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Orthopaedics Management In Orthopedics 353b3455

An open reduction and internal fixation (ORIF) is definitely required in a child with:

A
Intercondylar fracture femur
B
Lateral condylar fracture humerus
C
both bones forearm
D
Epiphyseal separation
High-Yield Explanation
Ans: B (Lateral condylar fracture humerus) Ref: Campbell's Operative Orthopaedics, 11th edition and Apley's System of Orthopaedics and Fractures. 9th editionExplanation:Forearm fractures in children are extra-articular injuries and can be managed conservatively with plaster after closed reduction of the fracture.All displaced physeal injuries demand anatomical reduction and internal fixation to avoid the complication of transphyseal bridging or altered growth.Reduction prior to internal fixation can be done with closed manipulation or by open surgery, the determinant being achievement of anatomical reduction.Intercondylar fractures of the femur may be amenable to closed reduction, whereas lateral condyle fractures of the humerus are difficult to assess and reduce closed.St is difficult to determine the amount of displacement of lateral condyle humerus fractures; when doubt exists, the fracture should be treated as displaced.Benign nondisplaced fractures of the lateral humeral condyle have known to be completely displaced at 1 week after casting, requiring open reduction and internal fixation.Lateral condylar fractures are notorious for complications - non-union, cubitus valgus, tardy ulnar nerve palsy.Closed treatment is often unsatisfactory and open reduction and internal fixation for lateral condyle humerus fractures are recommended -- hence the term "fracture of necessity".

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