Prospective study of pediatric medial humeral epicondyle fractures nonoperatively treated. Clinical, radiologic, and functional evaluation at long term

The objective of the study is to evaluate the natural history of the medial epicondyle avulsion in children with nonoperative treatment (NOPT) on different magnitude of displacement and long-term follow-up. A prospective study of 34 patients with medial epicondyle avulsion with (NOPT) was performed. Clinical test (stability, strength, atrophy, tenderness, Tinel test, and range of motion), subjective scores [Visual Analog Scale (VAS), Likert scale, side-to-side valgus test], and objective four scores were performed. Age at the time of injury was 8.9 ± 2.81 years. Follow-up was 7 ± 2.81 years. Four of the patients had anterior displacement. Displacement varied between 3 and 26 mm (10.49 ± 6.16 mm). Subjective: VAS and ordinal three-point Likert scale were excellent. Objective results were also excellent Mayo Elbow Score: 98.67 ± 4.31 (85–100), Oxford Elbow Score: 59.35 ± 1.68 (51–100), Elbow Assessment Score System: 96.27 ± 9.77 (57–100), Disabilities of the Arm, Shoulder, and Hand (DASH) score 0.64 ± 1.001 (0–4.16). We did not find any differences in strength or forearm diameter. There was an extension deficit in seven cases with a significant association with the magnitude of displacement (P = 0.02) and with the presence of concomitant lesions or anterior displacement of the medial epicondyle>5 mm. All except one were stable clinically on valgus stress. There is a significant association between the objective outcomes (...
Source: Journal of Pediatric Orthopaedics B - Category: Orthopaedics Tags: Upper Limb Trauma Source Type: research