Eight adolescent athletes (average age, 11 years; range, 9 to 15) underwent open reduction and internal fixation of acute, displaced medial epicondyle frac tures. Fixation was achieved with a screw and washer. Four patients (50%) had associated elbow disloca tions. Elbow motion in a brace was initiated 4 days after surgery. The brace allowed full flexion and exten sion but protected the elbow against valgus stress. Bracing was continued for 4 weeks. The average du ration of followup was 10 months (range, 6 to 13). All fractures united, and full motion was achieved in seven patients. One patient lost 5° of hyperextension com pared with the opposite elbow. All eight elbows were stable to valgus stress and were pain-free. All patients returned to full sports activity.
Get full access to this article
View all access options for this article.
References
1.
Bede WB, Lefebvre AR, Rosman MA Fractures of the medial humeral epicondyle in children. Can J Surg18137-142, 1975
2.
Blount WP Fractures m Children. Baltimore, Williams & Wilkins, 1955, pp 55-56
3.
Canale ST Fractures and dislocations, in Canale TS, Beatty JH (eds) Operative Pediatric Orthopaedics St Louis, Mosby Year Book, 1991, pp 837-1032
4.
Cooney WP- Elbow and forearm Trauma, in Poss R (ed): Orthopaedic Knowledge Update 3 Park Ridge, IL, American Academy of Orthopaedic Surgeons , 1990, pp 327-340
5.
Duun PS, Ravn P., Hansen LB, et al Osteosynthesis of medial humeral epicondyle fractures in children 8-year follow-up of 33 cases Acta Orthop Scand65439-441, 1994
6.
Fowles JV, Kassab MT, Moula T. Untreated intra-articular entrapment of the medial humeral epicondyle J Bone Joint Surg66B562-565, 1984
7.
Fowles JV, Slimane N., Kassab MT Elbow dislocation with avulsion of the medial humeral epicondyle J Bone Joint Surg72B. 102-104, 1990
8.
Higgs SL Fractures of the internal epicondyle of the humerus Br Med J2666-667, 1936
9.
Hines RF, Herndon WA, Evans JP Operative treatment of medial epicondyle fractures in children Clin Orthop223170-174, 1987
10.
Ireland ML, Andrews JR Shoulder and elbow injuries in the young athlete Clin Sports Med7473-494, 1988
11.
Josefsson PO , Danielsson LG: Epicondylar elbow fracture in children. 35-year follow-up of 56 unreduced cases Acta Orthop Scand57313-315, 1986
12.
Kilfoyle RM Fractures of the medial condyle and epicondyle of the elbow in children Clin Orthop4143-50, 1965
Moon MS, Kim I., Han IH, et al Arm wrestler's injury: Report of seven cases Clin Orthop147219-221, 1980
15.
Nyska M., Peiser J., Lukiec F., et al Avulsion fracture of the medial epicondyle caused by arm wrestling Am J Sports Med20347-350, 1992 16. Odgen JA: Skeletal Injury m Children Philadelphia, Lea & Febiger, 1982, pp 258-277
16.
Papavasiliou VA Fracture-separation of the medial epicondylar epiphysis of the elbow joint Clin Orthop171172-174 1982
17.
Rang MC Elbow, in Children's Fractures Philadelphia , JB Lippincott, 1983, pp 152-196
18.
Regan WD Acute traumatic sports injuries of the elbow in the athlete, in Griffin LY (ed) Orthopaedic Knowledge Update Sports Medicine Rosemont, IL, American Academy of Orthopaedic Surgeons, 1994, pp 191-203
19.
Schwab GH, Bennett JB, Woods GW, et al Biomechanics of elbow instability. The role of the medial collateral ligament. Clin Orthop14642-52, 1980
20.
Silberstein MJ, Brodeur AE, Graviss ER, et al Some vagaries of the medial epicondyle . J Bone Joint Surg63A524-528, 1981
21.
Skak SV, Grossman E., Wagn P. Deformity after internal fixation of fracture separation of the medial epicondyle of the humerus J Bone Joint Surg76B297-302, 1994
22.
Smith FM- Medial epicondyle injuries JAMA142: 396-402, 1950
23.
Speed JS, Boyd HB Fractures about the elbow. Am J Surg38727-738, 1937
24.
Stanley EA, Melhoff TL Elbow and forearm. Trauma, in Frymoyer JW (ed) Orthopaedic Knowledge Update 4 Rosemont, IL, American Academy of Orthopaedic Surgeons , 1993, pp 319-333
25.
Tachdjian MO Fractures of the medial epicondyle of the humerus, in Pediatric Orthopedics Second edition. Philadelphia , WB Saunders Co, 1990, pp 3121-3123
26.
Tayob AA, Shively RA Bilateral elbow dislocations with intra-articular displacement of the medial epicondyles J Trauma20. 332-335, 1980 28 Wilkins KE Fractures of the medial epicondyle in children Instr Course Lect403-10, 1991
27.
Wilkins KE Fractures and dislocations of the elbow region, in Rockwood CA Jr, Wilkins KE , King RE (eds) Fractures m Children Philadelphia, JB Lippincott, Co, 1991, pp 509-828
28.
Wilson JN The treatment of fractures of the medial epicondyle of the humerus . J Bone Joint Surg428778-781, 1960
29.
Wilson NI, Ingram R., Rymaszewski L., et al Treatment of fractures of the medial epicondyle of the humerus Injury19342-344, 1988
30.
Woods GW, Tullos HG Elbow instability and medial epicondyle fractures. Am J Sports Med523-30, 1977
