Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4535
Peer-review started: March 17, 2020
First decision: July 25, 2020
Revised: July 31, 2020
Accepted: August 25, 2020
Article in press: August 25, 2020
Published online: October 6, 2020
Processing time: 194 Days and 18.8 Hours
Neonatal distal humeral physeal fractures are rare and difficult to diagnose. Thus, missed diagnoses and delayed healing are possible. Few studies have reported surgical treatment, because a callus may develop at the fracture site 5 d after the fracture, resulting in difficult reduction, and reduction of the limb may cause further physeal injury. Other surgical challenges include the provision of adequate anesthesia and complexity of the operation. However, without appropriate reduction and fixation, a varus elbow deformity may develop. Manual reduction and percutaneous pin fixation are ideal treatment options.
A 4-day-old neonate with left elbow pain accompanied by limited movement for 4 d was admitted, and diagnosed with delayed physeal fracture of the distal humerus based on physical examination, ultrasonography, and magnetic resonance imaging. The patient was treated by manual reduction combined with percutaneous pin fixation under arthrography. Postoperatively, the reduction was successful. The upper limbs could have been lifted and the fingers could have been moved freely on the second day after the operation.
The techniques of manual reduction and percutaneous pin fixation, to treat neonatal distal humeral physeal fractures, are safe and reliable.
Core Tip: Physeal fractures of the distal humerus are rare in the neonate, and can be easily missed or misdiagnosed. Only a few reports of the management of such cases exist. Early diagnosis and treatment can be challenging. In this article, we present the case of a 4-day-old neonate with a left distal humeral physeal fracture, and introduce the use of manual reduction and percutaneous pin fixation under arthrography. Excellent results were achieved in this case. The techniques are an ideal treatment for this injury.