Medial epicondyle fracture (peds)
Background
- Not true Salter-Harris fracture (apophysis, not physis, is involved)
- 50% associated with elbow dislocation
Evaluation
- Displacement of medial epicondyle ossification center
- May become entrapped within elbow joint
- Use CRITOE to determine if bone in joint is medial epicondyle or nl trochlear oss center
- If think is trochlear but cannot see medial epicondyle fragment is medial epicondyle
- (Medial epicondyle normally ossifies before the trochlea)
- If think is trochlear but cannot see medial epicondyle fragment is medial epicondyle
- Fat pad sign not usually present because most injuries are extra-articular
Differential Diagnosis
Radiograph-Positive
- Distal humerus fracture
- Radial head fracture
- Capitellum fracture
- Olecranon fracture
- Elbow dislocation
Radiograph-Negative
- Lateral epicondylitis
- Medial epicondylitis
- Olecranon bursitis (nonseptic)
- Septic bursitis
- Biceps tendon rupture/dislocation
Management
- Ortho consult
- Long arm cast with elbow flexed 90˚ vs operative management[1]
See Also
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