Zeitschrift für Orthopädie und Unfallchirurgie
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The treatment of undisplaced fractures of the lateral humeral condyle is conservative. However, it is problematic that it is not possible to differentiate between a stable and an unstable, non-displaced fracture. A pragmatic approach is to X-ray the elbow without a cast 5 days after trauma and to compare those images with the initial ones. If there is a central increase of dislocation, then there is an indication of an unstable fracture. The dislocation can also be indicated by a translational movement, which is best observed in the border area. The aim of the study was to retrospectively determine the incidence of secondary dislocations of initially undisplaced and minimally dislocated fractures of the lateral humeral condyle in infants between 2010 and 2015. ⋯ 90% of all non-dislocated fractures of the lateral humeral condyle can be treated conservatively. It is important to find out which about 10% of children will experience a secondary dislocation safely and effectively. It has been shown that the strategy for the evaluation of a stable and an unstable fracture of the lateral humeral condyle by means of a radiological control after 5 days without a cast can be effective and cost-saving. With a high degree of certainty, the unstable fracture can be detected at the radiological control 5 days after trauma. If, after 5 days, the radiological control reveals unsure finding regarding the dislocation, it is advisable to recheck the fracture in the second radiological control after 14 days.