Medial epicondyle avulsion after elbow dislocation in an adolescent non-professional soccer player treated with a cannulated screw: a case report

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Alessio Pedrazzini
Alberto Visigalli
Piergiulio Valenti
Nicola Bertoni
Henry Yewo Simo
Roberto Bisaschi
Vanni Medina
Bianca Pedrabissi
Francesco Ceccarelli
Francesco Pogliacomi

Keywords

elbow, dislocation, medial epicondyle, reduction, fixation, screw, outcome

Abstract

Background and aim of the work: Medial epicondyle fractures of the humerus account for 11–20% of
all elbow injuries in children and in 30–55% of cases they are associated with an elbow dislocation. Undisplaced
fractures are usually treated conservatively but literature is controversial regarding the treatment of displaced
fractures (≥5mm) in paediatric fractures. In recent years, there is an emerging consensus that such patients may benefit more from open reduction and internal fixation. Authors report a case of a 15 years old nonprofessional soccer player who suffered of an elbow dislocation with an intra-articular fragment derived from avulsion of the medial epicondyle. Methods: Clinical and instrumental evaluation confirmed elbow dislocation with an intra-articular fragment derived of the medial epicondyle. After the reduction an open reduction and internal fixation with cannulated screw was performed. Results: Clinical evaluation after 90 days showed resolution of pain and almost complete ROM and complete recovery of strength and of functionality of the operated limb. Furthermore, x-rays demonstrated consolidation of the fracture. Conclusions: this case confirms that a precise evaluation of the fracture and its displacement is at the base of satisfactory outcomes. If fracture is displaced≥5mm and patient is near skeletal maturity open reduction and fixation is indicated.

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