Transepiphyseal Separation of Distal Humerus in Young Children: An Often-Missed Fracture – A Case Report

Abstract

Background: Transphyseal fracture of the distal humerus (TFDH) is a rare injury in young children. Clinical and radiological examinations can be unclear, leading to delayed diagnosis. The absence of the ossification center of the capitellum complicates the radiological diagnosis and is often reported as an elbow dislocation. Case Report: A 1-year-old boy with a left elbow injury following a crush by a cart presented to our department with polytrauma. Radiographs showed a medial displacement of the radius and ulna relative to the humerus with a metaphyseal spike, suggestive of TFDH. Surgical reduction and fixation with Kirschner wires were performed, with good recovery at 6 months. Conclusion: Awareness of TFDH is crucial for proper diagnosis. Radiographic findings of posteromedial displacement suggest TFDH, which can be confirmed with ultrasound.