clinical outcomes of total physeal separation in pediatric distal humerus fractures: a single-center experience

Background: total physeal separation (tps) of the distal humerus is a rare elbow injury in young children. because the distal humerus is predominantly cartilaginous at early ages, diagnosis can be challenging and is frequently mistaken for more common injuries, such as supracondylar fractures. given the critical role of the growth plate in skeletal development and elbow function, appropriate management is essential. despite several reports in the literature, comprehensive data with adequate follow-up remain limited. objectives: this study aimed to evaluate the clinical outcomes of tps of the distal humerus in pediatric patients treated at a tertiary referral center.methods: this retrospective case series included pediatric patients diagnosed with tps of the distal humerus who met the inclusion criteria and were treated at shafayahyaeian hospital. a total of 13 patients were enrolled, all of whom underwent closed reduction and percutaneous pinning (crpp). data were collected from medical records, radiographic images, and follow-up documentation. the variables assessed included demographic characteristics, mechanism of injury, neurovascular status, elbow range of motion (rom), and postoperative complications.results: at final follow-up, all patients demonstrated satisfactory elbow rom, approaching near-normal function. no cases of persistent neurological deficit, angular deformity (cubitus varus or valgus), or major complications such as pin-site infection were observed. functional outcomes were favorable, and crpp provided stable fixation with preservation of joint mobility.conclusion: crpp is a safe and effective treatment modality for tps of the distal humerus in pediatric patients. this technique is associated with favorable functional outcomes, preservation of neurovascular integrity, and minimal complications. early diagnosis and appropriate management are crucial for preventing long-term sequelae. further studies with larger sample sizes and longer follow-up periods are recommended.