- See:
-
Proximal Humeral Physeal Injuries
-
Condylar Fractures:
- Discussion:
- while
radial nerve paralysis occurs in adults, its rare in children;
- most represent neuorpraxias, & are expected to return w/ in 3-4 months;
-
acceptable reduction:
- overriding of 1 to 1.5 cm is accepted, as overgrowth is common in pediatric fracture of the humerus;
- angulation should be less than 15-20 deg;
- Treatment:
- in infants and young children, immobilize frx for 4-6 weeks by immobilizing arm to side of chest in modified Velpeau bandage or sling & swathe;
- if fracture is unstable or too much overriding then apply lateral skin traction for 2 to 3 weeks until callus forms;
- in children,
hanging cast method of treatment is not effective, since it requires compliance w/ pt in sleeping and staying in a semirecumbent or sitting posture
w/o support beneath the elbow;
- Cast Position:
- long arm cast is applied from the MP heads to the axilla w/ elbow in 90 deg of flexion and neutral rotation;
- if frx is in
distal third of humerus, place forearm in pronation;
- supinated position will result in a varus deformity at frx site;
- typically the cast/splint will have to be molded in valgus to counteract the varus angulation;
- Flexible IM Nails: (
synthes technique manual)
Biodegradable fixation of distal humeral physeal fractures.
Growth plate activity in the upper extremity.
Growth and predictions of growth in the upper extremity.
Fracture-separation of the distal humeral epiphysis.
Remodeling of Birth Fractures of the Humeral Diaphysis.
Fractures of the Distal Humeral Metaphyseal-Diaphyseal Junction in Children.
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