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INTRODUCTION: Lateral condyle fractures (LCF) of the distal humerus are one of the more common skeletal injuries in the pediatric population. The mean age of patients with these fractures is 6 years. In the majority of the cases, the diagnosis is based on clinical and radiographic examination. The most recent classifcation divides these fractures according to degree of displacement and stability. EVIDENCE ACQUISITION: A literature search was performed using Pubmed and Scopus database, until June 2020. Inclusion criteria were studies regarding lateral humeral condyle fractures in pediatric patients. Case reports were excluded. EVIDENCE SYNTHESIS: Most of the studies in literature are retrospective with contrasting opinions and conclusions on diagnosis, classifcation and management. CONCLUSIONS: Regarding the diagnosis and classifcation, the stability of the fracture remains in some cases diffcult to ascertain and MRI can be helpful in identifying the integrity of the articular cartilage and hence fracture stability. Displaced or unstable fractures are preferably treated by closed reduction and percutaneous pinning, while fractures that have rotation of the condylar fragment need to be treated surgically. ORIF can be performed by using different approaches, and the methods of fxation are K-wires or screws. The main factors associated with long-term results are quality of reduction and timing of treatment. The most serious complications are cubitus varus, nonunion, AVN of the condylar fragment and ulnar nerve palsy.

BACKGROUND: Obesity has been regarded to be protective against fracture in spite of its association with low levels of vitamin D. Vitamin D is the key regulator of bone metabolism and its deficiency contributes to higher level of parathyroid hormone (PTH), leading to the activation of bone turnover.METHODS: We studied 161 subjects of which 65 were young healthy subjects and 96 were elderly subjects. We measured creatinine, 25(OH)D, 1,25(OH)2D, PTH, albumin, and calcium plasma levels, we evaluated physical activity, and we calculated BMI. A sub-cohort of elderly subjects also underwent DXA scans.RESULTS: Overweight and obese subjects, as well as underweight ones, had lower levels of vitamin D but normal serum concentrations of 1,25(OH)2D and PTH was higher in underweight and obese subjects. Moreover, we found a nonlinear relationship between body mass index (BMI) and PTH with a significant U-shaped exponential regression. Regardless of BMI, 25(OH)D mean levels were higher in subjects who practice physical activity.CONCLUSIONS: These findings suggest that physical activity and BMI had a significant effect on the metabolism of bone and vitamin D, but the effect of BMI was different in underweight, normal weight or obese subjects. In obesity the real vitamin D deficiency could be estimate by serum 1,25(OH)2D concentrations whose lower levels contribute to the higher PTH production and consequently to bone loss and to a greater fracture risk. Refereed/Peer-reviewed