This is a retrospective case cohort series. The purpose is to document the results of excision of unreconstructable lateral condyle fractures. Two patients with comminuted open fractures involving the lateral condyle were assessed. The patients underwent primary excision of the lateral condyle. Fracture fragments were excised, the competency of the medial collateral ligament was assessed with fluoroscopy, and post-operatively the patients were placed in thermoplastic splint for four weeks followed by rehabilitation. In both cases, patients had no instability and no discomfort after excision of these fragments.
The management of highly comminuted fractures involving the lateral condyle remains problematic. It is significant that in both of these patients, that the medial collateral ligament was found to be without injury and no valgus instability was noted. Another essential factor noted was an intact lateral trochlear ridge. The authors did demonstrate a patient without an intact lateral trochlear ridge who subsequently developed ulnohumeral subluxation. Lastly, in the presence of an interosseous membrane injury, migration of the radial head can occur and would result in forearm and wrist dysfunction (the Essex-Lopresti lesion).
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Journal of Shoulder and Elbow