MRI contribution in minimally displaced lateral humerus condylar fractures in children


Khaled Kamoun
Malek Ben Chaalia
Emna Labbène
Malek Zouari
Mouna Bouaziz
Mourad Jenzri


Introduction: Diagnosis and treatment of displaced humerus lateral condylar fracture is well codified with open reduction and pinning. For non-displaced or minimally displaced lateral condylar (NMDLC) fractures, diagnosis can be challenging because of cartilaginous structures none visualized on radiographs.
Aim: To determine the usefulness of MRI in evaluating articular extension of NMDLC fracture.
Methods: We reviewed consecutive NMDLC fractures during 6 years including children younger than 15 years old with displacement lesser than 2 mm (Rigault type I) at initial radiographs divided in two groups: only line fracture was viewed (R1a), displacement gap lesser than 2 mm (R1b). After elbow cast immobilization, children have got MRI. Surgery was performed in complete articular fractures. All children were seen after 1 mouth then at 6 month for elbow evaluation.
Results: Thirty-one fracture, including twenty-two (70.97%) boys. Average age was 6.24 years (3 to 11). Fifteen fractures was classified R1a and sixteen R1b .According to MRI, seven fractures (22,6%) were metaphyseal Gp1, eleven (35,5%) were metaphyso-epiphyseal with an intact hinge cartilage Gp2 ,nine (29%) were complete Salter IV Gp3 and MRI reveals a supracondylar fractures in four cases. Fracture was metaphyseal more often in R1a group (40.0%) compared to R1b (6.3%). Gp3 group was significantly higher in R1b (50.0%) compared to R1a group (6.7%)For the sixteen R1b cases, 8 presented articular cartilage involvement on MRI (Gp3) with concordant operative findings.
Conclusion: MRI is effective in assessing epiphyseal extension fracture providing accurate information for appropriate treatment


Lateral condyle, Elbow, Fracture, Children, MRI



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