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Medial epicondyle fractures in children
Rubini Pathy1, Emily R Dodwell
1Hospital for Special Surgery, New York, New York, USA.
Current Opinion in Pediatrics
|January 8, 2015
Summary
Medial epicondyle fractures in children often involve intra-articular incarceration and pose diagnostic challenges. Operative fixation may be necessary for displaced fractures to restore function and enable return to sports.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Traumatology
Background:
- Medial epicondyle fractures are common in pediatric elbow injuries.
- These fractures are frequently associated with intra-articular incarceration, elbow dislocation, and ulnar nerve injury.
Purpose of the Study:
- To review the anatomy, clinical presentation, and management of medial epicondyle fractures.
- To discuss diagnostic controversies and indications for operative versus nonoperative treatment.
- To evaluate outcomes of different management strategies.
Main Methods:
- Review of recent literature on medial epicondyle fractures.
- Analysis of diagnostic accuracy and measurement of fracture displacement.
- Evaluation of surgical and non-surgical treatment outcomes.
Main Results:
- Radiographic assessment of displacement can be underestimated.
- Open reduction and internal fixation show variable outcomes, especially with intra-articular incarceration.
- Fixation of medial epicondyle fractures in adolescent athletes can facilitate return to sports.
Conclusions:
- Controversy exists regarding the optimal management of medial epicondyle fractures.
- Nonoperative treatment is effective for minimally displaced fractures but has a high nonunion rate.
- Operative fixation provides stability and functional recovery for displaced fractures, aiding return to activity. Further research is needed to standardize displacement measurement and clarify treatment indications.
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