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medial epicondyle fracture

Carley Vuillermin, Kyna S Donohue, Patricia Miller, Andrea S Bauer, Dennis E Kramer, Yi-Meng Yen
BACKGROUND: Incarcerated medial epicondyle fractures in association with elbow trauma are rare and an absolute indication for intervention. Because of the infrequent nature, outcomes following this injury are not well documented. We studied a large cohort of these injuries to determine factors associated with functional outcomes. It was hypothesized that a greater duration between initial presentation and time of surgery would lead to poorer outcomes. METHODS: A total of 32 patients aged 18 and under who underwent surgical treatment for an incarcerated medical epicondyle fracture at a level-1 pediatric trauma center from 2003 to 2015 were identified...
April 24, 2017: Journal of Pediatric Orthopedics
J Syed, A R Zamri, S Jamaluddin, J K Ruben, M Gopindran
Traumatic elbow dislocations in children are rare but most of them are complex dislocations, and in such dislocations, medial humerus epicondyle fractureis the most common associated injury. Fracture incarceration in the elbow joint occurs in 5-18% of medial humerus epicondyle fractures but ulnar neuropraxia is very rare. Open reduction internal fixation is indicated in medial humerus epicondyle fracture with fracture incarceration, ulnar neuropraxia, marked instability or open fracture. Operative treatment options include fragment excision and sutures, closed or open reduction and Kirschner wire fixation, open reduction and suture fixation, open reduction and smooth pin fixation, and open reduction and screw fixation...
March 2017: Malaysian Orthopaedic Journal
Brandon S Schwartz, Ebrahim Paryavi, W Andrew Eglseder, Raymond A Pensy, Joshua M Abzug
BACKGROUND: Medial epicondyle fractures in pediatric patients might be associated with an occult elbow dislocation and neurovascular damage. METHODS: A single case of a medial epicondyle fracture presenting with brachial artery transection was reviewed. Presentation, clinical course, and early outcome are reported. RESULTS: A 14-year-old patient presenting with an apparently isolated medial epicondyle fracture was found to have examination and diagnostic test findings consistent with brachial artery transection...
April 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
Federico Canavese, Lorenza Marengo, Alexandru Tiris, Mounira Mansour, Marie Rousset, Antoine Samba, Antonio Andreacchio, Alain Dimeglio
PURPOSE: The main goal of this study was to retrospectively evaluate the clinical, functional and radiographic outcomes of displaced medial epicondyle fractures with or without associated elbow dislocation in children undergoing surgical treatment and to evaluate upper-extremity function with the Quick Disbilities of the Arm, Shoulder and Hand (Quick DASH) questionnaire. The hypothesis was that patients with associated elbow dislocation would have similar functional outcome to patients with displaced fractures with or without intra-articular entrapment of the medial epicondyle...
March 22, 2017: International Orthopaedics
R Babst, C Schraner, F J P Beeres
AIM OF SURGERY: Reconstruction of the most important ligamentous and osseus structures of the elbow after terrible triad injury via the radial head to the lateral collateral ligament complex (LCL) and if necessary beginning at the coronoid process. The aim is a stable concentrically guided elbow with early functional follow-up treatment. The approach depends on the intraoperatively tested stability. INDICATIONS: Osteoligamentous terrible triad injury pattern with or without subluxation position following reduction and temporary immobilization...
April 2017: Operative Orthopädie und Traumatologie
Sagar Panthi, Kishor Khatri, Krishna Kharel, Raju Vaishya, Amit Kumar Agarwal, Vipul Vijay
PURPOSE: Fractures of the medial humeral epicondyle represent approximately 10% of all pediatric elbow fractures. Surgically treated pediatric fractures of the medial humeral epicondyle were analyzed retrospectively for their epidemiological, clinical, radiological and surgical parameters. The evaluation includes the Mayo elbow performance score (MEPS). METHODS: Twenty-five surgically treated fractures of the medial humeral epicondyle were analyzed...
January 4, 2017: Curēus
Jennifer J Beck, Richard E Bowen, Mauricio Silva
BACKGROUND: Medial epicondyle fractures are predominantly seen in adolescent, male patients. Historically, nonoperative intervention was the mainstay of treatment. With increasing upper extremity demands of young athletes and reports of valgus instability after nonoperative treatment, there has been an increased interest in operative indications. Controversy regarding proper imaging and measurement of displacement complicates decision-making algorithms. Review of recent literature is required for improved decision making...
November 17, 2016: Journal of Pediatric Orthopedics
Michael Saper, Candice Brady, Robert Zondervan, David Shneider
BACKGROUND: We describe the preliminary clinical results of a patellar stabilization technique to treat bidirectional patellar subluxation (BPS). METHODS: Patients: six patients (one male, five females; mean age 30.2years) underwent this procedure with a minimum of 24months follow-up. Patients were assessed for clinical instability, patellar complications, and need for revision surgery. Patient functional outcomes were evaluated using the criteria of Crosby and Insall and the Kujala Anterior Knee Pain Scale at the time of final follow-up...
December 2016: Knee
Derrick M Knapik, Cameron L Fausett, Allison Gilmore, Raymond W Liu
BACKGROUND: Medial epicondyle fractures may occur in isolation or with associated elbow dislocation. In the absence of open fracture or fragment incarceration, nonoperative management with immobilization has been shown to result in generally successfully outcomes comparable with those reported after surgical fixation. However, no comparative investigation has assessed outcomes after nonoperative treatment based on the presence or absence of elbow dislocation. METHODS: A systematic review was conducted investigating all studies in the literature reporting nonoperative outcomes for isolated medial epicondyle fractures and fracture-dislocations...
June 2017: Journal of Pediatric Orthopedics
M Burnier, G Buisson, A Ricard, V Cunin, J P Pracros, F Chotel
INTRODUCTION: Among the various elbow injuries in children that initially have normal radiographs, a certain number of occult fractures are only diagnosed correctly after the fact, during a follow-up visit. PURPOSE: This study evaluated the diagnostic contribution of ultrasonography in the treatment of acute elbow injuries in children and the strategic and economic impact of using this tool alongside radiography. MATERIALS AND METHODS: During this prospective study performed between January 1 and April 1 2014, elbow ultrasonography was performed within 6 days in all children under 15 years of age with a suspected occult fracture...
September 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Justin Chak Yiu Lam, Ka Lok Ryan Lee, James F Griffith
Brachialis periosteal avulsion injury is an uncommon injury occurring in young children. The injury may be misinterpreted or overlooked because of misleading or subtle radiological findings. A case of 7-year-old child with post-traumatic elbow pain and subtle findings on elbow radiography is presented. The injury was initially misinterpreted as an avulsion fracture of the medial epicondyle. Following radiological review, a diagnosis of brachialis periosteal avulsion injury was made. The radiographic and magnetic resonance imaging (MRI) findings of this injury are presented to stress the value of comparing the radiographic findings with previous imaging and to increase awareness of this uncommon injury...
November 2016: Skeletal Radiology
Katsuhisa Tanabe, Nao Miyamoto
Fracture of the humeral medial epicondyle is a relatively common injury in children. Surgery is a good option for treatment, but correct diagnosis is important. Most fractures occur after the ossification of the medial epicondylar apophysis. If a fracture occurs before the ossification of the medial epicondyle, it is undetectable by radiographs. Here we report a case of an unossified medial epicondyle fracture of the humerus. A 9-year-old boy had persistent pain in the medial side of the right elbow after a fall...
October 2016: Skeletal Radiology
Matthew Stepanovich, Tracey P Bastrom, John Munch, Joanna H Roocroft, Eric W Edmonds, Andrew T Pennock
PURPOSE: Long-term functional results remain equivocal between operative fixation and closed management of displaced humeral medial epicondyle fractures. The purpose of this study was to determine whether a functional difference exists between treatment types. METHODS: One hundred and forty patients with a displaced medial epicondyle fracture between 2007 and 2014 met the inclusion criteria. Of this large cohort, only 12 patients agreed to return to clinic at a mean follow-up of 3 years for prospective evaluation...
October 2016: Journal of Children's Orthopaedics
Aristides I Cruz, Joshua T Steere, J Todd R Lawrence
The medial epicondyle serves as the proximal attachment of the medial ulnar collateral ligament and the origin of the flexor pronator musculature and as such it is responsible for resisting the main static and dynamic restraints to valgus force at the elbow. Fractures through the physis in the developing elbow are common and treatment remains controversial. Biomechanical modeling predicts that anterior should be the direction of greatest displacement. Anatomic considerations predict that anterior displacement should have the greatest effect on elbow stability and range of motion making the ulnar collateral ligament too loose in flexion and too tight in extension and potentially leading to valgus laxity in flexion and a block to full extension...
June 2016: Journal of Pediatric Orthopedics
Asha Joselet Mathew, Geetha Sulochana Gopidas, Tintu Thottiyil Sukumaran
INTRODUCTION: The Supratrochlear Foramen (STF) is a variably shaped perforation present in the bony septum that separates the olecranon and coronoid fossae at the distal end of the humerus, between the two epicondyles. Its incidence varies widely from 0.3% to 58% in different races. AIM: This study aims to describe its prevalence and morphometry in relation to its shape and size and distance from the epicondyles. MATERIALS AND METHODS: A prospective study of 244 unpaired humerii, 130 of the left side and 114 of the right side of unknown age and sex were examined for the presence of STF and prevalence stated...
February 2016: Journal of Clinical and Diagnostic Research: JCDR
Gregory I Pace, William L Hennrikus
BACKGROUND: Open reduction and internal fixation of displaced medial epicondyle fracture dislocations in adolescents is recommended for incarceration of the epicondyle in the joint and for athletes who need a stable elbow for their sport. A screw placed across the epicondyle into the medial column avoiding the olecranon fossa is a common fixation method. One author has recommended adding a metal washer to the screw fixation because of the perceived risk of epicondyle fragmentation or penetration when using a screw alone...
March 2017: Journal of Pediatric Orthopedics
A Wenger, J Berger, H Piza-Katzer
BACKGROUND: Supracondylar humerus fractures are very common in pediatric populations. In cases of dislocated fractures, closed reduction and percutaneous K‑wire fixation is recommended. Initially, 10-16 % of the patients also present lesion of the ulnar nerve as well as median nerve palsy in 6.4% and radial nerve palsy in 2.6 % of cases, respectively. METHOD: We present the case of a 10-year-old boy with a dislocation of the elbow and fracture of the medial epicondyle...
August 2016: Der Unfallchirurg
Marcus D Biggers, Timothy M Bert, Alice Moisan, David D Spence, William C Warner, James H Beaty, Jeffrey R Sawyer, Derek M Kelly
To compare clinical and radiographic outcomes of medial epicondylar fractures treated operatively to those treated nonoperatively, 30 patients with 31 fractures were divided into three groups: (a) nondisplaced, six treated nonoperatively; (b) incarcerated fragment, four with operative treatment; and (c) displaced but not incarcerated, 21 fractures, 14 treated operatively and seven nonoperatively. Clinical outcomes were assessed with follow-up examination and the Japanese Orthopaedic Association elbow assessment score...
2015: Journal of Surgical Orthopaedic Advances
Phillip Bell, Brian P Scannell, Bryan J Loeffler, Brian K Brighton, R Glenn Gaston, Virginia Casey, Melissa E Peters, Steven Frick, Lisa Cannada, Kelly L Vanderhave
BACKGROUND: Although supracondylar humerus fractures are common in young children, the incidence in adolescents is much lower. As a result, there is a paucity of literature to guide treatment. The purpose of this study was to review the treatment and outcomes for a consecutive series of distal humerus fractures in adolescents and to compare outcomes between patients treated with percutaneous skeletal fixation and those treated with open reduction and fixation. METHODS: A retrospective review of patients 10 to 17 years of age who underwent surgical treatment for a distal humerus fracture from 2005 to 2014 was performed...
December 17, 2015: Journal of Pediatric Orthopedics
Mohamed Elbashir, Peter Domos, Mark Latimer
Elbow fractures are not uncommon in children, and some are associated with neurovascular injuries. Having a nerve injury in an elbow fracture without dislocation is rare and was not described in the literature. Here, we have reported probably the first case of an ulnar nerve injury in an elbow fracture without dislocation. A 9-year-old female presented to the emergency department after falling off a monkey bar. She had a painful, swollen and tender right elbow with no history or clinical signs of an elbow dislocation but had complete ulnar nerve palsy...
2015: Journal of Surgical Case Reports
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