Long-Term Outcomes of Operatively Treated Medial Epicondyle Fractures in Pediatric and Adolescent Patients.
Elbow
Fracture
Medial epicondyle
Pediatric
Trauma
Journal
Journal of hand surgery global online
ISSN: 2589-5141
Titre abrégé: J Hand Surg Glob Online
Pays: United States
ID NLM: 101759126
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
29
10
2020
accepted:
27
02
2021
entrez:
13
4
2022
pubmed:
14
4
2022
medline:
14
4
2022
Statut:
epublish
Résumé
Medial epicondyle fractures are among the most common pediatric elbow injuries. The management of these fractures continues to be debated. To better understand patient results with operative fixation, we reviewed the outcomes of operatively treated medial epicondyle fractures. A retrospective review was performed to identify all patients less than 18 years of age at the time of injury who were treated surgically for medial epicondyle fractures. Outcomes were assessed based on the Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity and Pain Interference domains, Visual Analog Scale for pain, subjective range of motion, ulnar nerve function, and requirement for secondary surgery. We identified a cohort of 95 patients treated for a medial epicondyle fracture with open reduction and screw fixation. Of these, 39 patients with a mean age of 12.2 years (SD, 2.2 years; range, 7.6-16.0 years) at surgery were assessed for an average follow-up of 6.3 years (SD, 3.2 years; range, 2.2-13.9 years). Outcome measures and pain scores were excellent. The mean PROMIS Upper Extremity score was 56.9, the mean Pain Interference score was 38.5, and the mean Visual Analog Scale score was 0.4.Sixteen patients (41%) required secondary surgery for symptomatic hardware removal. Seven patients (18%) developed sensory complaints and 2 (5%) developed motor complaints consistent with ulnar nerve irritability. Three patients (8%) reported dissatisfaction with elbow range of motion. Patients who required secondary surgeries had higher (worse) PROMIS Pain Interference scores. At an average of 6.3 years after surgery, the clinical outcomes for medial epicondyle fracture were excellent. While operative treatment for medial epicondyle fractures in children leads to excellent clinical outcomes, patients and surgeons should be aware of high rates of hardware removal. Therapeutic IV.
Identifiants
pubmed: 35415547
doi: 10.1016/j.jhsg.2021.02.006
pii: S2589-5141(21)00018-9
pmc: PMC8991540
doi:
Types de publication
Journal Article
Langues
eng
Pagination
124-128Informations de copyright
© 2021 The Authors.
Références
Am J Sports Med. 1977 Jan-Feb;5(1):23-30
pubmed: 848632
J Bone Joint Surg Am. 2004 Oct;86(10):2268-74
pubmed: 15466738
J Shoulder Elbow Surg. 2018 Jul;27(7):1191-1197
pubmed: 29567038
J Pediatr Orthop. 2019 Sep;39(8):e592-e596
pubmed: 31393295
J Orthop Traumatol. 2015 Jun;16(2):117-23
pubmed: 25062665
Arthroscopy. 2014 Jun;30(6):679-87
pubmed: 24795269
J Bone Joint Surg Am. 1998 Mar;80(3):431-8
pubmed: 9531213
J Child Orthop. 2015 Aug;9(4):295-302
pubmed: 26255147
J Shoulder Elbow Surg. 2010 Oct;19(7):951-7
pubmed: 20688542
J Am Acad Orthop Surg. 2016 Nov;24(11):744-749
pubmed: 27661391
Yonsei Med J. 2012 Nov 1;53(6):1190-6
pubmed: 23074121
Can J Surg. 1975 Mar;18(2):137-42
pubmed: 1116051
J Shoulder Elbow Surg. 2005 Mar-Apr;14(2):178-85
pubmed: 15789012
Acta Orthop Scand. 1986 Aug;57(4):313-5
pubmed: 3788492
Arthroscopy. 2021 Jun;37(6):1731-1739
pubmed: 33450409
Am J Sports Med. 2013 May;41(5):1152-7
pubmed: 23507792
J Hand Surg Am. 2019 Aug;44(8):635-640
pubmed: 31126813
J Hand Ther. 2009 Jul-Sep;22(3):209-19; quiz 220
pubmed: 19188042
J Shoulder Elbow Surg. 2002 Sep-Oct;11(5):493-7
pubmed: 12378170
J Pediatr Orthop. 2017 Mar;37(2):e80-e82
pubmed: 26974528
Acta Orthop Scand. 1994 Aug;65(4):439-41
pubmed: 7976294
J Pediatr Orthop. 2017 Jun;37(4):e224-e228
pubmed: 27741036
J Shoulder Elbow Surg. 2011 Apr;20(3):455-60
pubmed: 21397795
J Pediatr Orthop. 2018 Apr;38(4):e202-e206
pubmed: 27861213
J Pediatr Orthop. 2017 Oct/Nov;37(7):440-446
pubmed: 26536011
Clin Trials. 2017 Apr;14(2):187-191
pubmed: 28359191
Arch Orthop Trauma Surg. 2010 May;130(5):649-55
pubmed: 19960347
J Child Orthop. 2009 Oct;3(5):345-57
pubmed: 19685254
Clin Orthop Relat Res. 2019 Nov;477(11):2521-2530
pubmed: 31490347
J Pediatr Orthop. 2010 Oct-Nov;30(7):644-8
pubmed: 20864846
J Manipulative Physiol Ther. 2005 Jun;28(5):345
pubmed: 15965409
J Shoulder Elbow Surg. 2018 Aug;27(8):1366-1372
pubmed: 29907518
J Am Acad Orthop Surg. 2012 Apr;20(4):223-32
pubmed: 22474092
J Bone Joint Surg Br. 1990 Jan;72(1):102-4
pubmed: 2298765
J Child Orthop. 2016 Oct;10(5):413-9
pubmed: 27393557
J Hand Surg Am. 2014 Sep;39(9):1739-45
pubmed: 25037509
Injury. 2017 Aug;48 Suppl 2:S50-S53
pubmed: 28802421
J Bone Joint Surg Am. 2011 Mar 2;93(5):471-7
pubmed: 21368079
Am J Sports Med. 1992 May-Jun;20(3):347-50
pubmed: 1636868
J Pediatr Orthop. 2016 Jun;36 Suppl 1:S56-62
pubmed: 27100037
J Bone Joint Surg Am. 2001 Sep;83(9):1299-305
pubmed: 11568189