Operative fixation of medial epicondyle fractures: complication rates based on mode of fixation
Ena Nielsen, Lindsay M. Andras, Trevor J. Anesi, Nina Lightdale-Miric, J. Lee Pace
Abstract
The purpose of this study is to define the rate of implant failure and risk factors for failure in patients treated operatively for displaced medial epicondyle fractures.Patients <18 years of age with medial epicondyle humerus fractures that were treated with screw or k-wire fixation between 2005 and 2015 were eligible. Inclusion criteria included follow-up until radiographic union and no known medical conditions that could impair healing.Thirty four patients with 35 fractures were identified with an average age of 12 years old. 11.4% (n = 4/35) of fractures were treated using K-wires, 25.7% (n = 9/35) were treated using a screw and washer construction, and 62.9% (n = 22/35) were treated using screw alone. There were 16 reported complications (46%) including implant prominence requiring reoperation (6), implant failure (1), and fracture displacement (1). Other complications included non-union/delayed union (4), new ulnar nerve palsy (2), and decreased range of motion (2). Rates of complications were not different between the types of fixation (P = 1.0). Those who developed complications were younger than those who did not (P = 0.05). 91.4% of patients returned to full activity including weight bearing and throwing sports.Although 25% of patients experienced implant complications and the overall complication rate approached 50%, nearly all reported return to full activity.