Slide 123 — Post lateral condyle fracture deformity

Clean FRCS notes with inline figures

Blood supply of distal humerus

•Radial recurrent artery (comes from radial collateral artery)

•Interosseous recurrent artery (comes from middle collateral artery)

•Lateral condyle epiphysis

•Entry: posterolateral to origin of capsule and proximal to articular cartilage (end artery)

•Trochlea

•Lateral crista: from lateral condyle

Medial crista:

•Lateral part: across posterior surface of distal humerus metaphysis (end artery)

•Medial part: multiple vessels

•Fishtail deformity

•Area between medial ossification center and lateral condyle ossification center resorbs / fails to develop

•Type 1

•More common

•Sharp angled wedge

•Persistent gap between lateral condyle physis and medial trochlear due to underdevelopment of the lateral crista

•Type 2

•Smooth edge

•AVN of lateral part of medial crista of trochlear

•Varus

•1. Overgrowth (50%)

•2. Fishtail

•Malunion of lateral part of medial crista (type 1)

•Medial crista AVN (type 2)

•Valgus

•1. Nonunion → lateral condyle AVN

•2. Physeal arrest

•Nonunion

•Definition: 3 months

•Displaced >2mm + no K wire fixation → lateral condyle AVN

Management

•Before physeal closure → Osteotomy + BG (displaced <1cm, large fragment)

•After physeal closure

•Freshen edges + bone graft + compression for fixation

•Severe valgus deformity → osteotomy

•Ulnar nerve palsy → transposition

Direct Q&A

Q1 What diagnostic or radiographic findings support Post lateral condyle fracture deformity?

Blood supply of distal humerus

•Radial recurrent artery (comes from radial collateral artery)

•Interosseous recurrent artery (comes from middle collateral artery)

•Lateral condyle epiphysis

•Entry: posterolateral to origin of capsule and proximal to articular cartilage (end artery)

•Trochlea

•Lateral crista: from lateral condyle

Medial crista:

•Lateral part: across posterior surface of distal humerus metaphysis (end artery)

•Medial part: multiple vessels

Q2 What blood supply pattern is described for Post lateral condyle fracture deformity?

Radial recurrent artery (comes from radial collateral artery)

•Interosseous recurrent artery (comes from middle collateral artery)

•Lateral condyle epiphysis

•Entry: posterolateral to origin of capsule and proximal to articular cartilage (end artery)

•Trochlea

•Lateral crista: from lateral condyle

Q3 How is Post lateral condyle fracture deformity managed?

•Before physeal closure → Osteotomy + BG (displaced <1cm, large fragment)

•After physeal closure

•Freshen edges + bone graft + compression for fixation

•Severe valgus deformity → osteotomy

•Ulnar nerve palsy → transposition

Raw speaker-note hierarchy audit

#	lvl	marL	indent	logical	original note line
1	0	None	None	0	Blood supply of distal humerus
2	0	171450	-171450	1	Radial recurrent artery (comes from radial collateral artery)
3	0	171450	-171450	1	Interosseous recurrent artery (comes from middle collateral artery)
4	0	None	None	0	Lateral condyle epiphysis
5	0	None	None	0	Entry: posterolateral to origin of capsule and proximal to articular cartilage (end artery)
6	0	None	None	0	Trochlea
7	0	None	None	0	Lateral crista: from lateral condyle
8	0	None	None	0	Medial crista:
9	1	628650	-171450	2	Lateral part: across posterior surface of distal humerus metaphysis (end artery)
10	1	628650	-171450	2	Medial part: multiple vessels
11	0	None	None	0	Fishtail deformity
12	0	None	None	0	Area between medial ossification center and lateral condyle ossification center resorbs / fails to develop
13	0	None	None	0	Type 1
14	0	None	None	0	More common
15	0	None	None	0	Sharp angled wedge
16	0	None	None	0	Persistent gap between lateral condyle physis and medial trochlear due to underdevelopment of the lateral crista
17	0	None	None	0	Type 2
18	0	None	None	0	Smooth edge
19	0	None	None	0	AVN of lateral part of medial crista of trochlear
20	0	None	None	0	Varus
21	0	None	None	0	1. Overgrowth (50%)
22	0	None	None	0	2. Fishtail
23	0	171450	-171450	1	Malunion of lateral part of medial crista (type 1)
24	0	171450	-171450	1	Medial crista AVN (type 2)
25	0	0	0	0	Valgus
26	0	0	0	0	1. Nonunion → lateral condyle AVN
27	0	0	0	0	2. Physeal arrest
28	0	0	0	0	Nonunion
29	0	0	0	0	Definition: 3 months
30	0	0	0	0	Displaced >2mm + no K wire fixation → lateral condyle AVN
31	0	0	0	0	Mx:
32	0	0	0	0	Before physeal closure → Osteotomy + BG (displaced <1cm, large fragment)
33	0	0	0	0	After physeal closure
34	0	228600	-228600	1	Freshen edges + bone graft + compression for fixation
35	0	228600	-228600	1	Severe valgus deformity → osteotomy
36	0	228600	-228600	1	Ulnar nerve palsy → transposition

lvl

marL

indent

logical

original note line

None

Blood supply of distal humerus

171450

-171450

Radial recurrent artery (comes from radial collateral artery)

171450

-171450

Interosseous recurrent artery (comes from middle collateral artery)

None

Lateral condyle epiphysis

None

Entry: posterolateral to origin of capsule and proximal to articular cartilage (end artery)

None

Trochlea

None

Lateral crista: from lateral condyle

None

Medial crista:

628650

-171450

Lateral part: across posterior surface of distal humerus metaphysis (end artery)

628650

-171450

Medial part: multiple vessels

None

Fishtail deformity

None

Area between medial ossification center and lateral condyle ossification center resorbs / fails to develop

None

Type 1

None

More common

None

Sharp angled wedge

None

Persistent gap between lateral condyle physis and medial trochlear due to underdevelopment of the lateral crista

None

Type 2

None

Smooth edge

None

AVN of lateral part of medial crista of trochlear

None

Varus

None

1. Overgrowth (50%)

None

2. Fishtail

171450

-171450

Malunion of lateral part of medial crista (type 1)

171450

-171450

Medial crista AVN (type 2)

Valgus

1. Nonunion → lateral condyle AVN

2. Physeal arrest

Nonunion

Definition: 3 months

Displaced >2mm + no K wire fixation → lateral condyle AVN

Mx:

Before physeal closure → Osteotomy + BG (displaced <1cm, large fragment)

After physeal closure

228600

-228600

Freshen edges + bone graft + compression for fixation

228600

-228600

Severe valgus deformity → osteotomy

228600

-228600

Ulnar nerve palsy → transposition

Improved semantic hierarchy used for the study notes

#	semantic level	section?	rewritten line
1	0	yes	Blood supply of distal humerus
2	1		Radial recurrent artery (comes from radial collateral artery)
3	1		Interosseous recurrent artery (comes from middle collateral artery)
4	1		Lateral condyle epiphysis
5	1		Entry: posterolateral to origin of capsule and proximal to articular cartilage (end artery)
6	1		Trochlea
7	1		Lateral crista: from lateral condyle
8	0	yes	Medial crista:
9	2		Lateral part: across posterior surface of distal humerus metaphysis (end artery)
10	2		Medial part: multiple vessels
11	1		Fishtail deformity
12	1		Area between medial ossification center and lateral condyle ossification center resorbs / fails to develop
13	1		Type 1
14	1		More common
15	1		Sharp angled wedge
16	1		Persistent gap between lateral condyle physis and medial trochlear due to underdevelopment of the lateral crista
17	1		Type 2
18	1		Smooth edge
19	1		AVN of lateral part of medial crista of trochlear
20	1		Varus
21	1		1. Overgrowth (50%)
22	1		2. Fishtail
23	1		Malunion of lateral part of medial crista (type 1)
24	1		Medial crista AVN (type 2)
25	1		Valgus
26	1		1. Nonunion → lateral condyle AVN
27	1		2. Physeal arrest
28	1		Nonunion
29	1		Definition: 3 months
30	1		Displaced >2mm + no K wire fixation → lateral condyle AVN
31	0	yes	Management
32	1		Before physeal closure → Osteotomy + BG (displaced <1cm, large fragment)
33	1		After physeal closure
34	1		Freshen edges + bone graft + compression for fixation
35	1		Severe valgus deformity → osteotomy
36	1		Ulnar nerve palsy → transposition

semantic level

section?

rewritten line

yes

Blood supply of distal humerus

Radial recurrent artery (comes from radial collateral artery)

Interosseous recurrent artery (comes from middle collateral artery)

Lateral condyle epiphysis

Entry: posterolateral to origin of capsule and proximal to articular cartilage (end artery)

Trochlea

Lateral crista: from lateral condyle

yes

Medial crista:

Lateral part: across posterior surface of distal humerus metaphysis (end artery)

Medial part: multiple vessels

Fishtail deformity

Area between medial ossification center and lateral condyle ossification center resorbs / fails to develop

Type 1

More common

Sharp angled wedge

Persistent gap between lateral condyle physis and medial trochlear due to underdevelopment of the lateral crista

Type 2

Smooth edge

AVN of lateral part of medial crista of trochlear

Varus

1. Overgrowth (50%)

2. Fishtail

Malunion of lateral part of medial crista (type 1)

Medial crista AVN (type 2)

Valgus

1. Nonunion → lateral condyle AVN

2. Physeal arrest

Nonunion

Definition: 3 months

Displaced >2mm + no K wire fixation → lateral condyle AVN

yes

Management

Before physeal closure → Osteotomy + BG (displaced <1cm, large fragment)

After physeal closure

Freshen edges + bone graft + compression for fixation

Severe valgus deformity → osteotomy

Ulnar nerve palsy → transposition

123. Post lateral condyle fracture deformity

Clean FRCS notes with inline figures

Blood supply of distal humerus

Medial crista:

Management

Direct Q&A

Blood supply of distal humerus

Medial crista:

Radial recurrent artery (comes from radial collateral artery)

Raw speaker-note hierarchy audit

Improved semantic hierarchy used for the study notes