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. 2017 Jun;20(3):183-186.
doi: 10.1016/j.cjtee.2017.04.003. Epub 2017 Apr 14.

Transphyseal separation of the distal humerus in newborns

Cosimo Gigante  1 , Sunil Gurpur Kini  2 , Carlo Origo  3 , Andrea Volpin  1
Affiliations

Transphyseal separation of the distal humerus in newborns

Cosimo Gigante et al. Chin J Traumatol. 2017 Jun.

Abstract

Obstetric traumatic separation of the distal humeral epiphysis is a very uncommon injury, which presents a diagnostic challenge. These case serials reviewed the functional outcomes of 5 patients who had sustained a fracture-separation of the distal humeral epiphysis at birth. The diagnosis was made at a mean time of 40.8 h after delivery. All the patients were treated with gentle close manipulation, reduction under fluoroscopy and above-elbow cast application. After discharge, the patients were followed up for a mean of 30 months. Clinico-radiological results were excellent in four patients. One case necessitated closed reduction and percutaneous K-wire fixation at one week follow-up due to failed reduction. Cubitusvarus deformity was the only complication noted in 1 case. Good functional outcome can be expected in newborns with fracture-separation of the distal humeral epiphysis wherein the physis is anatomically reduced.

Keywords: Humerus; Infant, newborn; Separation of epiphysis.

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Figures

Fig. 1
Fig. 1
Radiographs of elbow in newborn can often be interpreted as normal.
Fig. 2
Fig. 2
Ultrasound examination of the same patient in Fig. 1, showing a displaced fracture of the distal physis.
Fig. 3
Fig. 3
Follow-up radiographs at one year.
Fig. 4
Fig. 4
Full range of movements at one year follow-up.
See this image and copyright information in PMC

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