American Academy of Orthopaedic Surgeons Annual Meeting

American Academy of Orthopaedic Surgeons Annual Meeting

Perspective from Jonathan D. Barlow, MD
April 06, 2020
2 min read

Surgery for medial epicondyle fractures yielded excellent function, minimal pain in pediatric patients

Perspective from Jonathan D. Barlow, MD
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Operative treatment of medial epicondyle fractures may lead to excellent upper extremity function and minimal pain interference among most pediatric patients, according to results.

Ronak Mukesh Patel

Using the patient-reported outcomes measurement information system (PROMIS) upper extremity and pain interference domains, VAS for pain, range of motion, ulnar nerve function and requirement for secondary surgery, Ronak Mukesh Patel, MD, and colleagues assessed the outcomes of 42 patients younger than 18 years of age who were treated surgically for medial epicondyle fracture between 2005 and 2016.

Although 19% of patients noticed mild sensory or motor issues related to the ulnar nerve and 7% of patients reported dissatisfaction with elbow range of motion, Patel told Healio Orthopedics that all patients reported excellent function and pain scores at final follow-up. Results showed patients had a mean PROMIS upper extremity score of 57, a mean PROMIS pain interference score of 38.3 and a mean VAS score of 0.3.

“The reoperation rate was high (45%), primarily related to removal of painful hardware,” Patel said. “We did not have any patients who required reoperation for symptomatic nonunion, which was a surprising finding.”

Researchers found worse PROMIS pain interference scores among patients who required secondary surgeries, but no differences in PROMIS upper extremity scores.

“Our results can help counsel patients and families of the aforementioned findings, as well as on the high rates of reoperation,” Patel said. – by Casey Tingle



Patel RM, et al. ePaper 282. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2020 (meeting canceled).


Disclosure: Patel reports no relevant financial disclosures.