Elbow Fractures Overview.

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Abstract

Conflict of interest statement: Disclosure: Muhammad Waseem declares no relevant financial relationships with ineligible companies. Disclosure: Wajeeha Saeed declares no relevant financial relationships with ineligible companies. Disclosure: Marjorie Launico declares no relevant financial relationships with ineligible companies. 3. J Pediatr Orthop. 2025 Oct 1;45(9):e804-e809. doi: 10.1097/BPO.0000000000003024. Epub 2025 Jun 2. Neonatal Physeal Fracture: What Treatment? Burnouf J(1), Budiartha L(1), du Cluzel de Remaurin X(1), Haumont E(1), Vinit N(1), Pannier S(1), Desailly E(2), Badina A(2). Author information: (1)Department of Pediatric Orthopedic Surgery, Université Paris Cité, Hôpital Universitaire Necker-Enfants Malades, Paris. (2)Fondation Ellen Poidatz, Pôle Recherche and Innovation, Saint-Fargeau-Ponthierry, France. BACKGROUND: The management of diaphyseal fractures in newborns is well established as conservative, involving immobilization without reduction. Newborn physeal fractures (NPF) are rarer lesions, and their management is poorly codified. In the literature, treatment varies from simple monitoring to surgical reduction and osteosynthesis. The aim of this study was to describe the long-term evolution of NPFs according to their location and initial management, and to establish treatment guidelines. METHODS: The first part of the study involved a systematic review of the literature according to PRISMA criteria. For the selected articles, patients were analyzed individually. For each patient, fracture location, time to treatment, type of treatment, and complications were recorded. Complications were classified as "minor" and "major." The second part of the study involved the collection of patients with NPF managed in our department. The same data were recorded. RESULTS: A total of 28 studies were selected. A total of 108 fractures (including 17 from our series) were analyzed. The most frequent locations were distal humerus (46%), proximal femur (27%), distal femur (13%), and proximal humerus (9%). Treatment was surgical for 17% of fractures. Considering the entire series, we found no significant relationship between the type of treatment and the complication rate. The most complication-prone site was the distal femur. However, these complications were primarily radiologic, with minimal clinical impact. They corrected progressively with growth. No patient required a long-term surgical procedure. No epiphysiodesis was reported. CONCLUSION: NPF has a favorable long-term outcome, irrespective of the type of treatment. We recommend that simple immobilization be the preferred treatment option. However, for distal femur fractures, reduction and possibly osteosynthesis should be considered due to the very slow correction of femoral deformities associated with orthopaedic treatment. LEVEL OF EVIDENCE: Level IV. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/BPO.0000000000003024