High T intercondylar fracture of the distal humerus in a 5 year old child: Case report

Abstract

Introduction: Intercondylar fracture of distal humerus is a rare paediatric orthopaedic entity. Only 55 cases of such fracture pattern have been reported. The aim is to add data to the scarce pre-existing literature and to discuss management guidelines. Case summary: We hereby present a case report of a 5 year old child who sustained a road traffic accident, injuring his right elbow. The X-ray revealed intercondylar fracture of distal humerus (High T type) with comminution of the olecranon fossa, the fractured medial and the lateral columns were rotated. Open reduction and internal fixation was performed using posterior approach. The medial and the lateral columns were reduced to the shaft and fixed with K-wires. The condyles were then fixed to each other using a transversely placed threaded K-wire. Above elbow slab was given to the patient for 4 weeks. The slab was then removed and elbow range of motion exercise started. Results: After one year of follow up, the Range of motion of elbow was 10 degrees to 130 degrees and no deficit in supination or pronation as compared to the contralateral side. Conclusion: Intercondylar fracture humerus is a rare injury in children. Proper radiograph including oblique views should be taken to prevent misdiagnosis. These fractured are to be managed by open reduction and internal fixation using K-wires for better results.