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Medial Epicondyle Fracture S42.443A 812.43



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