Executive Editor: Fergal Monsell General Editor: Chris Colton

Authors: Andrew Howard, Theddy Slongo

Pediatric distal humerus

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Glossary

Distal humeral anatomy

An understanding of the anatomy, biomechanics and growth plate patterns of the distal humerus is vital to the rational consideration of fracture care in children.

Lateral approach

The main indication for a lateral approach in the distal humerus are:

  • Displaced lateral condylar fractures (13-E/3.1 and 13-E/4.1)
  • Displaced capitellar fractures (13-E/8.1)
  • Displaced, unstable avulsion of the lateral collateral ligament (13-E/7L)
  • Irreducible supracondylar fractures (13-M/3)

Medial approach

The main indications for a medial approach to the distal humerus are:

  • Open fixation of medial epicondylar fractures
  • Visualization of the medial epicondyle for safe K-wire insertion when using bilateral crossed K-wiring
  • Ulnar nerve exploration

Note: The medial approach, including opening of the joint, is not an ideal procedure for supracondylar fractures.

Posterior approach

The main indications for a posterior approach in the distal humerus are:

  • Y-fractures or T-fractures (13-E/4.2)

Bear in mind that use of posterior approach for extension type supracondylar fractures, compromises the tension band effect of the posterior periosteum.

Anterior approach

The main indications for an anterior approach to the distal humerus are:

  • Vessel exploration
  • Nerve exploration

v1.0 2016-12-01