Medial epicondyle fractures in the pediatric population

J Am Acad Orthop Surg. 2012 Apr;20(4):223-32. doi: 10.5435/JAAOS-20-04-223.


Humeral medial epicondyle fractures in the pediatric population account for up to 20% of elbow fractures, 60% of which are associated with elbow dislocation. Isolated injuries can occur from either direct trauma or avulsion. Medial epicondyle fractures also occur in combination with elbow dislocations. Traditional management by cast immobilization increasingly is being replaced with early fixation and mobilization. Relative indications for surgical fixation include ulnar nerve entrapment, gross elbow instability, and fractures in athletic or other patients who require high-demand upper extremity function. Absolute indications for surgical intervention are an incarcerated fragment in the joint or open fractures. Radiographic assessment of these injuries and their true degree of displacement remain controversial.

Publication types

  • Review

MeSH terms

  • Child
  • Elbow Joint / blood supply
  • Elbow Joint / injuries
  • Fracture Fixation, Internal / methods*
  • Humans
  • Humeral Fractures / classification
  • Humeral Fractures / diagnosis
  • Humeral Fractures / epidemiology
  • Humeral Fractures / surgery*
  • Humeral Fractures / therapy
  • Immobilization
  • Joint Dislocations / diagnostic imaging
  • Joint Dislocations / epidemiology
  • Joint Dislocations / surgery
  • Multiple Trauma / surgery
  • Radiography
  • Treatment Outcome