Posttraumatic reconstruction of the elbow in the pediatric patient.

The elbow in a pediatric patient does not usually have the propensity for stiffness like that of the elbow in an adult. There are some posttraumatic conditions of the elbow in the pediatric patient that do require reconstruction. These include reconstruction for malunion after supracondylar humerus fractures and after Monteggia fractures. Nonunion of lateral condyle fractures also may require reconstruction. The posttraumatic elbow contracture in the pediatric patient is an operative challenge when the patient does not respond to conservative treatment. Patients with osteochondritis dissecans resulting in osteochondral loose bodies, significant loss of motion, or radiocapitellar subluxation will benefit from surgery. An entrapped median nerve or medial epicondyle after an elbow fracture or dislocation is an impending disaster that requires reconstruction immediately on recognition.