Lateral Humeral Condyle Fracture eMedicine Orthopedics

Description: In 1883, Stimson first described the fracture patterns in lateral condyle fractures in his book Treatise on Fractures. He described the fracture as beginning in the lateral metaphysis proximal to the condyle, coursing distally, and exiting through the articular surface through the medial trochlear notch or through the capitellotrochlear groove. In 1955, Milch recognized the significance of these fracture patterns as they related to elbow stability. Thus, the fracture patterns of the lateral condyle bear his name and are classified as either Milch I or Milch II fractures.
Problem The distal humerus is primarily cartilage at the age when these injuries typically occur, and knowledge of the secondary centers of ossification is necessary to understand the possible fracture patterns. Due to incomplete ossification, the fracture may appear subtle on radiographs as it courses through the cartilage anlage.
Author: Janos P Ertl, MD, Updated April 2010