Type four fracture of the medial epicondyle: a true indication for surgical intervention

Conservative treatment of posterolateral dislocation of the elbow with medial epicondyle fracture in children between 6 and 8 years old

“…3,6,13,29 Fibrous union of the medial epicondyle has also been frequently reported even after surgical fixation of the fracture. 17 Nevertheless, no cases of residual instability have been found in the majority of published studies. 9 Furthermore, Fowles et al 9 reported a greater loss of range of motion post-operatively relatively to non-operated patients.…”

“…In such cases, any closed manipulations are forbidden and urgent operation is required. 9,17,20 Surgical intervention is also required when reduction is not achieved by gentle manipulation. In this case, open inspection should be performed, even if no ulnar nerve symptoms are detected.…”

“…In this case, open inspection should be performed, even if no ulnar nerve symptoms are detected. 17 The median nerve is not as frequently injured as the ulnar nerve; however, it also needs to be clinically assessed. 20 Severe pain persisting after the reduction should alert for median nerve entrapment, and requires further surgical exploration.…”

“…Half of them are associated with elbow dislocations, mainly posterior. 4,12,17,20,25 Medial epicondyle fracture associated with dislocation of the elbow is classified as type IV fracture of the medial epicondyle according to Rang. 17,19 This type of injury usually occurs after a fall onto a supinated forearm with the elbow either in flexion or extension.…”

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

“…[10] For displaced fractures, open reduction with internal fixation is the most often used treatment method. [5], [10], [14], [15], [19] [24]. The fracture fragment can be approached by a posteromedial incision that allows good exposure of both the fracture site and the ulnar nerve.…”