T-condylar fractures of the distal humerus are very rare in children. When
they do occur they tend to affect those approaching skeletal maturity. Most
agree that the undisplaced fracture can be managed conservatively. With in
creasing displacement and comminution the opinions tend to differ. As an al
ternative to open reduction and internal fixation we report the use of clos
ed reduction and percutaneous pin fixation for displaced and comminuted T-c
ondylar fractures in a series of three young children. In addition to the c
lassical medial and lateral column fixation we report the use of a transcon
dylar wire to stabilise the distal fragments and discuss the use of intra-o
perative arthrography in low supracondylar fractures to exclude a missed in
tercondylar extension on plain ways. Although small this series represents
the largest series of children less than eight years of age.