Distal humeral fractures

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QUESTION 1 OF 1

A 9-year-old girl has fallen from monkey bars and landed on her hand. Radiographs demonstrate a lateral condyle distal humerus fracture with 5mm displacement and rotation with extension into the trochlear groove.
Which management approach will give her the best outcome?

QUESTION ID: 1085

1. A. A closed reduction of the fracture with the arm in an above elbow cast with the forearm in neutral rotation.
2. B. Exposure via a lateral approach viewing the reduction of the joint anteriorly and then 2 divergent Kirshner wires for stabilisation. Removal of the wires in 4-6 weeks’ time in clinic and follow up over 2 years.
3. C. Exposure via a lateral approach viewing the reduction of the joint posteriorly and then 2 divergent Kirshner wires for stabilisation. Removal of the wires in 4-6 weeks’ time in clinic and follow up over 2 years.
4. D. Exposure via a lateral approach viewing the reduction of the joint anteriorly and then 2 convergent Kirshner wires for stabilisation. Removal of the wires in 4-6 weeks time in clinic and follow up over 2 years.
5. E. Exposure via posterior approach to the distal humerus and reducing the fracture with direct visualisation of the joint surface. Once reduced place 2 divergent Kirschner wires for fixation. Removal of the wires in 4-6 weeks’ time in clinic and follow up over 2 years.
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