Elbow Injuries: Epicondyle Fracture (Medial)

Xray Views

Elbow XR: AP, lateral, external oblique

Acute Management

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

Operative Indications

• >5 mm displacement
• Ulnar nerve dysfunction
• Entrapment of avulsed fracture fragment in joint
• Displacement in high level athletes

Follow-up Timing

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

Notes

Complications: Ulnar nerve entrapment & injury

• Usually in children 9-14 years old
• May be mistaken for medial epicondyle ossification center
• Associated with elbow dislocations
• Most can be managed non-operatively

References

• Wheeless. Available at: http://www.wheelessonline.com/ortho/medial_epicondyle_frx_of_the_humerus. Accessed August 1, 2017.
• Orthobullets. Available at: http://www.orthobullets.com/pediatrics/4008/medial-epicondylar-fractures--pediatric. Accessed August 1, 2017.
• Radiopaedia. Available at: http://radiopaedia.org/articles/medial-epicondyle-fracture-1. Accessed August 1, 2017.
• General Guidelines For Management for Orthopedic Injuries card by the Nationwide Children’s Hospital, Department of Orthopedics