History: Six-year-old girl with pain after falling.
Diagnosis: Lateral condyle fracture
Findings: There is a left lateral condylar fracture, with anterior fat pad sign. Fragment is less than 2 mm displaced. Radial head is in place.
The lateral condyle typically ossifies at the age of ten years. At age six, as with this case, a lateral condylar fragment that looks like an ossification center (articulating with the radial head) cannot be an ossification center.
This type of fracture is considered a Salter-Harris type IV fracture.
Here are the follow-up x-rays both 3 and 6 weeks later
Followup imaging reveals bony bridging compatible with healing.Key points about lateral condyle fracture:
- Second most common pediatric elbow fracture (15%).
- Seen most often from age 4 to 10, peak incidence at age 6.
- Usually related fall on an outstretched hand with the elbow extended and the forearm abducted.
- Considered to be a Salter-Harris 4 injury.
- Stage or type 1 fractures with less than 2 mm displacement can be treated with immobilization.
- Open reduction recommended for all type 2 or 3 fractures.
- Easily missed if thought to represent a normal ossification center. The lateral condyle does NOT ossify until age 10.
