Davos Courses

Executive Editor: Fergal Monsell General Editor: Chris Colton

Authors: Andrew Howard, Theddy Slongo

Pediatric distal humerus 13-E/4.1M Open reduction; screw fixation

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Postoperative care

Note: Screw fixation gives absolute stability and additional plaster cast for immobilization to prevent secondary displacement is not mandatory.
A posterior plaster splint can be applied for 1-2 weeks for pain management, and in younger children to prevent use of the arm. In older children an arm sling is sufficient.

If the child remains for some hours/days in bed, the elbow should be elevated on pillows to reduce swelling and pain.

The postoperative protocol is as follows:

  • Discharge from hospital according to local practice (1-3 days)
  • First clinical and radiological follow up, depending on the age of the child, 4-5 weeks postoperatively out of the cast
  • In most cases, at this first x-ray control, the fracture is consolidated and stable so that cast is no longer required
  • During the first clinical follow-up, parents/carers should be informed about the timing of implant removal
  • Physiotherapy is normally not indicated

Screw removal

The screw can be removed after 2-3 months. Screw removal can be performed as a day case under light general anesthesia.

v1.0 2016-12-01