Background: Medial epicondyle fractures represent up to 20% of elbow fractures in children and adolescents. There is a growing body of literature to support surgical fixation for displaced fractures. However, controversy regarding imaging modality for displacement measurement and surgical indications remain controversial. The purpose of this survey was to gauge Latin American surgeons' practices and preferences for the evaluation and treatment of medial epicondyle fractures.
Methods: A web-based survey containing 19 questions was distributed to active members of SLAOTI (Sociedad Latinoamericana de Ortopedia y Traumatología Infantil) in November 2018. The survey elicited information regarding surgeon demographics, evaluation methods, the factors involved in the decision to perform surgery, and their experience in cases of symptomatic nonunion. Categorical variables were summarized using frequencies and proportions. Analysis of associations between surgeon demographics and treatment preferences were carried out.
Results: A total of 193 out of 354 completed questionnaires were returned (54% response rate). In total, 74% of the participants (142/193) favored radiographs for the evaluation of the fracture displacement, and 25.4% (49/193) added a computed tomography scan for a more detailed evaluation. The majority of respondents (48.2%) would consider a 5 mm displacement as the cutoff for surgical treatment, 21.8% 2 mm, 20.7% 10 mm, and 9.3% 15 mm. There were no differences between the experience of the participants, academic versus private setting, or training regarding surgical/nonsurgical management.
Conclusions: There are significant differences in opinions between SLAOTI members as to the optimal management of medial epicondyle fractures. Implications of disagreement in evaluation and treatment support the need for multicenter prospective studies to develop evidence-based guidelines for the management of this fracture.
Level Of Evidence: Level V-expert opinion. Cross-sectional electronic survey.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BPO.0000000000001457 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
[Application of elbow skin fold extension line in extreme elbow flexion in ulnar Kirschner wire insertion of extended supracondylar humeral fractures in children].
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi
January 2025
Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, the Affiliated Suqian Hospital of Xuzhou Medical University, Suqian Jiangsu, 223800, P. R. China.
Objective: To discuss the elbow skin fold extension line in Kirschner wire internal fixation of extended supracondylar humeral fractures in children.
Methods: The clinical data of 58 children with extended supracondylar fractures of the humerus who met the selection criteria between August 2021 and July 2024 were retrospectively analyzed. In 28 cases, needle placement of medial epicondyle of humerus was performed with the assistance of the elbow skin fold extension line (study group), and 30 cases were assisted by routine touch of the medial epicondyle of the humerus (control group).
Partial Avulsion Patterns in the Pediatric Humeral Medial Epicondyle.
Am J Sports Med
January 2025
Division of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Background: The anterior oblique bundle of the medial ulnar collateral ligament (UCL) inserts on the anteroinferior aspect of the humeral medial epicondyle, while the flexor pronator mass (FPM) originates superficial and proximal to the UCL. With valgus stress, these distinct footprints may produce injury patterns that affect only focal areas of the medial epicondyle.
Hypothesis: The proximal UCL can act on the medial epicondyle either in isolation or in conjunction with the FPM to form partial avulsion fracture patterns within the pediatric medial epicondyle, and the predominant pattern involves only the proximal UCL footprint.
Effects of forearm rotation on wrist flexor and extensor muscle activities.
J Orthop Surg Res
January 2025
Department of Orthopedic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami-Town, Ibaraki-Pref., Japan.
The forearm muscles coordinately control wrist motion, and their activity is affected by forearm rotation. Although forearm rotation has been implicated in the development of lateral and medial epicondylitis, its biomechanical background remains unknown. Therefore, the present study investigated the activity of wrist muscles in various forearm positions.
View Article and Find Full Text PDFThe Utility of the Radiocapitellar View in Pediatric Medial Epicondyle Fracture Evaluation.
J Pediatr Orthop
January 2025
Division of Sports Medicine, Boston Children's Hospital, Boston, MA.
Background: Anteroposterior (AP) and lateral radiographs often underestimate displacement in medial epicondyle fractures, further complicating the already debated operative indications. The radiocapitellar (RC) view is an alternative radiograph that allows for the separation of the humeroradial and humeroulnar joints. This study investigates the utility of the RC view in measuring displacement and identifying the need for operative intervention in pediatric medial epicondyle fractures.
View Article and Find Full Text PDFMidterm comparative result of absorbable screws and metal screws in pediatric medial humeral epicondyle fracture.
J Orthop Sci
January 2025
Department of Pediatric Orthopedics, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, 410013, China.
Backgroud: Medial humeral epicondyle fracture is a prevalent type of upper limb fractures in pediatric patients. This study aims to compare the follow-up clinical results and complications in 30 children with medial epicondyle fractures who were treated with either metal screws or absorbable screws at our hospital.
Methods: A retrospective review was conducted on 30 children with medial humeral epicondyle fractures, who were divided into two groups: Metal group (18 children) underwent fixation using metal screws, while Absorbable group (12 children) received absorbable screws between January 2016 and June 2024.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!