A 7-year-old boy falls on an outstretched hand. X-ray shows a fracture at the lateral condyle of the humerus with the fragment displaced by 4 mm. The fracture line extends into the articular surface. What is the most appropriate management?

• A Closed reduction and above-elbow cast for 3 weeks
• B Open reduction and internal fixation with K-wires ✓
• C Collar and cuff sling with early mobilisation
• D Closed reduction under image intensifier and long arm cast

Explanation

Lateral condyle fractures in children displaced more than 2 mm require open reduction and internal fixation because the fragment is entirely cartilaginous and closed reduction cannot be reliably maintained. Failure to fix these adequately leads to non-union, cubitus valgus deformity, and late ulnar nerve palsy. K-wire fixation after open reduction is the standard of care for this displacement.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.