Osteosynthesis of medial humeral epicondyle fractures in children: 8-year follow-up of 33 cases

Duun, Preben; Ravn, Pernille; Hansen, Lars P.; Buron, Birgitte

doi:10.3109/17453679408995489

Cited by 42 publications

(38 citation statements)

References 9 publications

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“…Farsetti et al [8] retrospectively compared two groups with medial epicondyle fractures displaced between 5 and 15 mm and demonstrated similar results between nonoperative and operative treatment. Nonunion may still occur in patients treated surgically [7].…”

Section: Discussionmentioning

confidence: 99%

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Alternative technique for open reduction and fixation of displaced pediatric medial epicondyle fractures

Glotzbecker

Shore

Matheney

et al. 2012

Journal of Children's Orthopaedics

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Purpose To describe an alternative positioning technique for the fixation of pediatric medial epicondyle fractures which offers some significant advantages over traditional supine positioning. Methods At our institution, 27 patients with a displaced medial epicondyle fracture requiring open reduction and fixation were positioned prone for the procedure. The internally rotated operative arm lies on the hand table with the elbow in a natural flexed, pronated position. The elbow can be brought into extension and flexion for appropriate intraoperative radiographs. The fracture is then reduced with the arm in flexion and pronation, without having to pull excessively on the fragment. After reduction, the fragment is held easily in place for surgical fixation. A similar group of patients from the same time period positioned supine was also examined and compared to the patients who had the surgery prone. Results The average age of the 27 patients was 11.2 years (range 5.1-16.9 years). Indications for operative treatment were displaced medial epicondyle fracture (14), medial epicondyle fracture with associated elbow dislocation (12), and medial epicondyle fracture with ulnar nerve symptoms (1). At a mean of 4.5 months of follow up (1-11 months), 7 patients required the removal of hardware for screw irritation. There were no infections in the 27 surgeries and there were no other intraoperative or postoperative complications. Mild loss of flexion and extension was common in the group. Patients who had surgery in the supine position were similar with regards to patient demographics and postoperative complications, including the need for screw removal. Conclusions While displaced medial epicondyle fractures can be treated successfully with traditional positioning, placing patients prone for the fixation of pediatric medial epicondyle fractures offers some significant advantages over supine positioning. Keywords Medial epicondyle Á Prone positioning Á Technique SummaryMedial epicondyle fractures constitute approximately 14 % of fractures involving the distal humerus and 11.5 % of all fractures in the elbow region [1][2][3]. Most often, this injury occurs in children between the ages of 9 and 14 years, with a peak incidence in the age range 11-12 years [1,4,5]. Treatment is generally nonoperative for nondisplaced or minimally displaced fractures. There is some controversy regarding the appropriate treatment in displaced fractures [1,2,[4][5][6][7][8][9][10][11][12][13][14]. Traditional descriptions of the surgical technique to fix fractures of the medial epicondyle recommend supine positioning. We describe a technique using prone positioning that offers some significant advantages when fixing these fractures.

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Section: Discussionmentioning

confidence: 99%

“…There is some controversy regarding the appropriate treatment in displaced fractures [1,2,[4][5][6][7][8][9][10][11][12][13][14]. Absolute indications for surgical treatment are incarceration in the joint or an elbow dislocation with ulnar nerve symptoms.…”

Section: Discussionmentioning

confidence: 99%

Alternative technique for open reduction and fixation of displaced pediatric medial epicondyle fractures

Glotzbecker

Shore

Matheney

et al. 2012

Journal of Children's Orthopaedics

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show abstract

“…EpicondylusradialisVerletzungen sind ausgesprochene Raritäten und meist nur kleinschalige Ausrisse, die mit kurzzeiti ger Gipsruhigstellung und funktionell be handelt werden können [4,7]. …”

Section: Epicondylus-radialisverletzungenunclassified

Luxationsfrakturen am Ellenbogengelenk im Kindesalter

Dirnagl

Voth

Frank

et al. 2015

Trauma Berufskrankh

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“…For nondisplaced and minimally displaced fractures, nonoperative treatment is generally recommended. 3,6,[9][10][11] Although it is accepted that a large number of these fractures proceed to nonunion, 3,4,6 the functional limitations have generally been felt to be low. 3,6,9 In higher-demand individuals, such as throwing athletes, medial epicondylar nonunion can lead to pain and symptomatic valgus instability.…”

mentioning

confidence: 99%

Symptomatic medial epicondyle nonunion: treatment by open reduction and fixation with a tension band construct

Shukla

Cohen

2011

Journal of Shoulder and Elbow Surgery

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Osteosynthesis of medial humeral epicondyle fractures in children: 8-year follow-up of 33 cases

Cited by 42 publications

References 9 publications

Alternative technique for open reduction and fixation of displaced pediatric medial epicondyle fractures

Alternative technique for open reduction and fixation of displaced pediatric medial epicondyle fractures

Luxationsfrakturen am Ellenbogengelenk im Kindesalter

Symptomatic medial epicondyle nonunion: treatment by open reduction and fixation with a tension band construct

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