ORIGINAL PAPER Paediatric lateral humeral condylar fracture outcomes at twelve years follow-up as compared with age and sex matched paired controls Juha-Jaakko Sinikumpu 1 & Tytti Pokka 1 & Sarita Victorzon 2 & Eija-Leena Lindholm 3 & Willy Serlo 1 Received: 3 August 2016 /Accepted: 13 March 2017 /Published online: 8 April 2017 # SICOT aisbl 2017 Abstract Introduction Lateral humeral condylar fractures are the sec- ond most common elbow fractures in children. We present the long-term clinical and radiographic results. Material and methods All children (<16 years) in the geo- graphic catchment area with lateral condylar fracture were asked to participate and 32 (76.2%) patients enrolled. Clinical and functional results are compared with randomly selected but age and sex matched normal controls at 12.4 years (range 10.6 to 16.0). Results Unsatisfactory clinical outcomes were found in 40.6% of the fracture cases vs. 6.3% controls (P = 0.003), according to Flynn’ s criteria. Flexion-extension range of mo- tion was decreased >5° in 13 cases (40.6%) and in four con- trols (12.5%, P = 0.013). One in four (N = 8, 25%) of the cases showed cubitus varus >5° and 15.7% (N = 5) had cubitus val- gus >5°, compared to one cubitus valgus (3.1%) in controls (P = 0.002). Conclusion The majority of the adolescent and young adult patients (59.4%) with a previous paediatric lateral humeral condylar fracture had recovered well and showed good or excellent overall outcomes according to Flynn’ s criteria for elbow assessment after a mean of 12.4 years post-injury. Long-term sequelae was unchanged regardless of treatment. Keywords Long-term outcome . Children . Humeral fracture . Lateral condyle Introduction Lateral humeral condylar fractures are the second most com- mon paediatric elbow fracture after supracondylar humeral fractures [1, 2]. It comprises about 10–20% of all childhood elbow fractures having the annual incidence of 1.6/10,000 [3–5]. Injuries to the elbow are becoming increasingly common [6], partly because of the increasing number of young athletes participating in highly competitive athletics [7]. The mecha- nism of injury includes either avulsion forces from the lateral ligaments with the elbow extended, or impaction of the radius on the capitellum after a fall on an outstretched arm [8]. Diagnosis is made based on radiographs and it may be difficult in children [9]. Non-displaced and stable fractures may be treat- ed by cast immobilization with close follow-up, but fractures displaced >2 to 3 mm may indicate surgical fixation [10, 11]. Many complications are known to be associated with child- hood lateral condylar humeral fractures, with poor outcomes often related to delayed or inadequate initial treatment [9, 12]. Lateral humeral condylar fractures are the most common in- juries that involve the growth line around the elbow region [13]. There are also intra-articular fractures, which may affect bone healing and the joint surface [14]. Lateral humeral con- dylar fractures more commonly result in a decreased range of movement than any other elbow fractures [15]. Up to 20% of patients with lateral condylar fracture show a cubitus varus deformity and >10% show a cubitus valgus deformity [16–18]. Cubitus varus is a potential finding even in non- displaced fractures and accurate fracture reduction will not always prevent a change in carrying angle [1, 19, 20]. Non- union is more frequently associated with lateral humeral * Juha-Jaakko Sinikumpu juha-jaakko.sinikumpu@ppshp.fi 1 Department of Children and Adolescents, Pediatric Surgery and Orthopedics, Oulu University Hospital, Oulu University, Medical Research Center Oulu, PEDEGO Research Group, P.o. BOX 23, FIN-90029 OYS Oulu, Finland 2 Department of Radiology, Vaasa Central Hospital, Vaasa, Finland 3 Department of Radiology, Oulu University Hospital, Oulu, Finland International Orthopaedics (SICOT) (2017) 41:1453–1461 DOI 10.1007/s00264-017-3451-0