Separation of the distal humeral epiphysis in a newborn: A case and literature review

Abstract

Objective - To present possible causes of elbow injury in a newborn based on the clinical case of a newborn with separation of the distal humeral epiphysis. Different diagnostic tools and treatment options that have been used by others with good results and rare complications are discussed.

Case report - A clinical case of a newborn where separation of the distal humeral epiphysis was diagnosed and treated, most likely due to traumatic childbirth. After reduction and immobilization, the normal position of the bones and function of the elbow joint were determined by clinical examination and diagnostic imaging.

Conclusion - Elbow injury in a new born is very rare, most often it results from traumatic childbirth; it rarely occurs later in the new born period. Newborns present with sensitivity to touch and irritability, decreased mobility of the affected limb and swelling in the area of the injury. Use of diagnostic methods of elbow injuries in the newborn period can be difficult. X-rays are not sufficiently accurate to deduce the nature of the injury, because the distal humeral epiphysis is not yet ossified. Therefore, for exact specification of the injury type, additional imaging diagnostics are usually required: ultrasound as the first line and magnetic resonance as second line imaging method, which help to differentiate between osteoarticular infection and traumatic injury. Treatment is usually conservative, with closed reduction and immobilization; serious complications associated with impaired joint function are rare.