[Effect of dia- and percondylar humeral fractures on the growth of the carpal bones in children].

Using surface measurements obtained from anterior-posterior X-rays, the carpal bones on the side of the previous supracondylar fracture were compared with those on the uninjured side. A disparity in growth was found between the two sides. Most often, an increased growth of the scaphoid was seen on the side of the fracture. Analysis of the data obtained from the measurements of all carpal bones did not lead to any definite conclusions. Of the seven carpal bones studied, a greater length (1 to 3 mm.) was found 86 times and a greater width (1 to 4 mm.) 53 times. Decreased length (1 to 4 mm.) was found 63 times and decreased width (1 to 3 mm.) 70 times. A comparison of surface indices indicated an increased growth in 9 to 11 year old children and in 13 to 16 year old children on the side of the broken arm. In patients between 13 and 16 years of age, increased growth (1 to 4 mm.) of the hamate was seen in 10, of the trapezium in 7 and of the trapezoid in 7 patients. Decreased growth was seen most often between 11 and 13 years of age and 13 to 16 years of age. These data indicate a discontinuous and uneven growth in the injured arm that is manifested years after healing of the supracondylar humeral fracture. This study indicates that after healing of the fracture, a temporary growth stimulus is present in some patients. This growth spurt is not limited to the broken bone but is also present far from the fracture in the carpus.