Surgical treatment of displaced medial epicondyle fractures in adolescent athletes

Eight adolescent athletes (average age, 11 years; range, 9 to 15) underwent open reduction and internal fixation of acute, displaced medial epicondyle fractures. Fixation was achieved with a screw and washer. Four patients (50%) had associated elbow dislocations. Elbow motion in a brace was initiated 4 days after surgery. The brace allowed full flexion and extension but protected the elbow against valgus stress. Bracing was continued for 4 weeks. The average duration of followup was 10 months (range, 6 to 13). All fractures united, and full motion was achieved in seven patients. One patient lost 5 degrees of hyperextension compared with the opposite elbow. All eight elbows were stable to valgus stress and were pain-free. All patients returned to full sports activity.