T-condylar fractures of the distal humerus in children and adolescents.

Abstract

This was a retrospective review of 17 T-condylar fractures in children and adolescents, aged 9-16 years. It examined the results by sex, age, arm injured, hand dominance, mechanism of injury, radiologic appearance, operative findings, operative procedure, outcome, and complications. There was a male-to-female ratio of 2.4:1. The large majority of patients received their fractures as a result of a fall. The majority of patients injured their nondominant left distal humerus. Five patients had a neuropathy, all of which spontaneously resolved. Fifteen patients underwent open reduction, internal fixation, with a mean postoperative follow-up of 16 months. The posteromedial (Bryan-Morrey) and the olecranon osteotomy approach resulted in a statistically significant better extension than the triceps-splitting approach (p < or = 0.05). Patients with articular damage had statistically significantly less extension at follow-up (p < or = 0.001). The use of continuous passive motion (CPM) in the immediate postoperative period resulted in a functional range of motion sooner and yielded a statistically significant increase in flexion at follow-up examination than when not used (p < or = 0.05).