Treatment of Medial Epicondyle Fracture without Associated Elbow Dislocation in Older Children and Adolescents

PURPOSE: Displaced medial humeral epicondyle fractures with or without elbow dislocation have been treated with open reduction and fixation using K-wires or screws. The purpose of this study is to evaluate the clinical and radiological outcomes of surgical treatments of medial humeral epicondyle fracture without elbow dislocation according to the fixation methods. MATERIALS AND METHODS: Thirty-one patients who had undergone open reduction and fixation of the displaced medial humeral epicondyle fracture without elbow dislocation were included. Group I consisted of 21 patients who underwent fixation with K-wires, and Group II comprised 10 patients who underwent fixation with cannulated screws. Immediate postoperative, final follow-up and normal anteroposterior radiographs were compared and the clinical outcome was assessed using the final Japanese Orthopaedic Association (JOA) elbow assessment score. RESULTS: On the immediate postoperative radiographs, the distal humeral width in Group II was larger than that in Group I. On the final follow-up radiographs, the epicondylar position in Group I was lower than that in Group II. There was no significant difference in the distal humeral width, epicondylar position and joint space tilt between the immediate postoperative, final follow-up radiographs and the normal side within each group. There was no significant difference in the final JOA score between groups. CONCLUSION: Open reduction followed by K-wire fixation or screw fixation of the displaced medial humeral epicondyle fracture without elbow dislocation in older children and adolescents resulted in improved radiologic outcome and good elbow function in spite of diverse radiologic deformities.

The Fractures of Humerus Shaft and Medial Epicondyle by Arm Wrestling

PURPOSE: To evaluate the mechanism of the humeral fractures induced by arm wrestling and the clinical results of its treatment. MATERIALS AND METHOD: We reviewed 7 humeral fractures induced by arm wrestling; 3 humeral shaft fractures, 4 humeral medial epicondyle fractures. The mechanism of the fractures and the clinical results were assessed by history and radiographs. RESULTS: Shaft fractures were produced by twist and axial compression force. Humeral medial epicondyle fractures were the avulsion fractures by excessive contraction of flexor muscles and developed in young age. We operated 6 of them and in all cases, we could obtain fracture healings without complication. CONCLUSION: The humeral fractures induced by arm wrestling have the differences in the ages and mechanisms as to the locations of the fractures and if the proper treatment is performed, the clinical results are satisfactory.