Incarcerated medial epicondyle fracture following pediatric elbow dislocation: 11 cases

Seth D. Dodds, Brody A. Flanagin, Daniel D. Bohl, Peter A. Deluca, Brian G. Smith

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Purpose To describe outcomes after surgical management of pediatric elbow dislocation with incarceration of the medial epicondyle. Methods We conducted a retrospective case review of 11 consecutive children and adolescents with an incarcerated medial epicondyle fracture after elbow dislocation. All patients underwent open reduction internal fixation using a similar technique. We characterized outcomes at final follow-up. Results Average follow-up was 14 months (range, 4-56 mo). All patients had clinical and radiographic signs of healing at final follow-up. There was no radiographic evidence of loss of reduction at intervals or at final follow-up. There were no cases of residual deformity or valgus instability. Average final arc of elbow motion was 4° to 140°. All patients had forearm rotation from 90° supination to 90° pronation. Average Mayo elbow score was 99.5. Four of 11 patients had ulnar nerve symptoms postoperatively and 1 required a second operation for ulnar nerve symptoms. In addition, 1 required a second operation for flexion contracture release with excision of heterotopic ossification. Three patients had ulnar nerve symptoms at final follow-up. Two of these had mild paresthesia only and 1 had both mild paresthesia and weakness. Conclusions Our results suggest that open reduction internal fixation of incarcerated medial epicondyle fractures after elbow dislocation leads to satisfactory motion and function; however, the injury carries a high risk for complications, particularly ulnar neuropathy.

Original languageEnglish (US)
Pages (from-to)1739-1745
Number of pages7
JournalJournal of Hand Surgery
Volume39
Issue number9
DOIs
StatePublished - Sep 2014
Externally publishedYes

Keywords

  • Incarcerated medial epicondyle fracture
  • elbow dislocation
  • open reduction internal fixation
  • pediatric

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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