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Medial epicondyle fractures in children.
- Source :
-
Current opinion in pediatrics [Curr Opin Pediatr] 2015 Feb; Vol. 27 (1), pp. 58-66. - Publication Year :
- 2015
-
Abstract
- Purpose of Review: The present review discusses the relevant anatomy, clinical presentation, and management of medial epicondyle fractures, including diagnostic controversies, the indications for operative and nonoperative management, and outcomes.<br />Recent Findings: Recent studies have highlighted the underestimation of fracture displacement seen on typical radiographic views and have attempted to define the location of the medial epicondyle on radiographs to improve the accuracy of measuring displacement. They have demonstrated variable outcomes following open reduction and internal fixation of medial epicondyle fractures that are associated with intra-articular incarceration. Newer evidence supports the fixation of medial epicondyle fractures in adolescent athletes, to allow return to competitive sports.<br />Summary: Medial epicondyle fractures of the distal humerus account for 12% of pediatric elbow fractures and are frequently associated with intra-articular incarceration of the fracture fragment, elbow dislocation, ulnar nerve injury, and other upper extremity fractures. Recent literature calls into question the accuracy of measuring fracture displacement, and controversy exists regarding optimal management of these fractures. Good outcomes have been achieved with nonoperative treatment for minimally displaced fractures, despite a high rate of nonunion. In patients with displaced fractures, fixation yields stability, functional range of motion, and the ability to return to previous activity levels, including sports. Complications include stiffness, instability, deformity, superficial wound infections, and symptomatic nonunion. Further study is required to standardize the measurement of displacement and to clarify indications for operative treatment in both sedentary and active children.
- Subjects :
- Adolescent
Casts, Surgical
Child
Child, Preschool
Elbow Joint anatomy & histology
Hand Strength
Humans
Humeral Fractures pathology
Humeral Fractures therapy
Physical Examination
Range of Motion, Articular
Tomography, X-Ray Computed
Treatment Outcome
Elbow Injuries
Elbow Joint diagnostic imaging
Fracture Fixation, Internal methods
Humeral Fractures diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1531-698X
- Volume :
- 27
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Current opinion in pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 25564187
- Full Text :
- https://doi.org/10.1097/MOP.0000000000000181