A medial epicondyle fracture is an avulsion injury to the medial epicondyle of the humerus; the prominence of bone on the inside of the elbow. Medial epicondyle fractures account for 10% elbow fractures in children. 25% of injuries are associated with a dislocation of the elbow.
Medial epicondyle fractures are typically seen in children and usually occur as a result of a fall onto an out-stretched hand. This often happen from falls from a scooter, roller skates, or monkey bars, as well as from injuries sustained playing sports. The peak age of occurrence is 10–12 years old.[1]
Symptoms include pain, swelling, bruising and a decreased ability to move or use the elbow. Initial pain may be managed with NSAIDs, opioids, and splinting. The management of pain in children typically follows guidelines, such as those from the Royal College of Emergency Medicine.[2]
The diagnosis is confirmed with X-rays and occasionally with a CT scan.
The treatment of these injuries is controversial, and there are currently ongoing international randomised studies. The SCIENCE study is an ongoing study funded by the National Institute for Health Research (UK). A similar study is being planned in the US, funded by the National Institutes for Health (US). These studies both seek to determine if surgery to restore the natural position of the elbow is better than allowing the bone to heal in a cast without restoring the natural position. Children and families internationally are being encouraged to participate in these research studies to resolve the uncertainties.
- ^ Kamath, Atul F.; Baldwin, Keith; Horneff, John; Hosalkar, Harish S. (2009). "Operative versus non-operative management of pediatric medial epicondyle fractures: a systematic review". Journal of Children's Orthopaedics. 3 (5): 345–357. doi:10.1007/s11832-009-0192-7. ISSN 1863-2521. PMC 2758175. PMID 19685254.
- ^ "Archived copy" (PDF). Archived from the original (PDF) on 2021-04-13. Retrieved 2021-03-06.
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