Corrective osteotomy and in situ fusion for late-presenting nonunion of lateral condyle fractures of the humerus in adults.

BACKGROUND

Late presentation of lateral condylar fractures of the humerus is not an uncommon problem in children, and to lesser extent, in adults. The various surgical interventions for repairing the fracture, correcting the deformity, or even performing anterior transposition of the ulnar nerve as a single procedure or in combination, especially in adults, is still a controversial topic, with a paucity of literature regarding this. There is a risk of loss of the available preoperative range of motion, nonunion, and avascular necrosis.

METHODS

In 19 patients with late presentation of lateral humeral condyle fracture, we assessed the results of only corrective osteotomy and internal fixation with lateral incision without anterior transposition of the ulnar nerve with regard to deformity correction, union, and functional results using the Mayo Elbow Performance Score with at least 24 months of follow-up. All patients (14 men, 5 women; average age, 29.1 years) had Milch type 2, 18 patients presented with cubitus valgus deformity, 1 presented with cubitus varus deformity, and 8 patients had tardy ulnar nerve symptoms.

RESULTS

Late-presenting lateral condylar fractures could be managed surgically with our procedure alone even if they have a tardy ulnar neuritis, with excellent results in 17 patients and good results in 2 patients.

CONCLUSION

In situ fusion, deformity correction, and internal fixation is a valuable method for the management of late-presenting lateral condylar fractures in adults.