• J M Murnaghan, N S Thompson, T C Taylor, Ap Cosgrove, and J Ballard.
• Department of Paediatric Orthopaedics, Royal Belfast Hospital for Sick Children, UK.
• Int. J. Clin. Pract. 2002 Jul 1; 56 (6): 475-7.

AbstractWe describe a case series involving a very unusual injury in children, i.e. a Milch 1 fracture of the lateral condyle with an associated dislocation of the elbow. This fracture configuration is normally stable as the intact capitellotrochlear groove serves as a lateral buttress for the coronoid-olecranon ridge of the ulna. In this series, however, each patient had an associated dislocation. These injuries usually present as a clinical dislocation and if the elbow is manipulated before radiographic imaging, the fracture line can be difficult to see on the post-reduction films. We recommend that all patients with a dislocated elbow should have elbow stability assessed under general anaesthesia, because a missed lateral condylar injury can lead to abnormalities in carrying angle, epiphyseolysis or an unstable elbow.

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