Second fracture of the distal humerus after varus malunion of a supracondylar fracture in children

Nine children sustained a second fracture of the distal humerus after union of an ipsilateral supracondylar fracture which had healed with cubitus var us, There were eight boys and one girl with a mean age of five years (1 to 8) at the time of the second fracture which occurred at a mean of 1.5 years after the first. In all patients, the second fracture was an epiphyseal in jury of the distal humerus, either associated with a fracture of the latera l metaphysis below the site of the previous supracondylar fracture, or a fr acture-separation of the entire distal humeral epiphysis, This suggests tha t the physis and epiphysis tend to be more subject to injury than the metap hysis of the distal humerus in children who have had a previous supracondyl ar fracture with varus malunion.