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Clin Orthop Surg.  2017 Dec;9(4):542-546. 10.4055/cios.2017.9.4.542.

A Neglected Markedly Displaced Medial Epicondyle Fracture with Simultaneous Ulnar Nerve Palsy in an Adolescent

Affiliations
  • 1Division of Pediatric Orthopedics, Department of Orthopedic Surgery, Ain-Shams University Faculty of Medicine, Cairo, Egypt. tamer.ahmed@med.asu.edu.eg
  • 2Department of Radiodiagnosis, Ain-Shams University Faculty of Medicine, Cairo, Egypt.

Abstract

Humeral medial epicondyle fractures constitute around 15% of pediatric elbow fractures. Up to 60% occur in association with elbow dislocations. Knowledge of potential imaging pitfalls when examining acute elbow fractures in children contributes significantly to accurate diagnosis. Nevertheless, management of missed pediatric medial epicondyle fractures has rarely been reported. We present an 11-year-old boy with a neglected and severely displaced medial epicondyle fracture with concurrent ulnar nerve palsy. We performed neural decompression, fragment excision, and muscular and capsuloligamentous reconstruction of the medial elbow. This study demonstrates that the surgical outcome of a late presenting fracture can be satisfactory in terms of function and neural recovery. It also underscores the importance of careful interpretation of elbow imaging including normal anatomic variants.

Keyword

Pediatric elbow trauma; Distal humeral epiphyseal injuries; Ulnar nerve ultrasound; Normal anatomic variants

MeSH Terms

Child
Delayed Diagnosis
Diagnostic Errors
Elbow Joint/injuries/*surgery
Epiphyses
Humans
Humeral Fractures/*complications/diagnostic imaging/*surgery
Male
Ulnar Neuropathies/*complications/*surgery
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