Transphyseal Distal Humerus Fracture

Abstract

The Transphyseal Distal Humerus Fracture is a true Salter–Harris type I distal humerus epiphysiolisis, and it is a very rare trauma lesion usually occurring under the age of 2–3 years old. It is difficult to analyze the x-rays at this age because the distal region of the humerus is still not ossified. Since it is not a frequent fracture, it is a must for physicians in charge of primary emergency health care to be aware of non-accidental injuries as an important cause to rule out. Other reasons for this fracture are a fall from bed from a small height and in a newborn with an history of difficult delivery. It is very common that primary care physicians as well as radiologists miss the diagnosis at first visit, so it is very important to carefully evaluate any swollen elbow in a very young child who may have or have not a clear history of recent trauma. A good result after proper treatment relies in an adequate diagnosis based first in standard plain radiographs taken in a strictly AP and lateral views; today it is recommended also to use ultrasound for the diagnosis. When the diagnosis is missed, it is likely that a cubitus varus may develop during follow up as the most frequent sequelae that will need a corrective surgery in future.