Medial Epicondyle Fracture (Elbow)

Description

The medial epicondyle is the bony bump on the inner side of the elbow, where forearm muscles and a key ligament attach. A fracture pulls this bump off, often during a fall, sometimes with a brief elbow dislocation, or from the repetitive pull of throwing.

How it happens (the mechanism)

The inner-elbow muscles and the main inner ligament both anchor to the medial epicondyle, which in a still-growing child is its own growth center (apophysis). A sudden outward (valgus) force — a fall, a dislocation, or a hard throw — yanks on those attachments and avulses the bump. Sometimes the fragment is pulled into the joint as a dislocated elbow relocates.

Symptoms

Pain, swelling, and tenderness on the inner side of the elbow, sometimes with numbness in the ring and small fingers (the nearby ulnar nerve).

Doctor examination and imaging

The doctor checks the inner elbow and the ulnar nerve; X-rays show how far the fragment has moved and whether it is caught in the joint.

Treatment

A minimally displaced fracture is usually treated in a cast for three to four weeks. Surgery (a small screw) is considered when the piece is significantly displaced, is caught inside the joint, or in a young throwing athlete who needs maximum inner-elbow strength.

Recovery and long-term outlook

Many heal well without surgery, even when the bump heals by a strong fibrous connection rather than perfectly back in place; the decision weighs displacement against the demands the child places on that elbow.

When to call the doctor

Call the office right away if your child’s fingers become numb, pale, blue, or cold; pain keeps worsening even after raising the arm and giving medicine; swelling does not improve with elevation; the cast feels too tight, cracked, or wet, or smells bad; or your child develops a fever.

Learn more

OrthoInfo (AAOS) — Elbow Fractures in Children: orthoinfo.aaos.org

This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.