Fracture of the distal humeral epiphysis is a relatively rare injury that occurs between birth and l
6 years of age before closure of the distal humeral epiphysis. It accounts for 6% of elbow epiphyseal injuries and 0.16-0.19% of total body fractures in children. Since Ashhust reported a total distal humeral epiphyseal separation fracture in 1910. Because the secondary ossification centers of the distal humeral epiphysis appear early and close differently in children, fractures are highly susceptible to misdiagnosis and delayed treatment after they occur. The disease occurs in children before the fusion of the distal humeral pity’ epiphysis, but is more common between the ages of neonate and 8 years. Most have a clear history of trauma. Whether the injury is fresh or old, the elbow is painful, with varying degrees of swelling, subcutaneous petechial hemorrhages, internal and external deformity of the elbow, and localized pressure pain. Bone rubbing sounds may be palpable. The diagnosis mainly depends on the X-ray examination. l963 Salter-Harris divided the epiphyseal injury into type V. The disease is generally considered to be a type I or type II injury, with type II being more common. Type I injuries have a fracture line from the lateral edge to the medial edge, completely passing through the epiphyseal growth plate and the epiphyseal part of the connection, this type is mostly seen in young children under the age of 1. In type II injuries, the fracture line is shifted from the lateral edge to the medial edge near the epiphysis, which not only separates and displaces the entire epiphysis below the growth plate, but also carries a small piece of bone at the epiphysis along with the epiphysis at the medial edge, which is mostly triangular in shape. This is called Thurston-Holdan’s sign or “horn sign”, and sometimes the bone fragment is thin, called “plate sign”, and this type is mostly seen in children over 2 years old. The following closed repositioning surgery is performed.