MANUAL MINORS
Fractures of the medial and lateral condyles involve the bony prominences on the distal humerus where it articulates with the forearm bones (radius and ulna). These fractures are less common than supracondylar fractures and typically result from direct trauma or force transmitted through the elbow. Lateral condyle fractures are more common, especially in children, while medial condyle fractures are rarer but more unstable.
Diagnosis
Diagnosis is based on a history of trauma, such as a fall onto the arm or a direct blow to the elbow. Patients present with pain, swelling, and limited mobility in the elbow joint. Anteroposterior and lateral X-rays confirm the fracture, and in some cases, a CT scan is necessary to better assess displacement and joint involvement. Lateral condyle fractures are more easily visualised on X-rays, while medial condyle fractures may be harder to identify.
Differential Diagnosis
Condition | Characteristics |
|---|---|
Supracondylar fracture | Occurs just above the condyles, with visible displacement. |
Radial head fracture | Pain in the radial head, common in adults. |
Epicondylitis | Chronic pain without trauma, affecting the tendons of the extensor or flexor muscles. |
Elbow dislocation | Deformity and loss of joint alignment, abnormal mobility. |
Olecranon fracture | Pain and deformity in the posterior elbow, with limited mobility. |
Emergency Management
In emergency management, the affected arm is immobilised with a splint to prevent movement and reduce pain. Analgesics and anti-inflammatory medications are administered to control pain.
A thorough neurological and vascular examination is crucial to assess potential nerve or vessel injury. Displaced fractures require urgent reduction, either closed or open, depending on the fracture’s stability and joint involvement.
Definitive Treatment
Definitive treatment depends on the degree of displacement. Non-displaced fractures can be managed conservatively with immobilisation for 4 to 6 weeks. Displaced fractures, especially those affecting the joint surface, require open surgical reduction and internal fixation with screws or pins to restore anatomical alignment and prevent long-term complications such as arthritis or loss of mobility. Physiotherapy is essential during recovery to restore elbow function.
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