Birth-related distal humerus epiphyseal separation: Outcome following surgical management

Distal humerus epiphyseal separation is a rare entity that can present as a birth-related injury. It commonly presents in children younger than 2 years of age and can be a result of a fall or forceful manipulation during delivery. It commonly presents with elbow swelling and decreased movement in newborns. It can be misinterpreted as elbow dislocations due to the lack of ossification in the distal part of the humerus on plain radiographs. Several treatment approaches have been reported in the literature including surgical and nonsurgical treatment modalities. We present a 2-day-old girl with a right distal humerus epiphyseal separation following spontaneous vaginal delivery. An anatomical and a stable reduction of the fracture was the aim in the management of this injury and was achieved using an arthrogram-assisted closed reduction and a single percutaneous Kirschner wire fixation. The patient was followed for 12 months and showed a satisfactory outcome.