A Blocking Barrier During Reduction of the Elbow Dislocation in Children: Incarcerated Medial Epicondyle Fracture

Abstract

Background: In children, an incarcerated medial epicondyle fracture of the distal humerus associated with elbow dislocation, may be missed on conventional radiographs. Other reliable radiological criteria are imperative for the diagnosis of these fractures. The purpose of the study was to investigate the clinical results of the operative treatment of incarcerated medial epicondyle fractures after elbow dislocation in children and define new radiological criteria in the diagnosis. Materials and Methods: A sea wave-like shaped parallel double line was seen on anterior-posterior elbow radiographs of non-fractured pediatric patients. The disruption of the sea wave-like sign was defined as a new diagnostic radiographic criterion in incarcerated medial epicondyle fractures after elbow dislocation in children. Seven children with an incarcerated medial epicondyle fracture. Results: The mean age was 12.14±2.1 years (range: 9-15 years) and the mean follow-up period was 29.1±13.6 months (range: 12-48 months). The mean Mayo elbow score was 92.8±4.8 (range: 85-100) at the final follow-up. The new diagnostic radiological criterion was identified in all incarcerated medial epicondyle fractured patients. Conclusions: The results of this study suggest that open reduction internal fixation of incarcerated medial epicondyle fractures after elbow dislocation resulted in satisfactory motion and function. The new diagnostic radiological criterion defined in this study is useful, does not incur any additional cost and may solve the diagnostic problems of incarcerated medial epicondyle fractures of the distal humerus after elbow dislocation in the pediatric population.