Medial Epicondyle Fracture

What is a medial epicondyle fracture?

The medial epicondyle is the bony bump on the inner side of the elbow — you can feel it easily on yourself. It's the attachment point for several important muscles and ligaments and is especially relevant in growing children, where it's an active growth area.

A medial epicondyle fracture happens when a piece of this bump breaks off, usually following a fall, a forceful pull on the arm, or sometimes during sports involving throwing.

The decision-making in these fractures is more nuanced than in some other paediatric fractures. The degree of displacement, hand dominance, sporting activity and other individual factors all influence what the right treatment looks like.

What does it feel like?

Common features include:

• Pain on the inner side of the elbow

• Swelling and bruising

• Reduced movement, particularly bending and straightening

• Tenderness directly over the medial epicondyle

• Sometimes a sense of instability when stressing the elbow inwards

In some cases there's also been a temporary or partial dislocation of the elbow at the time of injury, which adds to the picture.

How is it diagnosed?

X-rays are the standard imaging and usually demonstrate the fracture and its degree of displacement. Specific views are sometimes needed because the medial epicondyle can be tricky to assess on routine films.

Examination helps establish how stable the elbow is and how much the inner ligaments may have been affected. In some cases, additional imaging — CT or MRI — is useful to clarify the picture.

The combination of imaging and clinical assessment guides the management plan. Subtle injuries are sometimes missed initially, so a clear and thorough assessment is important.

What are the treatment options?

Minimally displaced fractures are often treated without surgery — a period in a cast or splint, followed by structured rehabilitation. More displaced fractures, particularly in children involved in throwing sports or where there's instability, are often best managed with surgical fixation.

Where surgery is required, the fragment is reattached using small screws or wires, with the goal of restoring the anatomy and the inner-side ligamentous support. Recovery typically takes a couple of months. Nev will work through the right approach for your child at your consultation.

When should you get it checked?

Seek prompt assessment if:

• Your child has elbow pain after a fall or pull on the arm

• There's swelling or bruising on the inner side of the elbow

• Movement is limited or painful

• There's tenderness specifically over the bony bump on the inner elbow

• You've been told there's a fracture and want a clear plan

Medial epicondyle fractures benefit from a careful, individualised assessment — the decisions can be subtle and matter for long-term elbow function.