Incidence
Occurs 10% of supracondylar humeral fractures
- varus malunion
Lateral condyle fracture
- AVN trochlea
Growth arrest of medial aspect physis
- rare
- post traumatic
Effects
Usually little functional defect
Cosmetic problem
- appearance can be unacceptable to parents and child
NHx
Does not correct with time
Operative Management
1. Lateral closing wedge osteotomy of the supracondylar region
- perform at skeletal maturity
- metaphyseal not diaphyseal
- preserve medial cortex
- beware abnormal position of radial nerve (passes through callous)
- 1mm of wedge for each degree
- fixation with plate
2. Complex Osteotomies
- posterior approach
- bilateral plates
- for severe deformities
3. Young patient / open physis
- guided growth
- application lateral 8 plate