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Delayed Reconstruction Following Incarceration of the Medial Epicondyle in the Elbow Joint

A Case Report and Review of the Literature

Lotz, Benedict1; Akilapa, Oluwasegun, MRCS2; Karthik, Karuppaiah, MBBS, MS, MRCS, MSc, MCh, FRCS(T&O)2,a

doi: 10.2106/JBJS.CC.17.00239
Case Reports

Case: Neglected medial epicondylar fractures with intra-articular incarceration are uncommon. At 6 weeks after an elbow dislocation, an 11-year-old child was referred to our unit with painless, restricted range of motion. Clinical assessment and radiographic imaging revealed an incarcerated medial epicondylar fragment in the ulnohumeral joint. We performed open reduction and internal fixation (ORIF) and transposed the ulnar nerve. The clinical and radiographic outcomes at the final follow-up were excellent.

Conclusion: The management of neglected pediatric medial epicondylar fractures with intra-articular incarceration is challenging. Identifying the fractured fragment is essential. Although the outcome following excision is variable, children who have undergone ORIF with ulnar nerve transposition have regained full function, despite delayed reconstruction.

1Heidelberg University, Heidelberg, Germany

2King’s College Hospital, London, United Kingdom

aE-mail address for K. Karthik:

Copyright © 2018 by The Journal of Bone and Joint Surgery, Incorporated
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