You are here

Medial Epicondyle Fracture S42.443A 812.43

 

synonyms:

Medial Epicondyle Fracture ICD-10

 

A- initial encounter for closed fracture

B-  initial encounter for open fracture

D- subsequent encounter for fracture with routine healing

G- subsequent encounter for fracture with delayed healing

K- subsequent encounter for fracture with nonunion

P- subsequent encounter for fracture with malunion

S- sequela

Medial Epicondyle Fracture ICD-9

  • 812.43(closed)
  • 812.53(open)

Medial Epicondyle Fracture Etiology / Epidemiology / Natural History

  • 11% of peds elbow fxs
  • most common ages =9-14yrs

Medial Epicondyle Fracture Anatomy

  • Valgus force to the elbow typically causing avulsion of the flexor prohator origin and meidal collateral ligament.

Medial Epicondyle Fracture Clinical Evaluation

  • Medial elbow pain and swelling
  • Instability to valgus stress.
  • Document NV exam before and after any treatment.

Medial Epicondyle Fracture Xray / Diagnositc Tests

Medial Epicondyle Fracture Classification / Treatment

  • nonsurgical treatment  even for widely displaced fxs.  Posterior mold initially, LAC for <3wks.  Begin AROM asap-7-10 days depending on fx.  Nonsurgical management usually results in a painless nonunion with good elbow function and little elbow instability.  Prolonged immobilization should be avoided to prevent stiffness
  • 35 yr follow-up displaced (mean 6mm) treated with immobilization showed very good function and ROM, with 55% pseudoarthrosis.  Symptoms did not differ between groups c or s pseudoarthrosis. (Josefsson PO, Acta Orthop Scand 57:313:1986)
  • surgery = increased radiographic union, but more minor symptoms than conservative treatment
  • Surgery indicated for irreducible incarceration of the medial epicondyle within the joint, suspected ulnar nerve entrapment, open fracture, fractures in throwing athletes with valgus instability. 
  • Relative indications=children likely place excessive valgus stress on elbow such as gymnast or pitcher(Case SL, Am J Sports Med 25:682;1997)
  • fragment excision is associated with poor outcomes in adulthood (Farsetti JBJS83A:1299;2001)

Medial Epicondyle Fracture Associated Injuries / Differential Diagnosis

  • up to 50% may be associated with elbow dislocation

Medial Epicondyle Fracture Complications

Medial Epicondyle Fracture Follow-up Care

Medial Epicondyle Fracture Review References

Disclaimer

The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer