Distal Humerus Metaphyseal-Diaphyseal Junctional Fracture of a Four-Year-Old Child Treated With Intramedullary Steinmann Wire Fixation: A Case Report.

Distal humeral metaphyseal-diaphyseal fractures are rare and inherently unstable injuries. Non-operative treatments can make it hard to maintain reduction. Open or closed reduction with percutaneous K-wire fixation may be the preferred treatment option for these fracture types. This case report describes successfully managing a rare distal humerus metaphyseal-diaphyseal junctional (MDJ) fracture in a four-year-old child using intramedullary Steinmann wire fixation. A four-year-old male child applied to the emergency service with a swollen elbow. He had a history of trauma 10 days ago. There was a long arm splint on his arm. A displaced distal MDJ fracture of the left humerus was detected on the radiograph. Due to its instability, we preferred surgical management. With a lateral incision, we obtained a successful reduction after manipulation. Subsequently, we achieved the anatomical reduction with three Steinmann pins. We applied two Steinmann pins intramedullary, and the other one crosses from the medial epicondyle and exits the lateral cortex, forming a crossed-pin configuration at the fracture site. We immobilized the extremity for four weeks with a long arm splint. At the end of the fourth week, we removed the Steinmann pins. After removing the wires, we began an active range of motion exercises. The plain X-ray at the two-month follow-up revealed good fracture healing with no residual elbow deformity. The patient could perform a complete elbow range of motion. The case highlights the challenges in treating pediatric distal metaphyseal-diaphyseal humerus fractures, and it demonstrates the effectiveness of this intramedullary Steinmann wire fixation technique in achieving stable fracture reduction and promoting rapid healing in a small child.