The most common mechanism of injury is believed to occur when the elbow is forced into varus (bottom left), which, along with the extensor muscles and lateral collateral ligaments, applies an avulsion force to the lateral condyle. When the fracture line extends to the trochlear notch (bottom right), the elbow becomes unstable.
Reproduced with permission from: Beaty JH, Kasser JR. The elbow: Physeal fractures, apophyseal injuries of the distal humerus, avascular necrosis of the trochlea, and T-condylar fractures. In: Rockwood and Wilkins' Fractures in Children, 5th ed, Beaty JH, Kasser JR (Eds), Lippincott Williams & Wilkins 2001. Copyright © 2001 Lippincott Williams & Wilkins.
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