• Seth D Dodds, Brody A Flanagin, Daniel D Bohl, Peter A DeLuca, and Brian G Smith.
• Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT; Connecticut Orthopaedic Specialists, Hamden, CT. Electronic address: seth.dodds@yale.edu.
• J Hand Surg Am. 2014 Sep 1; 39 (9): 1739-45.

PurposeTo describe outcomes after surgical management of pediatric elbow dislocation with incarceration of the medial epicondyle.MethodsWe conducted a retrospective case review of 11 consecutive children and adolescents with an incarcerated medial epicondyle fracture after elbow dislocation. All patients underwent open reduction internal fixation using a similar technique. We characterized outcomes at final follow-up.ResultsAverage follow-up was 14 months (range, 4-56 mo). All patients had clinical and radiographic signs of healing at final follow-up. There was no radiographic evidence of loss of reduction at intervals or at final follow-up. There were no cases of residual deformity or valgus instability. Average final arc of elbow motion was 4° to 140°. All patients had forearm rotation from 90° supination to 90° pronation. Average Mayo elbow score was 99.5. Four of 11 patients had ulnar nerve symptoms postoperatively and 1 required a second operation for ulnar nerve symptoms. In addition, 1 required a second operation for flexion contracture release with excision of heterotopic ossification. Three patients had ulnar nerve symptoms at final follow-up. Two of these had mild paresthesia only and 1 had both mild paresthesia and weakness.ConclusionsOur results suggest that open reduction internal fixation of incarcerated medial epicondyle fractures after elbow dislocation leads to satisfactory motion and function; however, the injury carries a high risk for complications, particularly ulnar neuropathy.Type Of Study/Level Of EvidenceTherapeutic IV.Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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