{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T12:17:28Z","timestamp":1787833048144,"version":"build-2784847793"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":238,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Orthopedics"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transphyseal separation of the distal humerus (TSDH) is an uncommon injury, typically seen in children under 3 years of age, with very few cases reported beyond this age group. Diagnosing this injury is challenging due to its cartilaginous nature. TSDH in infants is commonly treated with manual reduction and long\u2010arm cast application; however, a few case series have suggested that surgical treatment may be a better option in older children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Summary<\/jats:title>\n                    <jats:p>A 5\u2010year\u2010old boy presented with left elbow swelling and restricted movements after a fall on an outstretched hand 2 days earlier. On physical examination, the three\u2010point bony relationship was maintained, and the distal neurovascular status was intact. Radiographs of the left elbow joint showed posteromedial displacement of the radioulnar complex with maintained radio\u2010capitellar line. The TSDH was suspected, and intraoperative arthrography was planned. The diagnosis of TSDH was confirmed intraoperatively with the aid of arthrography. The patient underwent closed reduction and percutaneous K\u2010wire fixation after confirming optimal alignment. Postoperatively, the elbow was immobilized using an above\u2010elbow posterior slab. At 5 weeks, the slab was removed, and gradual range\u2010of\u2010motion exercises were initiated. At the 2\u2010month follow\u2010up, the child had a satisfactory range of motion. At the 15\u2010month follow\u2010up, the patient demonstrated an excellent, pain\u2010free range of motion with no residual deformity or radiographic abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The TSDH in older children is a rare entity. The accurate reduction and timely diagnosis should be given priority so as to avoid late complications. If appropriate intervention is done ensuring adequate reduction and stable fixation, even with limited resources, excellent results can be achieved in such challenging cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/cro\/9974926","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:19:15Z","timestamp":1787829555000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transphyseal Separation of the Distal Humerus in a 5\u2010Year\u2010Old Child: A Rare Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4134-342X","authenticated-orcid":false,"given":"Sushil","family":"Pokhrel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9111-3697","authenticated-orcid":false,"given":"Shivaji","family":"Karki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0422-2003","authenticated-orcid":false,"given":"Sushil","family":"Sah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7532-0717","authenticated-orcid":false,"given":"Ganga","family":"Tiwari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-15-00297"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198062010-00007"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-4891-3"},{"key":"e_1_2_9_4_2","first-page":"99","article-title":"Detection and Treatment of Traumatic Separation of the Distal Humeral Epiphysis in a Neonate: A Case Report","volume":"15","author":"S\u00f6y\u00fcnc\u00fc Y.","year":"2009","journal-title":"Turkish Journal of Trauma and Emergency Surgery"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453678109050106"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12306-015-0366-z"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(01)00102-4"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000001455"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197456020-00004"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.14.12788"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2007.12.005"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s43465-020-00333-x"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0558"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.24911\/SJP.106-1578123593"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1302\/1863-2548.13.180156"},{"key":"e_1_2_9_16_2","unstructured":"BeatyJ. H.andKasserJ. R. editors. Rockwood and Wilkins\u2032 Fractures in Children. 7th ed. Lippincott Williams & Wilkins; Philadelphia: 2010. Fractures Involving the Entire Distal Humeral Physis; pp. 533\u2013593. Rockwood Wilkins Fract Child 7th Ed Lippincott Williams Wilkins. 201AD; 533\u201393."},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1515\/jpm.2009.047"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20160503-01"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2012.02.007"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197961040-00013"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14062037"}],"container-title":["Case Reports in Orthopedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cro\/9974926","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/cro\/9974926","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cro\/9974926","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:19:17Z","timestamp":1787829557000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/cro\/9974926"}},"subtitle":[],"editor":[{"given":"Shashank","family":"Kaushik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/cro\/9974926"],"URL":"https:\/\/doi.org\/10.1155\/cro\/9974926","archive":["Portico"],"relation":{},"ISSN":["2090-6749","2090-6757"],"issn-type":[{"value":"2090-6749","type":"print"},{"value":"2090-6757","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-02-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"9974926"}}