High Yield Overview

LATERAL CONDYLE FRACTURES - PEDIATRIC

Intra-Articular | Nonunion Risk | ORIF Often Required

15%Of pediatric elbow fractures

6yPeak age

2mmDisplacement threshold

HighNonunion risk

WEISS/JAKOB CLASSIFICATION

Type I

PatternLess than 2mm displacement, articular hinge intact

TreatmentLong arm cast, close follow-up

Type II

Pattern2-4mm displacement or rotation

TreatmentORIF with K-wires

Type III

PatternDisplaced greater than 4mm, articular surface disrupted

TreatmentORIF with K-wires

Critical Must-Knows

INTRA-ARTICULAR fracture (elbow and wrist joint)
Greater than 2mm displacement = surgical indication
High risk of nonunion due to synovial fluid bathing fracture
Late complications: nonunion, malunion, cubitus valgus, tardy ulnar nerve palsy
Lateral approach - do NOT dissect posterior (blood supply)

Examiner's Pearls

"
Milch Type I = Salter-Harris IV (lateral to trochlear ridge)
"
Milch Type II = Salter-Harris II (through trochlear ridge, unstable)
"
Nonunion causes lateral spur and cubitus valgus
"
Tardy ulnar nerve palsy occurs years later due to valgus

Clinical Imaging

Imaging Gallery

Preoperative anteroposterior radiograph of the elbow revealing fracture lateral condyle in association with posterolateral dislocation of elbow.Credit: Sharma H et al. via BMC Musculoskelet Disord via Open-i (NIH) (Open Access (CC BY))

Preoperative lateral radiograph of the elbow revealing elbow dislocation.Credit: Sharma H et al. via BMC Musculoskelet Disord via Open-i (NIH) (Open Access (CC BY))

Postoperative anteroposterior radiograph of the elbow revealing internal fixation of the lateral condyle fracture with the help of 2 K-wires. The elbow dislocation was reduced first by closed techniqu — Postoperative anteroposterior radiograph of the elbow revealing internal fixation of the lateral condyle fracture with the help of 2 K-wires. The elboCredit: Sharma H et al. via BMC Musculoskelet Disord via Open-i (NIH) (Open Access (CC BY))

Postoperative lateral radiograph of the elbow revealing internal fixation of the lateral condyle fracture with the help of 2 K-wires.Credit: Sharma H et al. via BMC Musculoskelet Disord via Open-i (NIH) (Open Access (CC BY))

Critical Exam Concepts

Intra-Articular Fracture

Crosses the articular surface. Unlike supracondylar, this is an intra-articular fracture. Anatomic reduction required to prevent degenerative changes and angular deformity.

The 2mm Rule

Greater than 2mm displacement = ORIF. Less than 2mm can be treated non-operatively but needs close follow-up (can displace in cast). Some advocate surgery for greater than 2mm on any view.

High Nonunion Risk

Synovial fluid prevents healing. Fracture bathed in synovial fluid from elbow joint. Combined with pull of extensor origin, high risk of nonunion. This is why surgery is often needed.

Tardy Ulnar Nerve Palsy

Delayed complication of cubitus valgus. Nonunion causes lateral spur and progressive valgus. Ulnar nerve is stretched over time. May present years later with ulnar neuropathy.

Quick Decision Guide

Type	Displacement	Articular Step	Treatment
Weiss Type I	Less than 2mm	Intact cartilage hinge	Cast, weekly XR for 3 weeks
Weiss Type II	2-4mm	Gap but some contact	ORIF with K-wires
Weiss Type III	Greater than 4mm	Complete articular disruption	ORIF with K-wires

Mnemonic

1 OUT, 2 THROUGHMilch Classification

Type I = Lateral to trochlear ridge

Elbow is stable (Salter-Harris IV)

Type II = Through trochlear ridge

Elbow potentially unstable (Salter-Harris II)

Memory Hook:Type 1 stays OUT (lateral), Type 2 goes THROUGH (trochlear ridge)

Mnemonic

NUTSLateral Condyle Complications

Nonunion

Most common serious complication due to synovial fluid

Ulnar nerve palsy (tardy)

Delayed onset due to progressive cubitus valgus

Tilted (cubitus valgus)

Angular deformity from lateral physeal arrest

Stiffness

From prolonged immobilization or malunion

Memory Hook:Don't go NUTS - treat lateral condyle fractures properly!

Mnemonic

STAY ANTERIORSurgical Approach

Stay anterior and lateral

Lateral Kocher approach

Avoid posterior dissection

Posterior blood supply to fragment

Memory Hook:STAY ANTERIOR - blood supply from posterior, don't strip it!

Overview and Epidemiology

Why This Fracture Matters

The lateral condyle fracture is the second most common pediatric elbow fracture (after supracondylar) but has a higher complication rate. It is intra-articular, prone to nonunion, and can lead to progressive cubitus valgus and tardy ulnar nerve palsy.

Epidemiology

15% of pediatric elbow fractures
Second only to supracondylar
Peak age 5-7 years
Slight male predominance
Usually fall onto outstretched hand

Anatomy Involved

Lateral condyle (capitellum + part of lateral trochlea)
Extends through articular surface
Physis involved (Salter-Harris pattern)
Lateral collateral ligament attaches to fragment

Anatomy and Biomechanics

Blood Supply - Do Not Strip Posterior

The blood supply to the lateral condyle enters posteriorly. During ORIF, do NOT dissect or strip the soft tissues from the posterior aspect of the fragment. Use an anterior/lateral approach and visualize the articular surface from the front.

Key Anatomical Points

The lateral condyle includes:

Capitellum (articulates with radial head)
Lateral portion of trochlea (variable extent)
Lateral epicondyle (common extensor origin)

Blood supply: Enters posteriorly. The fragment has NO anterior blood supply once fractured. Protect posterior soft tissues during surgery.

Deforming forces: Extensor muscles (attached to lateral epicondyle) pull the fragment distally and rotate it, causing displacement.

Classification Systems

Weiss/Jakob Classification (Most Clinically Useful)

Type	Displacement	Description	Treatment
Type I	Less than 2mm	Minimally displaced, cartilage hinge intact	Long arm cast 90°, weekly XR x3
Type II	2-4mm	Partial articular disruption, some contact	ORIF with K-wires
Type III	Greater than 4mm	Complete displacement, no articular contact	ORIF with K-wires

This classification is more practical for guiding treatment than Milch.

Clinical Assessment

History

Fall mechanism (FOOSH with varus stress)
Time since injury
Any swelling or deformity
Neurovascular symptoms
Previous elbow injury

Examination

Lateral elbow swelling and tenderness
Ecchymosis (may be extensive)
Full neurovascular exam
Check elbow stability (compare to opposite)
ROM likely limited by pain

Differential Diagnosis

In young children, the lateral condyle may not be ossified (appears around age 1-2). An effusion (fat pad sign) with lateral tenderness but no visible fracture on X-ray suggests an occult lateral condyle fracture. Consider MRI or arthrogram, or treat as a fracture and follow closely.

Investigations

Radiological Investigations

View	What to Check	Key Finding
AP elbow	Fragment size and displacement	Measure gap on AP
Lateral elbow	Rotation of fragment	Fragment often rotates posteriorly
Internal oblique	Better visualization of fracture	45° internal rotation
Comparison views	Opposite elbow	Helps in young children

Internal oblique view is particularly helpful as it places the fracture line in profile.

Management

Greater than 2mm = ORIF

The threshold for surgery is greater than 2mm displacement. Some authors are more aggressive and operate on any fracture greater than 2mm on ANY view. Non-operative fractures need weekly X-rays for 3 weeks as they can displace in cast.

Non-Operative Management (Weiss Type I)

Indications: Displacement less than 2mm, intact cartilage hinge.

Treatment: Long arm cast in 90 degrees elbow flexion.

Follow-up: Weekly X-rays for first 3 weeks. If any displacement occurs, convert to ORIF.

Duration: Cast for 4-6 weeks until union confirmed.

Key point: Close follow-up is mandatory. Up to 20% of initially non-displaced fractures may displace.

Screws vs K-wires

Traditional fixation is with smooth K-wires to avoid physeal injury. Some surgeons use a cannulated screw in older children (near skeletal maturity) for more stable fixation. Screws should NOT cross the physis in young children.

Surgical Technique Considerations

ORIF Technique for Lateral Condyle

Position: Supine with arm on hand table.

Approach: Lateral/Kocher interval between anconeus and ECU.

Critical step: Visualize the articular surface from ANTERIOR. Do NOT strip soft tissues from posterior fragment.

Reduction: Reduce articular surface anatomically. The metaphyseal reduction usually follows.

Fixation: Two smooth K-wires, usually 1.6mm. Divergent configuration. Cross fracture site but avoid olecranon fossa.

Complications

Complications of Pediatric Lateral Condyle Fractures

Complication	Incidence	Cause	Management
Nonunion	Most serious	Synovial fluid, inadequate fixation	ORIF if early, osteotomy if late
Cubitus valgus	Common with nonunion	Lateral physeal arrest	Osteotomy if symptomatic
Tardy ulnar nerve palsy	Delayed (years)	Progressive valgus stretches nerve	Ulnar nerve transposition
Stiffness	Common	Prolonged immobilization	Physiotherapy, rarely need release
AVN	Rare	Posterior soft tissue stripping	Prevention - protect blood supply
Malunion	With late reduction	Missed or delayed diagnosis	Osteotomy if functional limitation

Tardy Ulnar Nerve Palsy

Tardy ulnar nerve palsy is a delayed complication occurring years after the original injury. It develops because nonunion leads to cubitus valgus, which progressively stretches the ulnar nerve around the medial epicondyle. Treatment is ulnar nerve transposition (often anterior subcutaneous) and may require corrective osteotomy.

Postoperative Care

Post-Operative Protocol

Day 0-1Immediate Post-Op

Long arm backslab in 90 degrees elbow flexion. Neurovascular checks. Elevate and ice.

Week 1-2First Follow-Up

Check wound and pin sites. X-ray to confirm maintained reduction. Convert to long arm cast.

Week 4Assess Union

X-ray to assess healing. If good callus, may remove pins (in clinic). Continue cast.

Week 6Cast Removal

X-ray confirms union. Remove cast. Begin active ROM exercises. Avoid passive stretching.

Month 3-6Recovery

Full return to activities. Final check of motion, alignment, carrying angle. Follow long-term if any concern.

Outcomes and Prognosis

Prognosis Depends on Prompt Diagnosis and Treatment

Good outcomes when:

Fracture recognized early
Displacement greater than 2mm treated surgically
Anatomic articular reduction achieved
Union confirmed before discharge from follow-up

Poor outcomes when:

Diagnosis delayed
Fracture displaces in cast and missed
Nonunion develops

Special Considerations

Management of Nonunion

Early nonunion (less than 3-6 months): ORIF with bone grafting still possible. Better outcomes than late reconstruction.

Established nonunion (greater than 6 months): In situ fixation with bone grafting or corrective osteotomy. The nonunion may be too sclerotic for direct healing without osteotomy.

Late nonunion with cubitus valgus: May require supracondylar osteotomy for angular correction plus ulnar nerve transposition.

Evidence Base and Key Studies

Bauer et al. - Lateral Condyle Fractures

Bauer et al. • J Pediatr Orthop (2004)

Key Findings:

Reviewed outcomes of pediatric lateral condyle fractures
Greater than 2mm displacement associated with higher nonunion rate
ORIF for displaced fractures yielded good outcomes
Close follow-up essential for non-op cases

Clinical Implication: The 2mm threshold is supported by outcome data. Displaced fractures need ORIF.

Limitation: Retrospective; variable follow-up.

Jakob et al. - Classification and Treatment

Jakob et al. • J Pediatr Orthop (1975)

Key Findings:

Described the Weiss/Jakob classification
Type I can be treated non-operatively
Type II-III require ORIF
Emphasized importance of weekly XR follow-up

Clinical Implication: Classification guides treatment - Type I vs Type II-III is the key distinction.

Limitation: Original descriptive paper.

Dhillon et al. - Nonunion Management

Dhillon et al. • J Pediatr Orthop (2012)

Key Findings:

Outcomes of late presenting lateral condyle fractures
Early intervention better than late
In situ fixation can be considered for late cases
Cubitus valgus correction may be needed

Clinical Implication: Early fixation of nonunion is better. Late cases may need staged reconstruction.

Limitation: Small numbers; single center.

Hasler et al. - K-wire vs Screw Fixation

Hasler et al. • J Pediatr Orthop (2007)

Key Findings:

Compared K-wire and screw fixation
Both methods effective
K-wires preferred in young children (physis open)
Screws may be used in older children

Clinical Implication: K-wires remain standard in young children; screws may be considered near skeletal maturity.

Limitation: Non-randomized.

Tejwani et al. - Tardy Ulnar Nerve Palsy

Tejwani et al. • J Am Acad Orthop Surg (2006)

Key Findings:

Review of tardy ulnar nerve palsy mechanism
Progressive cubitus valgus stretches nerve
Treatment is anterior transposition
May need osteotomy for valgus correction

Clinical Implication: Prevent tardy ulnar palsy by treating lateral condyle fractures properly initially.

Limitation: Review article.

Exam Viva Scenarios

Practice these scenarios to excel in your viva examination

VIVA SCENARIOStandard

Scenario 1: Displaced Lateral Condyle Fracture

EXAMINER

"A 6-year-old child presents after a fall with lateral elbow pain and swelling. X-rays show a lateral condyle fracture with 3mm displacement. How would you manage this?"

EXCEPTIONAL ANSWER

This is a displaced lateral condyle fracture in a 6-year-old child. With 3mm displacement, this falls into the Weiss Type II category, which requires operative management. The key principle here is that this is an intra-articular fracture, and displacement greater than 2mm is associated with nonunion and malunion. My management would be to take this child to the operating room for open reduction and internal fixation. The approach is a lateral Kocher approach. Critically, I would stay anterior and NOT strip soft tissues from the posterior aspect of the fragment as the blood supply enters posteriorly. I would directly visualize the articular surface to confirm anatomic reduction. I would fix with 2 divergent smooth K-wires, typically 1.6mm, crossing the fracture but avoiding the olecranon fossa. Post-operatively, I would apply a long arm backslab in 90 degrees elbow flexion. I would follow up at 1 week to check the wound and confirm maintained reduction on X-ray. I would remove wires at around 4 weeks and continue cast until 6 weeks when union should be confirmed. I would explain to the family that this fracture has a risk of nonunion due to the synovial environment, and that close follow-up is important. Long-term, I would monitor for cubitus valgus and tardy ulnar nerve palsy.

KEY POINTS TO SCORE

3mm displacement = Weiss Type II = ORIF

Intra-articular fracture, anatomic reduction required

Lateral approach, do NOT strip posterior soft tissues

Fix with 2 divergent K-wires

Monitor for nonunion and cubitus valgus

COMMON TRAPS

✗Attempting non-operative treatment for 3mm displacement

✗Stripping posterior soft tissues (AVN risk)

✗Using screws across physis in young child

✗Not warning about nonunion risk

✗Not planning appropriate follow-up

LIKELY FOLLOW-UPS

"What if this was a 14-year-old?"

"How would you manage a nonunion presenting at 6 months?"

"What is tardy ulnar nerve palsy?"

VIVA SCENARIOChallenging

Scenario 2: Late Presentation Nonunion

EXAMINER

"A 10-year-old presents 4 months after a fall. He was treated at another hospital with casting. He now has an established nonunion of the lateral condyle with 15 degrees of cubitus valgus. There is no ulnar nerve dysfunction. How would you manage this?"

EXCEPTIONAL ANSWER

This is an established lateral condyle nonunion presenting 4 months after injury with 15 degrees of cubitus valgus but no ulnar nerve symptoms. This is a challenging scenario. My assessment would include a thorough clinical examination including carrying angle (comparing to opposite side), range of motion, and ulnar nerve function (intrinsics, sensation). I would obtain X-rays and possibly CT to assess the nonunion site, any sclerosis, and the degree of malunion. My management options include: 1) In situ fixation with bone grafting if the fragment can be reduced without excessive manipulation - this may require opening the nonunion site, removing fibrous tissue, and grafting. 2) If the fragment is fibrosed in a significantly malpositioned location and the articular surface cannot be restored, I might accept the position and address only the angular deformity with a supracondylar osteotomy later if needed. At 15 degrees of valgus without ulnar symptoms, I would counsel the family that the deformity is likely to progress slightly as the child grows due to lateral physeal arrest. I would monitor for tardy ulnar nerve palsy, which may take years to develop. If the family is very concerned about the valgus, supracondylar corrective osteotomy could be considered. Currently, with no functional limitation and no nerve symptoms, I would favour observation with regular follow-up. I would explain that ulnar nerve transposition might be needed in the future if symptoms develop.

KEY POINTS TO SCORE

4 months = established nonunion

Options: in situ fixation or accept and address deformity later

15° valgus with no ulnar symptoms = can observe

Monitor for progressive valgus and tardy ulnar nerve palsy

May need supracondylar osteotomy and/or nerve transposition later

COMMON TRAPS

✗Aggressive open reduction that risks AVN

✗Not counseling about progressive valgus

✗Forgetting about tardy ulnar nerve palsy

✗Promising full correction of deformity

✗Not comparing to opposite side

LIKELY FOLLOW-UPS

"What if there was ulnar nerve dysfunction?"

"What is your threshold for supracondylar osteotomy?"

"How would you manage if the nonunion was only 3 weeks old?"

VIVA SCENARIOStandard

Scenario 3: Minimally Displaced Fracture - Non-Op

EXAMINER

"A 5-year-old child presents with a lateral condyle fracture with 1.5mm displacement on the AP view and no displacement on the lateral view. How would you manage this?"

EXCEPTIONAL ANSWER

This is a Weiss Type I lateral condyle fracture with less than 2mm displacement. In principle, this can be managed non-operatively, but close follow-up is mandatory because up to 20% of these fractures can displace in cast. My management would be to apply a long arm cast in 90 degrees elbow flexion. I would arrange weekly X-rays for at least the first 3 weeks. If there is any displacement beyond 2mm on follow-up, I would convert to operative management. I would counsel the family that while we are managing this without surgery initially, there is a risk the fracture may displace in the cast and require an operation. At 3 weeks, if the fracture remains in acceptable position, I would continue the cast until 5-6 weeks when we would X-ray to confirm union. I would explain the importance of attending all follow-up appointments. The reason for this vigilance is that nonunion and malunion of lateral condyle fractures can lead to serious late complications including cubitus valgus and tardy ulnar nerve palsy.

KEY POINTS TO SCORE

1.5mm = Weiss Type I = can try non-operative

Long arm cast in 90° flexion

Weekly X-rays for first 3 weeks mandatory

Convert to ORIF if displaces beyond 2mm

Explain risk of displacement to family

COMMON TRAPS

✗Not arranging weekly X-ray follow-up

✗Not warning about displacement risk (up to 20%)

✗Not converting to surgery if it displaces

✗Discharging too early before confirming healing

✗Not explaining consequences of missed displacement

LIKELY FOLLOW-UPS

"What if it displaces?"

"Would your management differ if this was 3mm?"

"What are the long-term complications of untreated lateral condyle fractures?"

MCQ Practice Points

Displacement Threshold Question

Q: What is the displacement threshold for ORIF of pediatric lateral condyle fractures? A: 2mm. Greater than 2mm displacement, or any rotation of the fragment, requires ORIF. Less than 2mm can be treated non-operatively with close follow-up.

Classification Question

Q: In the Milch classification, what distinguishes Type I from Type II lateral condyle fractures? A: Exit point relative to trochlear ridge. Type I exits LATERAL to the trochlear ridge (elbow stable). Type II exits THROUGH the trochlear ridge (elbow potentially unstable). Type II is more common.

Blood Supply Question

Q: Why should posterior soft tissue stripping be avoided during ORIF of lateral condyle fractures? A: Blood supply enters posteriorly. The blood supply to the lateral condyle fragment comes from posterior. Stripping posterior soft tissues risks avascular necrosis.

Nonunion Cause Question

Q: Why is lateral condyle fracture at high risk of nonunion? A: Synovial fluid bathes the fracture. The intra-articular location means synovial fluid prevents hematoma formation and bone healing. This is compounded by the deforming force of the extensor muscles.

Tardy Ulnar Nerve Question

Q: What is tardy ulnar nerve palsy and how does it relate to lateral condyle fractures? A: Delayed ulnar neuropathy due to progressive cubitus valgus. Nonunion leads to lateral physeal arrest and valgus deformity, which stretches the ulnar nerve over years. Treatment is transposition.

Fixation Question

Q: What is the standard fixation for pediatric lateral condyle fractures? A: 2 divergent smooth K-wires. This avoids physeal damage. Screws may be considered in older children near skeletal maturity.

Australian Context

Clinical Practice

Common pediatric elbow fracture
Most tertiary centers manage these
ORIF is standard for displaced fractures
K-wire fixation is the norm

Follow-Up

Close follow-up emphasized for non-op cases
Weekly X-rays for first 3 weeks
Long-term monitoring for angular deformity
Patient education about tardy ulnar palsy

LATERAL CONDYLE FRACTURES - PEDIATRIC

High-Yield Exam Summary

Key Facts

•15% of pediatric elbow fractures (2nd most common)
•INTRA-ARTICULAR fracture
•High nonunion risk (synovial fluid)
•Blood supply from posterior - do NOT strip

Management

•Less than 2mm: cast with weekly XR
•Greater than 2mm: ORIF
•Fix with 2 divergent K-wires
•Lateral approach, stay ANTERIOR

Classification

•Weiss I: less than 2mm - non-op
•Weiss II: 2-4mm - ORIF
•Weiss III: greater than 4mm - ORIF
•Milch I: lateral to trochlear ridge

Complications - NUTS

•Nonunion (most common serious)
•Ulnar nerve palsy (tardy - years later)
•Tilted (cubitus valgus)
•Stiffness

Key Surgical Points

•Lateral approach, stay ANTERIOR
•Visualize articular surface
•2 divergent smooth K-wires
•Do NOT strip posterior soft tissues

Type

Displacement

Articular Step

Treatment

Weiss Type I

Less than 2mm

Intact cartilage hinge

Cast, weekly XR for 3 weeks

Weiss Type II

2-4mm

Gap but some contact

ORIF with K-wires

Weiss Type III

Greater than 4mm

Complete articular disruption

ORIF with K-wires

Type

Displacement

Description

Treatment

Type I

Less than 2mm

Minimally displaced, cartilage hinge intact

Long arm cast 90°, weekly XR x3

Type II

2-4mm

Partial articular disruption, some contact

ORIF with K-wires

Type III

Greater than 4mm

Complete displacement, no articular contact

ORIF with K-wires

View

What to Check

Key Finding

AP elbow

Fragment size and displacement

Measure gap on AP

Lateral elbow

Rotation of fragment

Fragment often rotates posteriorly

Internal oblique

Better visualization of fracture

45° internal rotation

Comparison views

Opposite elbow

Helps in young children

Complication

Incidence

Cause

Management

Nonunion

Most serious

Synovial fluid, inadequate fixation

ORIF if early, osteotomy if late

Cubitus valgus

Common with nonunion

Lateral physeal arrest

Osteotomy if symptomatic

Tardy ulnar nerve palsy

Delayed (years)

Progressive valgus stretches nerve

Ulnar nerve transposition

Stiffness

Common

Prolonged immobilization

Physiotherapy, rarely need release

AVN

Rare

Posterior soft tissue stripping

Prevention - protect blood supply

Malunion

With late reduction

Missed or delayed diagnosis

Osteotomy if functional limitation

Displacement Threshold Question

Classification Question

Blood Supply Question

Nonunion Cause Question

Tardy Ulnar Nerve Question

Fixation Question

Type	Fracture Exit	Equivalent	Stability
Type I	Lateral to trochlear ridge	Salter-Harris IV	Elbow stable
Type II	Through trochlear ridge	Salter-Harris II	Elbow potentially unstable

Lateral Condyle Fractures - Pediatric

Lateral Condyle Fractures - Pediatric

LATERAL CONDYLE FRACTURES - PEDIATRIC

WEISS/JAKOB CLASSIFICATION

Critical Must-Knows

Examiner's Pearls

Clinical Imaging

Imaging Gallery

Critical Exam Concepts

Intra-Articular Fracture

The 2mm Rule

High Nonunion Risk

Tardy Ulnar Nerve Palsy

Quick Decision Guide

1 OUT, 2 THROUGHMilch Classification

NUTSLateral Condyle Complications

STAY ANTERIORSurgical Approach

Overview and Epidemiology

Epidemiology

Anatomy Involved

Anatomy and Biomechanics

Blood Supply - Do Not Strip Posterior

Key Anatomical Points

Fracture Configuration

Classification Systems

Weiss/Jakob Classification (Most Clinically Useful)

Milch Classification (Anatomical)

Clinical Assessment

History

Examination

Investigations

Radiological Investigations

MRI and Arthrography

Management

Greater than 2mm = ORIF

Non-Operative Management (Weiss Type I)

Operative Management (Weiss Type II-III)

Surgical Technique Considerations

ORIF Technique for Lateral Condyle

Percutaneous Pinning

Complications

Complications of Pediatric Lateral Condyle Fractures

Postoperative Care

Post-Operative Protocol

Outcomes and Prognosis

Prognosis Depends on Prompt Diagnosis and Treatment

Special Considerations

Management of Nonunion

Cubitus Valgus Management

Late Presenting Fractures

Evidence Base and Key Studies

Bauer et al. - Lateral Condyle Fractures

Jakob et al. - Classification and Treatment

Dhillon et al. - Nonunion Management

Hasler et al. - K-wire vs Screw Fixation

Tejwani et al. - Tardy Ulnar Nerve Palsy

Exam Viva Scenarios

Scenario 1: Displaced Lateral Condyle Fracture

Scenario 2: Late Presentation Nonunion

Scenario 3: Minimally Displaced Fracture - Non-Op

MCQ Practice Points

Australian Context

Clinical Practice

Follow-Up

LATERAL CONDYLE FRACTURES - PEDIATRIC

Key Facts

Management

Classification

Complications - NUTS

Key Surgical Points

Lateral Condyle Fractures - Pediatric

Lateral Condyle Fractures - Pediatric

LATERAL CONDYLE FRACTURES - PEDIATRIC

WEISS/JAKOB CLASSIFICATION

Critical Must-Knows

Examiner's Pearls

Clinical Imaging

Imaging Gallery

Critical Exam Concepts

Intra-Articular Fracture