Lateral Condyle Fracture
Elbow fractures are common in our paediatric patients and lateral condyle fractures are the second most common type of elbow fracture (around 16%). Your child’s elbow is a complex joint and made up of 3 bones – the radius and ulna from the forearm and the humerus from the upper arm. In a lateral condyle fracture (fracture is just another word for break in the bone), the outside part of the humerus at the elbow has been broken. This is often due to a fall and landing awkwardly on that arm.
In the A&E department doctors will check to ensure no other part of your child’s elbow has been hurt as well as to check for any problems with swelling. Your child will be placed into a backslab – half a cast – to allow the arm to swell and to help keep them comfortable. You will either be booked into a fracture clinic if the injury is none too severe, or, if there is concern, an orthopaedic doctor will be asked to come and assess the injury.
How your child’s injured arm gets treated depends on the severity of the break and what doctors call ‘displacement’ – how far the bones have moved. The less severe injuries, where the bone ends have not moved too far, can be treated with a cast that goes above the elbow for around 6 weeks. This type of treatment avoids an operation. During this time your child will need weekly x-rays however as sometimes the bones can move, despite being in a cast. If that were to happen, surgeons would need to do an operation where dye is place into the joint and x-ray is used to see the break in more detail. The dye in the joint allows the surgeons to see if the joint surface has been damaged as result of the break. Surgeons can then decide if they can treat the injury by holding it with wires, that are later pulled out in clinic, or by placing a small cut on the outside of the elbow allowing the bone ends to be put back to where they broke off from, before then placing the wires. Both require a cast that goes above the elbow for 6 weeks. The cast gets changed at 4 weeks to allow wire removal in clinic before placing your child’s arm back into cast for the final 2 weeks of treatment.
Outcomes in treated cases are generally good with the majority of movement recovered by 6 months after the injury. In those children treated with wires simple skin infections can occur but are treated with antibiotics. Sometimes a deformity (abnormal shape) can be seen at the elbow. This is rarely big enough to need further treatment but surgeons can correct it with an operation if required.