NONDISPLACED AND MINIMALLY DISPLACED FRACTURES OF THE LATERAL HUMERALCONDYLE IN CHILDREN - A PROSPECTIVE RADIOGRAPHIC INVESTIGATION OF FRACTURE STABILITY

Subsequent displacement of nondisplaced or minimally displaced fractur es of the lateral humeral condyle while immobilized in plaster may con tribute to severe complications. The possibility of assessing the stab ility of such fractures may be a help in planning the initial treatmen t. Our prospective investigation of 112 children aged 1-11 years aimed at describing radiographic criteria for prognosticating the stability of the fractures. According to the radiographic findings, the fractur es were allocated to one of three groups representing stable fractures , fractures with undefinable risk, and fractures with high risk of lat er displacement. All children were treated with splinting only. Sixty- five fractures were classified as stable and turned out to be so witho ut exception. Displacement occurred in six of 35 (17%) of the fracture s judged uncertain and in five of 12 (42%) of those judged unstable. T he subsequent displacement was 1 or 2 mm, and in one case, 3 mm. The d efined criteria were found to be efficient in separating the stable an d the high-risk fractures with acceptable confidence. The group of fra ctures with undecided risk of subsequent displacement was fairly large -one third of the total material. The implication the findings may bea r to the treatment strategy of fractures is analyzed in a work in prog ress.