• Dirk Walther Sommerfeldt and Peter Paul Schmittenbecher.
• Department of Pediatric Traumatology, Altona Childrens Hospital, Bleickenallee 38, 22763, Hamburg, Germany. dirk.sommerfeldt@kinderkrankenhaus.net.
• Eur J Trauma Emerg Surg. 2021 Apr 1; 47 (2): 313324313-324.

PurposeNon-unions of the distal humerus are rare complications of common children's fractures such as radial condyle fractures and supracondylar fractures. The aim of this paper was to update the knowledge about etiology, reasons, management, and results of these troublesome, and sometimes debilitating entities.MethodsThe sparse literature concerning nonunions following condylar or supracondylar fractures was analyzed together with the presentation of some typical clinical cases.ResultsIn most of the cases, non-unions were induced by neglect, unstable fixation, too early implant removal, too much revision surgery, and an inconsequent transfer of follow-up algorithms, or combinations of the above. Treatment of non-union should start as early as possible because the effort of required surgery increases with time that the nonunion has been neglected. Often a combination of stable fixation of the pseudarthrosis and correction of the elbow axis are necessary to achieve a satisfying outcome.ConclusionIn pediatric traumatology, qualified and consequent care for children's fractures of the distal humerus can prevent rare complications such as non-unions in almost any situation. If such a disturbance of healing is noticed, immediate and adequate, i.e. children specific surgical consequences achieve best results.

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