Up to 90% of medial epicondyle fractures treated with conservative measures result in nonunion. However, only 21% become symptomatic. The current case review discusses the history and treatment of a symptomatic medial epicondyle nonunion in a 14-year-old over a 2-year period. Initial conservative treatment was insufficient. However, open reduction and internal fixation afforded the patient a full resolution of symptoms with return to all activities at 10 weeks postoperatively. The patient remains asymptomatic more than 2 years after the initial injury. Open reduction and internal fixation achieved excellent outcomes in the treatment of a symptomatic medial epicondyle nonunion.

Objective To examine the incidence and risk factors of any-cause reoperation after primary ACLR in children and adolescents. Design Retrospective Cohort Setting Electronic medical records from a large tertiary care, single institution integrated healthcare delivery system. Patients Patients were under the age of 18 years and had anterior cruciate ligament reconstruction. They were excluded if they had a multi-ligamentous knee injury or <1 year follow-up. Interventions Patients were further identified to have undergone a subsequent knee operation ipsilaterally or contralateral ACLR. Main outcome measures The rate of any-cause reoperation was our primary outcome measure. Results The median age was 16. There were 208 females (53.9%) and 178 males (46.1%) included. The median follow-up was 25 months with a minimum of 12 months (interquartile range: 16.0, 46.0). The rate of any-cause reoperation was 34.7%. There was no statistically significant difference between those who underwent reoperation versus those who did not undergo reoperation relative to age, sex, BMI, graft type, or the presence of concomitant meniscal injury. The rates of ipsilateral ACLR and contralateral ACLR at any time during the study period was 8.0% and 10.9% respectively. There was no statistically significant difference for rate of reoperation between graft types, between various concomitant injuries, between those who underwent meniscus repair or no repair. Conclusions This study reflects a 34.7% rate of a subsequent knee operation after ACLR in patients younger than 18 years. These findings can be used to inform pediatric patients undergoing primary ACLR on their risk of returning to the operating room.

No abstract

Surgical technique and outcomeAfter the patient was prepped, a 4 cm incision was made at the location where the hernia was palpable, directly over the lateral aspect of the left peroneal tendons. Blunt dissection revealed the peroneal tendons herniating