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Paediatric medial humeral epicondyle fracture management

2019 approach

Firth, Amy M.; Marson, Ben A.; Hunter, James B.

doi: 10.1097/MOP.0000000000000707
ORTHOPEDICS: Edited by Daniel W. Green

Purpose of review The management of displaced medial humeral epicondyle fractures in children remains controversial. The indications for surgery, the ideal surgical strategy and the implications of a painful nonunion remain unclear.

Recent findings This article describes the state of the evidence and the art in the management of medial humeral epicondyle fractures concentrating on recent research and current opinion. Treatment of paediatric medial epicondylar fractures of the elbow remains the domain of expert opinion and subject to great variance. Anatomical, biomechanical and computer simulation models suggest great importance should be given to the medial epicondyle and the structures, which insert onto it. However, this does not correlate with outcomes as reported by patients, parents and surgeons.

Summary The question of which paediatric medial humeral epicondylar fractures benefit from operative fixation remains unanswered. A large randomized prospective trial is required.

Department of Trauma and Orthopaedics, Queen's Medical Centre, Nottingham, UK

Correspondence to James B. Hunter, BA, FRCSEd(Orth), Department of Trauma and Orthopaedics, Queen's Medical Centre, Nottingham, UK. Tel: +44 115 924 9924 x63244; e-mail:

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