Medial Epicondyle Fractures

Medial Epicondyle Fractures

Occur in kids btw 9-12 years
Either fall on outstretched hand or avulsion injuries (2o to elbow dislocations)
Traction apophysis for MCL & wrist flexors
Ossification center fuses with metaphysis @ 15 yrs
20% fragment incarcerated in joint

Classification = descriptive (location of fragment & extent of displacement)

The distinction between medial condyle and epicondyle fractures is on physical exam and x-ray (although x-ray can be confusing.)
– medial epicondyle fractures are unstable to valgus stress; medial condyle fractures are unstable to varus stress.
– if trochlear ossification center seen but not medial epicondyles then medial epicondyle #ed & incarcerated in joint (medial epicondyle ossifies 1st)

Treatment
– immobilization in long arm cast for those with 1 cm displacement (possibly > 5 mm displacement)