J Korean Orthop Assoc.  2015 Dec;50(6):513-519. 10.4055/jkoa.2015.50.6.513.

Operative Treatment of Displaced Medial Epicondyle Fractures Using K-Wires Cross-Fixation

• Heo YM
• Kim SB
• Yi JW
• Lee JI
• Yoo HJ
• Kim TG

• KMID: 2185092
• DOI: http://doi.org/10.4055/jkoa.2015.50.6.513

Abstract

PURPOSE
The aim of this study was to investigate the clinical and radiological outcomes following reduction of displaced medial humeral epicondyle fracture with a K-wire cross-fixation.
MATERIALS AND METHODS
Seventeen patients (mean age, 12.7 years; 12 boys and 5 girls) who underwent cross-fixation using K-wires in displaced medial epicondyle fracture, regardless of dislocation, were included. Surgical outcomes were estimated using the Elbow Assessment Score of the Japanese Orthopaedic Association. Statistical significance between the elbow assessment score and age, fracture type, dislocation, displacement width, and size difference between bilateral medial epicondyles was estimated 6 weeks after surgery.
RESULTS
The mean elbow assessment score among the patients was 98 points (range, 94-100 points). Displaced medial epicondyle fractures were radiologically classified according to 3 groups: minimally displaced (2 cases), entrapped (9 cases), and associated with dislocation (6 cases). The mean displacement width of the fracture fragment was 11.6 mm. At 6 weeks postoperatively, the medial length of the distal humerus (28.6 mm) was greater compared to that of the contralateral side (28.1 mm). Displacement of the fracture fragment was statistically related to the elbow assessment score (p=0.011). The other assessed values did not show statistical meaning.
CONCLUSION
Open reduction of the displaced medial humeral epicondyle fracture using K-wire cross-fixation in children and adolescents showed favorable clinical results with no instability or elbow complications.

Keyword

humerus; medial epicondyle; fracture; K-wire; fixation

MeSH Terms

Adolescent
Asian Continental Ancestry Group
Child
Dislocations
Elbow
Humans
Humerus

Figure

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  Figure 1 A 17-year-old male with a fracture in which bone fragment is positioned in the articular space. (A, B) Bone fragment positioned in the articular space, anteroposterior (AP) and lateral view. (C, D) Elbow was not reduced because of a bone fragment seen in AP and oblique view.

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  Figure 2 Pre- and postoperative state of a 17-year-old male. (A, C) Bone fragment positioned in the articular space, anteroposterior (AP) and oblique view. (B, D) Bone fragment was fixed by 4 K-wires seen in AP and oblique view.

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  Figure 3 Method for measurement of displacement degree of bone fragment and medial epicondyle width. (A) Displacement degree was defined as distance of between proximal point of the fractured site and the same point of bone fragment (a, proximal point of the fractured site in the humerus; b, same point in a fractured bone fragment; D, distance between a and b). (B) Medial width was measured like (m, midline of the humerus which was the longitudinal axis; p, apex of the medial epicondyle; L, length; U, ulna side; R, radial side).

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