gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Article

Send article

Clinical Manifestation of Symptomatic Fishtail Deformity

Meeting Abstract

Search Medline for

  • presenting/speaker Emiko Horii - Kansai Medical University, Orthopaedic Dept, Hirakata, Japan
  • Yoshitaka Hamada - Kansai Medical University, Orthopaedic Dept, Hirakata, Japan
  • Katsu Toyama - Kansai Medical University, Orthopaedic Dept, Hirakata, Japan
  • Shukuki Koh - Japanese Red Cross Nagoya Daiichi, Nagoya, Japan
  • Junko Otuka - Japanese Red Cross Nagoya Daiichi, Nagoya, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-221

doi: 10.3205/19ifssh0068, urn:nbn:de:0183-19ifssh00689

Published: February 6, 2020

© 2020 Horii et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objectives/Interrogation: Aseptic necrosis of the distal humerus seldom occurs after pediatric elbow trauma. We experienced five cases, then report clinical manifestation and their surgical outcomes.

Methods: Five cases included 4 boys and 1 girl with an average age of 11.8 years. Past history revealed that all patients had had elbow trauma at an average age of 4.5 years (range 3.0 - 7.4). Three cases of supracondylar fracture had been treated per-cutaneus pinning in two and another was conservatively. Two cases of lateral condyle fracture had been treated by open reduction and fixation. All of them had been dismissed because of smooth recovery. All patients returned clinic with elbow pain and restricted motion and X-rays showed fishtail deformity. One case was treated close observation with restriction of sports activity. Two cases with atypical medial condyle fracture were treated screw fixation. Other two cases which showed osteochondral dissecans of the capitellum were treated by osteochondral bone peg grafting.

Results and Conclusions: An average follow-up is 1.5 year. Range of motion improved in all patients. Pain was subsided all but one case which had shown the radial head subluxation preoperatively.

Regardless severity of the initial trauma, aseptic necrosis occurred after pediatric elbow trauma. It became symptomatic several years later and X-ray showed fish-tail deformity. Although short time outcomes were good, all elbows already showed osteoarthritic changes. There is no fundamental treatment for fish-tail deformity. Early detection of aseptic necrosis might prevent severe progress of fishtail deformity.