scholarly journals Intra-articular displacement of an avulsed medial (internal) epicondyle ossification centre in the paediatric elbow: a radiographic finding not to be missed

2019 ◽  
Vol 12 (11) ◽  
pp. e231635
Author(s):  
Amir Qadeer ◽  
Michael Paddock
Keyword(s):  
Emergency Department ◽  
Internal Fixation ◽  
Open Reduction ◽  
Radiographic Finding ◽  
Medial Epicondyle ◽  
Ossification Centre ◽  
Elbow Pain

We present the case of an 11-year-old girl who was presented to the Emergency Department with right elbow pain and swelling following a fall. Radiography demonstrated intra-articular displacement of an avulsed medial epicondyle ossification centre, which was not readily identified at presentation. She proceeded to an uncomplicated open reduction and internal fixation.

scholarly journals Cast immobilisation in situ versus open reduction and internal fixation of displaced medial epicondyle fractures in children between 7 and 16 years old. A study protocol for a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044627
Author(s):  
Tero Hämäläinen ◽  
Matti Ahonen ◽  
Ilkka Helenius ◽  
Jenni Jalkanen ◽  
Markus Lastikka ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Ulnar Nerve ◽  
Operative Treatment ◽  
Open Reduction ◽  
Nonoperative Treatment ◽  
Medial Epicondyle ◽  
University Hospital ◽  
Fractures In Children ◽  
Patient Reported ◽  
Nerve Dysfunction

IntroductionMedial epicondyle fracture of the humerus is a common injury in childhood. There is uniform agreement that minimally displaced fractures (dislocation ≤2 mm) can be treated nonoperatively with immobilisation. Open fractures, fractures with joint incarceration or ulnar nerve dysfunction require surgery. There is no common consensus in treatment of closed medial epicondyle fractures with >2 mm dislocation without joint incarceration or ulnar nerve dysfunction. We hypothesise that there is no difference in treatment outcomes between nonoperative and operative treatment.Methods and analysisThis is a multicentre, controlled, prospective, randomised noninferiority study comparing operative treatment to non-operative treatment of >2 mm dislocated paediatric medial epicondyle fractures without joint incarceration or ulnar nerve dysfunction. A total of 120 patients will be randomised in 1:1 ratio to either operative or nonoperative treatment. The study will have a parallel nonrandomised patient preference arm. Operative treatment will be open reduction and internal fixation. Nonoperative treatment will be upper limb immobilisation in long arm cast for 4 weeks. Data will be collected at baseline and at each follow-up up to 2 years. Quick-DASH is used as primary outcome measure. Secondary outcomes are patient-reported pain, differences in range of motion, Pediatric Quality of Life Inventory, cosmetic visual analogue scale and Mayo Elbow Performance Score.Ethics and disseminationEthical approval has been obtained from Helsinki University Hospital (HUS) ethical board HUS/1443/2019. Each study centre has obtained their own permission for the study. A written authorisation from legal guardian will be acquired and the child will be informed about the trial. Results of the trial will be disseminated as published articles in peer-reviewed journals.Trial registrationThe trial has been registered at clinicaltrials.gov with registration number NCT04531085.

scholarly journals Clinical Outcomes and Return to Play in Youth Overhead Athletes After Medial Epicondyle Fractures Treated With Open Reduction and Internal Fixation

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712097657
Author(s):  
E. Lyle Cain ◽  
W. Gage Liesman ◽  
Glenn S. Fleisig ◽  
Lindsay E. Grosz ◽  
Karen Hart ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Small Sample ◽  
Medial Epicondyle ◽  
Return To Play ◽  
Overhead Athletes ◽  
Overhead Athlete ◽  
The Mean ◽  
Radiographic Union

Background: There is limited literature regarding outcomes after operative treatment of displaced medial epicondyle avulsion fractures in adolescent athletes. Most studies have had a relatively small sample size and have not assessed return to play of the overhead athlete. Purpose: To examine return to play and outcomes of youth overhead athletes who underwent open reduction and internal fixation (ORIF) with screw fixation. Study Design: Case series; Level of evidence, 4. Methods: Charts and radiographs were queried between January 2003 and June 2018 for young overhead athletes (age, <17 years) who underwent ORIF for displaced medial epicondyle fracture. Patients with open fracture or concomitant injury were excluded. Radiographs from postoperative follow-up visits were examined for radiographic union. Eligible patients were asked to provide responses to the American Shoulder and Elbow Surgeons Standardized Assessment Elbow questionnaire and Kerlan-Jobe Orthopaedic Clinic questionnaires as well as questions regarding return to play. Results: Overall, 29 patients were included in the study; the mean age at surgery was 14.7 years (range, 12.9-16.5 years). There were 25 baseball players, 3 football quarterbacks, and 1 tennis player. Of the 23 patients with available images at least 3 months after surgery, 96% demonstrated radiographic union at last follow-up. Imaging for the 1 patient with nonunion was taken 3 months after ORIF, and it is unknown if he eventually had union. All patients (100%) were successfully contacted to complete questionnaires at a mean follow-up of 4.8 years (range, 1.0-13.5 years). The mean KJOC score was 93.0, and the mean scores for the American Shoulder and Elbow Surgeons Elbow questionnaire were 8.9, 35.6, and 9.8 for pain, function, and satisfaction, respectively. One overhead athlete did not return to play, while the other 28 returned at a mean 7 months after surgery. No patient underwent revision ORIF, 1 underwent hardware removal, and 1 underwent ulnar nerve transposition. No players underwent ulnar collateral ligament reconstruction after primary ORIF of the medial epicondyle. Conclusion: ORIF of displaced medial epicondyle fractures is a reliable and successful procedure in adolescent overhead athletes with high demands, with relatively low risk of major complications, reinjury, or reoperation.

scholarly journals OUTCOME OF OPEN REDUCTION AND INTERNAL FIXATION OF DISPLACED MEDIAL EPICONDYLE HUMERUS FRACTURES IN CHILDREN

1969 ◽  
Vol 5 (1) ◽  
pp. 630-634
Author(s):  
WAQAR ALAM ◽  
DILAWAR KHAN ◽  
MUHAMMAD IDREES ◽  
FAIZ ALI SHAH ◽  
SHAMS UR REHMAN ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Teaching Hospital ◽  
Open Reduction ◽  
Kirschner Wire ◽  
Medial Epicondyle ◽  
Elbow Fracture ◽  
Fractures In Children ◽  
Humerus Fractures

BACKGROUND: Medical epicondyle fracture is one of the commonest elbow fracture in children.Various treatment options exist inadequate treatment leads to elbow deformity. Our study will highlightone treatment option with open reduction and fixation with k-wires or one screw and one k-wire.OBJECTIVE: To determine the functional outcome of open reduction and internal fixation ofdisplaced medial epicondyle humerus fractures in children.MATERIAL AND METHODS: This Descriptive cross sectional study was conducted simultaneouslyat five orthopaedic units: Orthopaedic Unit District Headquarter Hospital Timergara Lower Dir,Orthopaedic Unit, Saidu Teaching Hospital Swat, Department of Orthopaedics and Trauma Khalifa GulNawaz Teaching Hospital Bannu, Orthopaedics and Traumatology Unit “ A” Lady Reading HospitalPeshawar and Department of Orthopaedics and Trauma, Pak International Medical College Peshawarfrom January 2012 to September 2014. Twenty one children meeting the inclusion criteria were operatedunder general anaesthesia and tourniquet control and fracture was stabilized with either two kirschnerwires or a screw and single kirschner wire. All patients were discharged on first or second postoperativeday and advised active movements of fingers. Patients were called for follow up visit after two, six andtwelve weeks and elbow functions and deformity was evaluated in each visit using modified criteria ofHardacre et al (25).RESULTS: Twenty one patients including 14 males and 7 females with mean age 12.3 years (range 6 to15 years) had displaced fracture of medial epicondyle and were operated. Two of our patients were lostin follow up and they were excluded from the final results. After evaluating our results according tomodified Hardacre et al criteria, five patients (26.32%) had excellent results, eleven (57.89%) patientshad good results and three (15.78%) patients had poor results.CONCLUSION: Early surgical stabilization of displace medial epicondyle humerus fractures inchildren results in excellent and good functional outcome in majority of patients.KEY WORDS: Medial epicondyle humerus, Open reduction and internal fixation, Kirschner wire.

scholarly journals Elbow dislocation with bicondylar humeral fracture in an adult: a unique type of injury

2019 ◽  
Vol 5 (2) ◽  
pp. 78-80
Author(s):  
Mohit Kumar Arora ◽  
Ela Madaan ◽  
Sandeep Kumar
Keyword(s):  
Case Report ◽  
Internal Fixation ◽  
Elbow Joint ◽  
Open Reduction ◽  
Age Groups ◽  
Elbow Dislocation ◽  
Medial Epicondyle ◽  
Lateral Condyle ◽  
Rare Injury ◽  
Unique Type

Simultaneous fracture of lateral condyle and medial epicondyle of humerus along with elbow dislocation is very rare injury in adults. Only a few cases have been reported in literature in pediatric age groups. The authors describe a case report of fracture of lateral condyle and medial epicondyle of humerus along with elbow dislocation in a young adult. The patient sustained injury in the form of fall from bike. Clinically the patient had swelling and deformity of the elbow joint. There were contusions present in the skin around the elbow joint. There was no distal neuro-vascular deficit. Appropriate radiological investigations were done. The elbow joint was then reduced and found to be unstable. Hence, patient was taken up for surgery in the form of open reduction and internal fixation. The functional outcome of the surgery is presented in the case report. Open reduction and internal fixation are the treatment of choices in these types of cases.

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