Executive Editor: Fergal Monsell

General Editor: Chris Colton

Authors: Andrew Howard, Theddy Slongo

Pediatric distal humerus 13-E/7L

General considerations

Avulsion of the lateral collateral ligament is a rare injury in children. It occurs mostly in older children in combination with elbow dislocation.

Note: The lateral epicondyle is only ossified around the age of 13-14 years and cannot be seen on an x-ray before then. The stability of all reduced elbow dislocations in younger children must, therefore, be checked under image intensification.

Undisplaced avulsion of the lateral epicondyle can be treated conservatively. Displacement of more than 5 mm is a sign for potential instability, in which case the fragment with the attached ligament requires fixation.

Timing of treatment

These fractures do not require emergency surgery. The surgery can be planned in the regular clinical program over the next days.

The following points influence the timing of the treatment:

Appendix

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Decision support

Authors' added material

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v1.0 2016-12-01