• Vigil James, Abigail Chin Chii Chng, Francesca Lim May Ting, Yiong Huak Chan, and Sashikumar Ganapathy.
• From the Children's Emergency, KK Women's and Children's Hospital, Singapore, Singapore.
• Pediatr Emerg Care. 2021 Dec 1; 37 (12): e1339e1344e1339-e1344.

BackgroundThe lateral humeral condyle fractures in children accounts for one fifth of all elbow fractures. These fractures have a propensity to displace because of the pull of the extensor muscles on the condyle.ObjectivesThe aim of this study was to examine the epidemiology, injury patterns, complications, and predictors for conservative/surgical management in patients with lateral condyle humeral fractures between 0 and 18 years of age.MethodsThis was a single-center retrospective study conducted between January 2006 and December 2016.ResultsThere were 268 patients identified with lateral condyle elbow fracture. Majority of the patients (81.4%) with lateral condyle humeral fractures presented with either undisplaced or minimally displaced (<2 mm) fractures. The initial management in majority (90.7%) of the patients was conservative. Of the patients, 26.8% had secondary displacement at follow-up. The overall proportion of patients who required surgical intervention was 36.2%. Varus deformity of elbow (2.2%) and malunion (0.4%) were the complications noticed on long-term follow-up. Increased age and undisplaced fracture were statistically significant positive predictors for conservative management. The presence of concurrent elbow injuries and type of fracture (displaced >2 mm) were statistically significant positive predictors for surgical management.ConclusionsOur study demonstrated that majority of the patients with lateral condyle humeral fractures had presented with either undisplaced or minimally displaced (<2 mm) fractures. The positive predictors for conservative management of fractures were increased age and undisplaced fracture. The positive predictors for surgical management of lateral condyle humerus fractures were concurrent injuries in elbow and type of fracture (displaced >2 mm). Physician vigilance to the possibility of additional migration of lateral condyle fractures initially managed conservatively, and the need for subsequent surgical stabilization plays an important role in the management of these fractures.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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