Dissolution of the Trochlea After Supracondylar Fracture of the Humerus in Childhood

Dissolution of the trochlea is seldom described as a complication of fractures of the distal end of the humerus in children. We report 6 cases of fishtail deformity after displaced supracondylar fractures of the humerus in children. The age at time of fracture was from 4 years 6 months to 6 years 11 months. The fractures were treated by closed reduction and pin fixation in good position. Diagnosis of fishtail deformity was made between 7 months and 4.5 years postinjury. Five patients complained of pain, cracking, and stiffness. The 6 cases reported here support anatomical studies and previous literature that proposed a vascular etiology of fishtail deformity (osteonecrosis of the lateral ossification center of the trochlea).