Management of severely displaced medial epicondyle fractures

The role of surgical fixation of the displaced medial epicondyle fracture remains controversial. We reviewed 20 patients with displaced (mean 10 mm) fractures, all associated with elbow dislocation. All elbows were therefore unstable, and all were managed nonoperatively. Although all fractures healed by fibrous union, the functional results were good. Clinical and radiological tests were used to assess the static stability of the ulnar collateral ligament. All patients had demonstrable ulnar collateral ligament laxity, but only one patient had slight impairment of elbow function. None had late-onset ulnar neuritis. We have shown that even the severe forms of this injury can be managed without internal fixation.