Medial humeral epicondylar fracture in children and adolescents.
OBJECTIVE
To assess treatment outcomes of young patients with medial epicondylar fracture of the elbow using standard operative protocols.


METHODS
24 consecutive patients with medial humeral epicondylar fracture underwent surgery by one of the 3 methods: (1) 2 parallel Kirschner wires, (2) 2 parallel Kirschner wires plus a tension-band wire, and (3) a screw plus an anti-rotation Kirschner wire. Fractures displaced less than 5 mm were treated conservatively (casting for 3 weeks). Outcome was assessed clinically and radiologically. The Mayo Clinic Elbow Performance Index was measured.


RESULTS
The 3 patients with undisplaced fractures had good radiological results and scores. One patient with a displaced fracture refused surgery and subsequently developed pseudarthrosis and cubitus valgus. All operatively treated patients had good scores, but 2 treated with 2 parallel Kirschner wires alone developed pseudarthrosis. Patients in this group needed longer rehabilitation to attain a functional range of movement than those in other groups (treated together with a tension-band wire or screw).


CONCLUSIONS
Surgery is recommended for children with displaced medial epicondylar fractures of more than 5 mm. The use of a tension-band wire, instead of a screw, together with Kirschner wires is the preferred treatment for younger children.
Ip
D
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Department of Orthopaedics and Traumatology, Pamela Youde Nethersole Eastern Hospital, Hong Kong. ipd8686@pacific.net.hk
Tsang
W L
WL
D000293:Adolescent; D001863:Bone Screws; D001864:Bone Wires; D002648:Child; D004551:Elbow Joint / Q000503:physiopathology; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome