Osteosynthesis for nonunion of the lateral humeral condyle

The treatment of established nonunion of the lateral humeral condyle is controversial. Twenty patients who had osteosynthesis of the nonunion were evaluated to clarify the changes in range of motion and the factors influencing those changes. The average age of the patients at surgery was 13.6 years (range, 6-25 years). The average duration of followup was 8.8 years. Outcome was rated as excellent in seven patients and good in 13 patients according to the score of Broberg and Morrey. In five of the 20 patients, the preoperative range of motion was limited and their motion improved an average of 35degrees as a result of surgery. In the remaining 15 patients, the range of motion did not change or was reduced an average of 19degrees postoperatively. Of the 15 patients, 11 had Milch Type II injuries and four had Milch Type I injuries. In the 11 patients with Milch Type II injuries, the loss of range of motion postoperatively averaged 13degrees. However, in the four patients with Milch Type I injuries, loss of range of motion postoperatively averaged 21degrees. Complications such as delayed union, nonunion, or infection occurred in five patients. The main factors influencing the results of osteosynthesis are the age of the patient, the preoperative symptoms, and the postoperative complications.