When associated with a crush injury, open fracture is more likely. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. If the thumb fracture involves a joint, there is an increased tendency to develop arthritis in the long term even if the fracture is treated perfectly. Rang M. Children's Fractures. [QxMD MEDLINE Link]. Failure to identify and appropriately treat these fractures can lead to long-term reduced function and disability. Note the small fragment of metaphysis attached to the medial epicondyle; this finding indicates a Salter-Harris type II injury. J Am Acad Orthop Surg 1999;7:403-412. Diagnostic difficulties stem both from the complex developmental anatomy of the elbow and from significant differences between children and adults in the patterns of injury after elbow trauma. 3. On an anteroposterior view obtained after reduction of the lateral condyle fracture (C), the olecranon fracture is more obvious. Get new journal Tables of Contents sent right to your email inbox, A Simple Technique for Pinning Distal Phalanx Fractures in the Emergency Department Setting, Articles in PubMed by Rebecca G. Burr, MD, Articles in Google Scholar by Rebecca G. Burr, MD, Other articles in this journal by Rebecca G. Burr, MD, Indirect Reduction and Submuscular Plating of Subtrochanteric Femur Fracture, Nonoperative Management of Pediatric Upper Extremity Fractures or Dont Throw Away the Cast, Hip Arthroscopy of the Central and Peripheral Compartments by the Lateral Approach, Surgical Treatment of Pediatric Femoral Shaft Fractures, Closed Reduction for Developmental Dislocation of the Hip in Infants, Privacy Policy (Updated December 15, 2022). Less frequently (4 of 48 in Jakob's series), the fracture passes through the lateral aspect of the metaphysis, crosses the physis, and continues through the ossified capitellum, with the typical radiographic appearance of a Salter-Harris type IV fracture (see the image below). Although the proximal radius is the most common site of elbow fracture in adults, it accounts for only 5% of elbow fractures in children. Tendon Avulsion Injuries of the Distal Phalanx The fracture originates in the lateral aspect of the distal humeral metaphysis and passes obliquely to the physis. 4(1):25-9. (B) Anteroposterior contralateral comparison. The presence of a metaphyseal flake fracture is not specific because some medial epicondyle avulsions extend into the metaphysis as a Salter-Harris type II fracture. Unable to load your collection due to an error, Unable to load your delegates due to an error. [45] It has also been suggested that extension force in infants may be more likely to cause a transphyseal fracture than supracondylar fracture. The technique is cost and time effective when treating patients with this type of injury. If the medial epicondyle is not seen in its normal anatomic position, it should be searched for elsewhere, including within the elbow joint. Table 1 summarizes the evaluation and management of finger dislocations and fractures. The distal humeral articular surface has several grooves and ridges that are important in determining anatomic stability after a fracture. The peak age of occurrence for these fractures is 4-10 years. Transphyseal fractures of the distal humerus typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small Salter-Harris type IV fracture | Radiology Reference Article Medially, the trochlear notch articulates with a corresponding ridge along the ulna. Finger dislocations can occur at the distal interphalangeal (DIP), proximal interphalangeal (PIP), or metacarpophalangeal (MCP) joints. See the image below. Fractures of the medial epicondyle account for 10-15% of elbow fractures in children.
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