Medial epicondyle fracture of the humerus

Fracture of the medial epicondyle of the humerus

Overview

A medial epicondyle fracture of the humerus is a type of elbow fracture that occurs at the bony prominence on the inner side of the elbow joint. This fracture is most commonly seen in children and adolescents, particularly those involved in sports activities that involve throwing or overhead motions.

Anatomy

The medial epicondyle is a part of the humerus, the long bone of the upper arm. It serves as the attachment site for the ulnar collateral ligament and the common flexor tendon, which are crucial for the stability and movement of the elbow joint. The medial epicondyle is located on the distal end of the humerus, near the elbow.

Mechanism of Injury

Medial epicondyle fractures typically occur due to a fall on an outstretched hand (FOOSH) or a direct blow to the elbow. In children, these fractures can also occur due to a sudden pull on the arm, such as when a child is lifted by the arm. The fracture may be associated with an elbow dislocation, which can complicate the injury.

Clinical Presentation

Patients with a medial epicondyle fracture often present with pain, swelling, and tenderness over the medial aspect of the elbow. There may be visible deformity if the fracture is displaced. Limited range of motion and weakness in the affected arm are common symptoms. In some cases, there may be associated ulnar nerve symptoms, such as numbness or tingling in the ring and little fingers.

Diagnosis

Medial epicondyle fracture of the humerus

Diagnosis of a medial epicondyle fracture is typically made through clinical examination and confirmed with radiography. X-rays of the elbow are used to assess the fracture pattern, displacement, and any associated injuries. In some cases, advanced imaging such as CT scan or MRI may be necessary to evaluate complex injuries.

Treatment

The treatment of medial epicondyle fractures depends on the severity and displacement of the fracture. Non-displaced or minimally displaced fractures can often be managed conservatively with immobilization in a cast or splint. Displaced fractures may require surgical intervention to realign and stabilize the bone fragments. Surgical options include open reduction and internal fixation (ORIF) using screws or wires.

Rehabilitation

Rehabilitation following a medial epicondyle fracture involves physical therapy to restore range of motion, strength, and function of the elbow. Early mobilization is encouraged to prevent stiffness, but activities that stress the elbow should be avoided until healing is complete. Full recovery can take several months, and return to sports should be guided by a healthcare professional.

Complications

Potential complications of medial epicondyle fractures include nonunion, malunion, and persistent elbow stiffness. Ulnar nerve injury is another possible complication, which can lead to sensory and motor deficits in the hand. Early recognition and appropriate management of these complications are essential for optimal outcomes.

Related pages

• Elbow fracture
• Humerus
• Ulnar nerve
• Orthopedic surgery