Elbow Injuries Epicondyle Fracture (Lateral)

Authors: Melody Glenn, MD, Andrew Little, DO, Mary Haas, MD
Updated: 12/12/2016

Elbow Injuries: Epicondyle Fracture (Lateral)

Milch 1 vs Milch 2 fractures

Xray Views

Elbow XR: AP, lateral, internal oblique

Acute Management

  • Long-arm posterior splint with elbow at 90° flexion and forearm supination
  • Consider a long arm cast instead

Operative Indications

  • \>2 mm displacement
  • Any joint incongruity
  • Fracture non-union

Follow-up Timing

  • Non-operative: Follow up in 5-7 days
  • Operative: Follow up in 2-3 days


Milch Classification

  • Type I: Fx line is lateral to trochlear grove
  • Type II: Fx line into trochlear groove

Complications: Ulnar nerve injury and avascular necrosis

  • Usually in children 5-10 years old
  • Majority will require operative stabilization


  • Wheeless’ Textbook of Orthopaedics. [Source]
  • Orthobullets [Source]
  • Radiopaedia [Source]
  • General Guidelines For Management for Orthopedic Injuries card by the Nationwide Children’s Hospital, Dept of Orthopedics