When Is a Medial Epicondyle Fracture a Medial Condyle Fracture?

摘要

An otherwise healthy 10-year-old boy initially presented to the senior author (A.B.) for evaluation of persistent right elbow stiffness after fracture management. The right-hand-dominant patient sustained an injury to the elbow approximately 10 weeks earlier, while playing football. Within a few hours of the injury, he underwent evaluation in a pediatric emergency department (ED), where he presented with moderate right elbow pain and weakness with movement. He reported no history of numbness, tingling, or associated injuries. Clinical findings included swelling and tenderness on the medial aspect of the right elbow. The patient had decreased range of motion (ROM) secondary to pain, with sensory function and pulses intact, and brisk distal capillary refill. Physical examination and systems review were otherwise unremarkable. Lateral and anteroposterior (AP) radiographs of the right elbow (Figure 1) were obtained in the ED. There was an elbow effusion. On the lateral radiograph, a small bony fragment was noted anterior to the distal humeral metaphysis; there was no identifiable fracture line on the AP view. A long-arm posterior splint was applied, with the elbow at 90° of flexion and the wrist in neutral position. The patient was discharged home with follow-up instructions.