Displaced T-condylar and supracondylar fracture of the distal humerus

Case contributed by Mohammad A. ElBeialy
Diagnosis certain


History of fall.

Patient Data

Age: 40 years
Gender: Female

Condylar and supracondylar fracture of the elbow.

Comminuted T- condylar fracture of the left distal humerus is noted with intra-articular extension.  Posterior displacement of the distal fragment is seen in the sagittal plane; with mild lateral/valgus displacement and rotation noted in the coronal plane. No radial or ulnar fracture is noted. Soft tissue swelling is noted around the elbow. Mild joint effusion with likely lipohemarthrosis.

External fixation and pinning was done initially followed by open reduction and internal fixation with satisfactory alignment.

Case Discussion

Type III comminuted and displaced T-condylar and supracondylar fracture of the distal humerus.

T- or Y-condylar fractures of the distal humerus are very rare in children and rare in adults as well. They require a higher energy force than that is required in supracondylar fractures. The semilunar notch of the olecranon acts as a wedge during the axial load with a direct fall on the flexed elbow; this wedge splits the trochlea and the fracture line ascends through the central groove of the trochlea and goes up proximally to the supracondylar fracture line splitting or separating the medial and lateral condyles of the humerus.

Post-operative complication in this patient was stiffness of the elbow with mild tenderness and pain as well as limited range of movement in flexion and limited terminal end range extension.

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