Some vagaries of the medial epicondyle.

Silberstein, M J; Brodeur, Armand E.; Graviss, E R; Luisiri, Atchawee

doi:10.2106/00004623-198163040-00002

Cited by 57 publications

(18 citation statements)

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“…15,19,22 The major stabilizing ligamentous structure in the elbow is the anterior band of the ulnar collateral ligament. The posterior band provides stability only in flexion.…”

Section: Discussionmentioning

confidence: 99%

Operative treatment of displaced medial epicondyle fractures in children and adolescents

Lee

Shen

Chang

et al. 2005

Journal of Shoulder and Elbow Surgery

116

102

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“…15,19,22 The major stabilizing ligamentous structure in the elbow is the anterior band of the ulnar collateral ligament. The posterior band provides stability only in flexion.…”

Section: Discussionmentioning

confidence: 99%

Operative treatment of displaced medial epicondyle fractures in children and adolescents

Lee

Shen

Chang

et al. 2005

Journal of Shoulder and Elbow Surgery

116

102

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“…The fracture is caused by a valgus trauma, often an indirect trauma on the extended elbow, and is commonly complicated by dislocation (Blount 1955, Rang 1974, Silberstein et al 1981, Ogden 1982. It is generally agreed that undisplaced fractures should be treated with an angled plaster cast for 3 weeks.…”

Section: Discussionmentioning

confidence: 99%

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

Duun¹,

Ravn²,

Hansen³

et al. 1994

SORT

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“…The flexor mass (composed of the flexor carpi radialis, palmaris longus, and part of the pronator teres), as well as the ulnar collateral ligament, has its origin on the anterior aspect of the apophysis [1,9,14,15].…”

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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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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Some vagaries of the medial epicondyle.

Cited by 57 publications

References 0 publications

Operative treatment of displaced medial epicondyle fractures in children and adolescents

Operative treatment of displaced medial epicondyle fractures in children and adolescents

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

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

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