Yonsei Med J.  2012 Nov;53(6):1190-1196. 10.3349/ymj.2012.53.6.1190.

Treatment of Medial Epicondyle Fracture without Associated Elbow Dislocation in Older Children and Adolescents

• Park KB
• Kwak YH

• KMID: 1414263
• DOI: http://doi.org/10.3349/ymj.2012.53.6.1190

Abstract

PURPOSE
Displaced medial humeral epicondyle fractures with or without elbow dislocation have been treated with open reduction and fixation using K-wires or screws. The purpose of this study is to evaluate the clinical and radiological outcomes of surgical treatments of medial humeral epicondyle fracture without elbow dislocation according to the fixation methods.
MATERIALS AND METHODS
Thirty-one patients who had undergone open reduction and fixation of the displaced medial humeral epicondyle fracture without elbow dislocation were included. Group I consisted of 21 patients who underwent fixation with K-wires, and Group II comprised 10 patients who underwent fixation with cannulated screws. Immediate postoperative, final follow-up and normal anteroposterior radiographs were compared and the clinical outcome was assessed using the final Japanese Orthopaedic Association (JOA) elbow assessment score.
RESULTS
On the immediate postoperative radiographs, the distal humeral width in Group II was larger than that in Group I. On the final follow-up radiographs, the epicondylar position in Group I was lower than that in Group II. There was no significant difference in the distal humeral width, epicondylar position and joint space tilt between the immediate postoperative, final follow-up radiographs and the normal side within each group. There was no significant difference in the final JOA score between groups.
CONCLUSION
Open reduction followed by K-wire fixation or screw fixation of the displaced medial humeral epicondyle fracture without elbow dislocation in older children and adolescents resulted in improved radiologic outcome and good elbow function in spite of diverse radiologic deformities.

Keyword

Medial epicondyle fracture; elbow dislocation; fracture fixation

MeSH Terms

Adolescent
Bone Screws
Bone Wires
Child
Dislocations/*prevention & control
Elbow Joint/*pathology
Female
Humans
Humeral Fractures/*surgery
Male

Figure

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  Fig. 1 Several deformities at final follow-up radiography after K-wire pinning. All patients were fixed with 2 K-wires during 6 weeks. (A) A 9 year old girl shows hyperplasia. (B) An 11 year old boy shows double-contoured medial epicondyle. (C) A 9 year old boy shows hypoplasia.

• 

  Fig. 2 Several deformities at final follow-up radiography after screw fixation. (A) A 14 year old boy shows hypoplasia. (B) A 10 year old boy who had undergone the operation at 8 weeks from the initial injury shows hyperplasia. (C) An 8 years old girl shows pseudoarthrosis at final follow-up after screw removal, but the patient has 125 degrees range of motion and also has difficulties in overhead throwing motion.

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