthopaedics describes its typical mechanism as a fall on an outstretched arm with the elbow in varus, causing avulsion of the lateral humeral condyle (p. 1778).
Important distinctions
| Force at elbow | Expected injury |
|---|---|
| Varus | Lateral condyle fracture |
| Valgus | Medial epicondyle avulsion, ulnar collateral ligament injury, and sometimes radial neck fracture |
So the key association is:
FOOSH + elbow extension + varus = lateral condyle fracture of humerus.
Clinical relevance
- It is an intra-articular fracture and often crosses the physis, so it behaves like a Salter-Harris type IV injury.
- It is prone to displacement and non-union because the lateral fragment can be pulled by the extensor muscles.
- Undetected displacement or non-union may cause cubitus valgus later, which can stretch the ulnar nerve.
- Management depends on displacement: minimally displaced stable fractures may be casted with close radiographic follow-up, while displaced fractures generally need fixation.
The screenshot’s main concept is correct, but “all are treated by ORIF” is too absolute. The decision is based mainly on fracture displacement and stability.
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