Operative treatment of displaced medial epicondyle fractures in children and adolescents

Lee, Hsieh Hsing; Shen, Horng-Der; Chang, Jen-Huei; Lee, Chian Her; Wu, Shing‐Sheng

doi:10.1016/j.jse.2004.07.007

Cited by 115 publications

(119 citation statements)

References 19 publications

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“…[17] A high index of suspicion is necessary to avoid missing a displaced, intra-articular medial condyle fracture in the young. In both types, swelling is concentrated medially, and there may be valgus instability of the elbow joint.…”

Section: Pathological Discussionmentioning

confidence: 99%

Case Report on Cubitus Varus Deformity as a Complication of United Medial Condyle of Humerus Fracture- A Rare Fracture in Children

Chetia¹,

Bidyananda²,

Patowary³

2017

jemds

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Section: Pathological Discussionmentioning

confidence: 99%

Case Report on Cubitus Varus Deformity as a Complication of United Medial Condyle of Humerus Fracture- A Rare Fracture in Children

Chetia¹,

Bidyananda²,

Patowary³

2017

jemds

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“…The consistent good results were achieved by operated fixation as reported by Hines et al, Lee et al and Fowles et al along with our own series would advocate surgical intervention when there is a displacement. 1,4,16 Operative management allows for anatomic reduction internal fixation of the fragment and incase of incarceration, removal Pro**** -Pronation of the offending fragment under direct visualization followed by stabilization. Surgical reduction and fixation of medial epicondyle along with its strong flexor pronator muscle origin and medial collateral ligament may contribute to critical restraint against valgus instability and allow for early elbow movements.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 There is a wide agreement on conservative treatment for undisplaced or minimally displaced medial epicondyle fractures. 4 Such injuries are simply treated with immobilization and early motion to obviate stiffness. 5 However opinions differ regarding management of displaced medial epicondyle fractures.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the definition of displacement varies between studies; some denominate the displaced fractures if >2 mm, but others, rely on >5 mm.1 Some literatures testify excellent to good results with conservative management, but above 60% of patients demonstrate radiographic nonunion that may lead to valgus instability. 4 Here, we present 20 cases of surgically managed elbow medial epicondyle avulsion injuries in children and adolescents. We aimed to characterize functional outcome, range of motion, ulnar nerve dysfunction, heterotopic ossification, and any other complications.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Results of Surgically Treated Medial Humeral Epicondylar Apophyseal Avulsion Injury in Children and Adolescent.

Joshi¹,

Sundararaj²

2014

J Lumbini Med Coll

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ABSTRACT:Introduction: Fractures of the medial humeral epicondyle represent approximately 10% of all paediatric elbow fractures. Objective of our study was to assess treatment outcomes of children and adolescent with medial epicondylar fracture of the elbow using standard operative protocols. Methods: Twenty surgically treated fractures of the medial humeral epicondyle were analysed & reviewed for their epidemiological, clinical and surgical parameters. A valgus stress test was performed under general anesthesia or sedation. All patients underwent open reduction internal fixation using a similar technique. The medial epicondylar fragment was anatomically reduced and fixed in all cases with screws, Kirshner wires or tension band wiring. At final evaluation, union (radiologically) and elbow function [MAYO elbow performance score (MEPS)] was assessed. Results: An evaluation of all of our patients after a mean follow-up of 8.75 months (SD=4.76) after initial surgery was possible. The mean age of patients at the time of injury was 10.8 years (SD=2.3). Fifteen (75%) dominant elbows were injured in our study and 12(60%) elbows had an associated elbow dislocation. On examination in operating room post anaesthesia, all of the elbow injuries revealed some degree of valgus instability. All of our patients(n=20) showed good to excellent results in the MAYO elbow performance score (MEPS). Radiographically, union was achieved in all cases. Three patients developed postoperative ulnar nerve neuropraxia, all recovered at time of final follow up. One patient developed mild lateral heterotrophic ossification but did not require any additional surgical intervention. Conclusion: Our results suggest that open reduction internal fixation of displaced medial epicondyle fractures leads to satisfactory motion and function. A valgus stress test in operating room can reveal the true nature of joint instability that can warrant operative stabilization of medial epicondylar injuries.

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“…Medial epicondyle fracture of the humerus is one of the most common elbow fractures in children [1][2][3][4][5]; however, to our knowledge, there is few report of elbow fracture dislocation with an interposed free bone fragment in medial epicondyle fracture [6]. The purpose of this report is to show a case of such condition, and to show how to diagnose and treat it.…”

Section: Introductionmentioning

confidence: 99%

Interposed Free Bone Fragment in Dislocated Medial Epicondyle Fracture of the Elbow: A Case Report

Kaneko

2014

J Med Cases

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A 13-year-old girl fell down on her left hand, resulting in elbow dislocation with medial epicondyle fracture of the humerus. The dislocation was immediately reduced manually; however, open reduction and internal fixation of the fracture was performed because the medial epicondyle showed > 5 mm displacement. Her passive motion under general anesthesia was smooth and full after the fixation. However, her elbow motion was limited to 60° postoperatively. Postoperative imaging showed a free bone fragment interposed within her elbow. We removed the interposed bone fragment, and the patient showed full active elbow motion without pain in 4 weeks. To the best of our knowledge, there is few report of elbow fracture dislocation with an interposed free bone fragment in medial epicondyle fracture. The possibility of small isolated bone fragment interposition should be considered in medial epicondyle fractures with elbow dislocation.

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Operative treatment of displaced medial epicondyle fractures in children and adolescents

Cited by 115 publications

References 19 publications

Case Report on Cubitus Varus Deformity as a Complication of United Medial Condyle of Humerus Fracture- A Rare Fracture in Children

Case Report on Cubitus Varus Deformity as a Complication of United Medial Condyle of Humerus Fracture- A Rare Fracture in Children

Clinical Results of Surgically Treated Medial Humeral Epicondylar Apophyseal Avulsion Injury in Children and Adolescent.

Interposed Free Bone Fragment in Dislocated Medial Epicondyle Fracture of the Elbow: A Case Report

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