(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
- careful molding of the lateral plate is necessary to obtain maximum screw purchase;