Closed reduction and percutaneous stabilization of pediatric T-condylar fractures of the humerus

T-condylar fractures of the humerus are a rare fracture pattern in children. The usual recommendation is to treat them with open reduction and internal fixation, in accordance to the usual practice in adult fracture patterns. This involves extensive surgical approach to the elbow to allow anatomic reduction and placement of hardware for rigid fixation. The authors present a technique of closed reduction of the intra-articular component of the T-condylar fracture that is stabilized with partially threaded pins that afford interfragmentary compression, followed by the use of two elastic titanium intramedullary nails to stabilize the supracondylar component of the fracture as well. Two adolescents (12 and 14 years of age) with a T-condylar elbow fracture were treated, with the described technique. Both fractures healed without complications. Hardware was removed in the outpatient clinic after 4 weeks, and both patients returned to sports with full range of elbow motion 6 weeks postoperatively.