Medial Epicondyle Fracture of the Humerus
Medial Epicondyle Fracture of the HumerusWhen people fall, they have an instinct to extend their arms in front of their body to protect their chest and abdomen from impact with the ground. While this can spare the vital organs from injury, it can also place the bones of the arm at risk. This is one way that people can sustain a medial epicondyle fracture of the humerus.
What is a Medial Epicondyle Fracture of the Humerus?Most of the upper arm contains the long bone called the humerus. There are thickened projections where the humerus joins the elbow. The thickened portion on the inside of the arm is called the medial epicondyle. A fracture in this projection is called a medial epicondyle fracture of the humerus and is different from a humerus shaft fracture.
How does this Fracture Develop?While this fracture is rare in adults, it is more common in children, along with pediatric wrist and hand fractures. When someone extends their arms to protect their body from impact with the ground or an incoming car, such as in a car accident, the force is transmitted from their hands through their arms. If the elbows are locked in place, the medial epicondyle can be damaged, leading to a fracture.
Treatment is Dependent on the FractureSome of these fractures are relatively minor, requiring only a splint or a cast for a few weeks. Traumatic injuries, such as those found in major car accidents, are more severe and could require surgical fixation in the case of open fractures or displaced fractures.
Complications of a Medial Epicondyle FractureThe biggest complication that people need to worry about is elbow instability. Because the medial epicondyle is an integral part of the elbow, damage to the medial epicondyle can lead to elbow stability problems. While many people are familiar with a shoulder dislocation, the elbow can dislocate as well. People with a history of this fracture are at risk for dislocating their elbow in future injuries.
Other Structures Are at RiskOne of the structures that is placed at risk by this fracture is a UCL injury. Standing for ulnar collateral ligament, this is the ligament that pitchers will injure playing baseball. In fact, chronic use of the elbow in sports such as baseball and golf can lead to a medial epicondyle fracture. If this ligament is torn, patients can have it repaired operatively.
Differential DiagnosisThe differential diagnosis includes:
- Humerus Shaft Fracture
- Distal Humerus Fracture
- Epicondylitis
- Radius or Ulna Fracture
- Elbow Dislocation
The overwhelming majority of these fractures heal without any issues. Because this fracture does not involve the growth plate, there is no damage to the growth potential of the bones. Most fractures will heal completely in the span of four to six weeks.
Surgical IndicationsSimilar to other fractures, a comminuted, displaced, or open fracture will require surgery to repair the bones. Pins and plates may be used to hold the bones in place to ensure the bones heal properly. Once the surgery is completed, rehabilitation after traumatic injuries may be necessary to strengthen the muscles around the elbow and prevent future dislocations.
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Photo Attribution: By Chrisnorlin at the English language Wikipedia, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=9587979
