- Secondary to valgus load on extended elbow
- Or secondary to dislocation
- 50% are metaphyseal, 50% SH variety
Angulation
| Degree of Angulation | |
|---|---|
| Mild | 0-30° |
| Mod | 30-60° |
| Severe | > 60° |
Displacement
| Degree of Apposition | |
|---|---|
| Mild | > 70% apposition |
| Mod | > 50% apposition |
| Severe | < 50% apposition |
- Significant angulation is tolerated, but little translation is tolerated
- Look for medial epicondyle in the joint
- Reduce with varus stress & digital pressure
Treatment
| Treatment | |
|---|---|
| < 30° | collar & cuff |
| >30° or > 3 mm displaced | closed reduction if < 45° angulate acceptif > 45° angulated – surgery |
| > 60° | complete displacement ORIF |
Indications for ORIF
- Irreducible to < 45°
- SH IV displaced
- Complete displacement
Never Excise & discard head
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.