A prospective controlled trial of the fracture of the humeral medial epicondyle--how to treat?

Twenty-one patients, 11 male and nine female, with fracture of medial humeral epicondyle were treated. The mean age of the patients was 21 (range 8-52) years. The average initial displacement was 13 (range 3-24) mm, and four out of 21 patients had a dislocation of the elbow joint. Two patients were first treated conservatively, but later on operation for removal of the non-united fragment and reattachment of the ligaments and muscles was necessary. One patient was treated by primary excision of the fragment. Eighteen patients were treated by open reduction and internal fixation using self-reinforced polyglyclycolide (SR-PGA) screws in five patients, poly-l-lactide (SR-PLLA) screw in one, small (SR-PGA) rods in seven and Kirschner-wires in five patients. Solid union took place in 14 out of 18 patients and a good stability of the elbow joint was achieved. Fifteen patients scored an excellent result according to the scale of Broberg and Morrey. Although this series was not randomly allocated in respect of the method of treatment, it shows that medial epicondylar fractures can be fixed with absorbable implants without any need for removal procedure.