Fracture of the Medial Humeral Epicondyle in Children: A Comparison of Operative and Nonoperative Management


To compare clinical and radiographic outcomes of medial epicondylar fractures treated operatively
to those treated nonoperatively, 30 patients with 31 fractures were divided into three groups: (a)
nondisplaced, six treated nonoperatively; (b) incarcerated fragment, four with operative treatment;
and (c) displaced but not incarcerated, 21 fractures, 14 treated operatively and seven nonoperatively.
Clinical outcomes were assessed with follow-up examination and the Japanese Orthopaedic Association
elbow assessment score. Average elbow scores were 98 in nondisplaced fractures, 94 with an
incarcerated fragment, 95 in displaced fractures treated operatively, and 94 in displaced fractures treated nonoperatively. The only nonunion was in a fracture with an incarcerated fragment. Both operative and nonoperative treatment produced good outcome scores in displaced but not incarcerated fractures, but radiographic deformity and instability were more frequent in those treated nonoperatively. (Journal of Surgical Orthopaedic Advances 24(3):188–192, 2015)

Key words: children, medial epicondyle fracture, nonoperative treatment, operative treatment, outcomes

Marcus D. Biggers, MD; Timothy M. Bert, MD; Alice Moisan, BSN David D. Spence, MD; William C. Warner, Jr., MD; James H. Beaty, MD; Jeffrey R. Sawyer, MD; Derek M. Kelly, MD