- See: Pediatric Elbow Injuries
- most frx involving total distal humeral physis occur before age 6 or 7;
- in an infant less than one year of age, whose elbow is swollen 2nd to trauma or suspected trauma, frx involving the entire distal humeral
physis should always be suspected;
- proximal radius and ulna maintain anatomical relationship to each other but are displaced posterior and medially in relation to distal humerus;
- distinguish between DHPS and elbow dislocation:
- in elbow dislocation, proximal radius & ulna usually are displaced posterolaterally & relationship between proximal radius & lateral condyle epiphysis is disrupted;
- in physeal separation displacement is usually posterior & medial;
- arthrogram is helpful in cases in which ossification centers are not present;
- infants: closed reduction and casting (elbow flexed);
- children: closed reduction and percutaneous pinning (lateral pins);
- arthrogram may help confirm adequacy of the reduction;
- delayed diagnosis: after 5-6 days manipulation may increase the risk of AVN
Fracture separation of the distal humeral physis in the newborn.
Radiographic diagnosis of fracture-separation of the entire distal humeral epiphysis.
Fracture-separation of the distal humeral epiphysis.
Physeal fractures of the distal humerus: avoiding the pitfalls.
Epiphyseal separation of the distal end of the humerus with medial displacement.
Fracture-separation of the distal humeral epiphysis in young children.
Fracture separation of the distal humeral epiphysis.
Fracture separation of the distal humeral epiphysis in children younger than three years old.