title: Incarcerated medial epicondyle fracture following pediatric elbow dislocation: 11 cases.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT; Connecticut Orthopaedic Specialists, Hamden, CT. Electronic address: seth.dodds@yale.edu.
authors.forename: Seth D
authors.initials: SD
authors.lastname: Dodds
authors.affiliation: Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT; Connecticut Orthopaedic Specialists, Hamden, CT.
authors.forename: Brody A
authors.initials: BA
authors.lastname: Flanagin
authors.affiliation: Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT; Connecticut Orthopaedic Specialists, Hamden, CT.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Bohl
authors.affiliation: Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT; Connecticut Orthopaedic Specialists, Hamden, CT.
authors.forename: Peter A
authors.initials: PA
authors.lastname: DeLuca
authors.affiliation: Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT; Connecticut Orthopaedic Specialists, Hamden, CT.
authors.forename: Brian G
authors.initials: BG
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D002648:Child; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011859:Radiography; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D000092464:Elbow Injuries
keywords: Incarcerated medial epicondyle fracture; elbow dislocation; open reduction internal fixation; pediatric