Case report demonstrates spontaneous restoration of elbow flexion following malunion in a pediatric patient, suggesting conservative observation may permit substantial functional joint remodeling.
CASE: A 4-year-old boy developed malunion after open reduction and internal fixation (ORIF) of a rare lateral condylar humeral fracture running from the lateral humerus, through the trochlear cartilage, to the medial trochlea. Five months after ORIF, the active elbow flexion was limited to 50°. Magnetic resonance imaging (MRI) showed a step-off of the anterior trochlear cartilage, causing the limited flexion. After conservative observation for 5 years, the flexion improved to 135° and MRI showed that the step-off had disappeared. CONCLUSION: This case indicates that it is possible for pediatric patients to recover their range of motion following malunion of an elbow fracture.
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Matsui et al. (2024) studied this question.
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