Medial Epicondyle Fracture Fixation in the Lateral Decubitus Position

Courtesy: Scott Kozin, Dan Zlotolow, Shirner’s hospital for Children, USA

Fixation of the medial epicondyle fracture remains controversial, with arbitrary degrees of displacement providing treatment guidelines in the predominating literature. The degree of displacement has not only been shown to be difficult to determine with plain films, but more importantly is irrelevant to the outcome. Any displacement can signal detachment and therefore insufficiency of the medial collateral ligament (MCL). Likewise, a large amount of displacement may only involve the muscular origin, sparing the ligament, and may be treated with immobilization alone. The status of the ligament, and not the displacement of the epicondyle, should guide treatment. We therefore advocate for an examination under anesthesia of all medial epicondyle fractures unless they are truly non-displaced.