Avascular Necrosis Following Pediatric Distal Humerus Fracture: A Report of 2 Cases and Follow-Up Strategies Publisher



Bayat N ; Haj Zargarbashi R ; Baghdadi T ; Tabatabaei Irani P
Source: Journal of Orthopedic and Spine Trauma Published:2026

Abstract

Background: Supracondylar humerus fractures are the most common pediatric elbow injuries. Avascular necrosis (AVN) of the distal humerus is rare and may present months to years after injury, even when minimally displaced. Case Report: Two children developed distal humeral AVN after supracondylar fractures, one treated in a cast and one with percutaneous pinning. Both later reported pain, motion loss, and deformity. Imaging confirmed AVN, with a fishtail deformity in one case and cubitus-varus deformity in the other. The first was observed with preserved function; the second underwent a lateral closing wedge extension osteotomy with good recovery. Conclusion: Distal humeral AVN can follow both nondisplaced and displaced injuries. Young patients and higher-risk patterns warrant prolonged follow-up until trochlear ossification. Early recognition and a structured surveillance plan support timely intervention and better outcomes. © 2026 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences. This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 International license (https://creati.