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Adult Lateral Condyle Fracture

(See: - Pediatric Lateral Condyle Frx)

Discussion

  • frxs of lateral condyle that involve capitulum alone or extend medially to involve the lateral portion of trochlea;
  • see capitellum fracture

Lateral approach »

  • typically the plate is positioned posteriorly, and can be placed if needed as far as the posterior aspect of the capitellum;
    • remember that the lateral column is nonarticular posteriorly, therefore low placement of the plate will ensure that at least two screws can engage the distal fragment;
    • distal screws are typically aimed anterosuperior, but ensure that screws do not penetrate anterior cortex of capitellum;
  • plate molding:
    • careful molding of the lateral plate is necessary to obtain maximum screw purchase;
      • lateral column of the distal humerus diverges about 20 deg from the humeral shaft axis and terminates distally as the capitellum;
    • first the 3.5 mm reconstruction plate is bent to accomodate the valgus bow of the distal humerus (requires a bending press);
    • next bend the plate to accommodate the curved bow of the capitellum