Narrative review by Patel and Ganley (2012) addressing how to evaluate pediatric medial epicondyle fractures and when to operate, with focus on the reliability of plain radiographic displacement measurement and evolving operative indications for fractures that don't meet classic surgical criteria.
When you see a pediatric elbow injury with medial-sided tenderness, don't rely solely on plain-film displacement measurements to rule out significant fracture — 3D CT may reveal >1 cm displacement in cases that look minimally displaced on x-ray.
For fractures outside the classic operative indications, weigh elbow stability, patient age, and athletic demands (especially overhead throwers) before defaulting to nonoperative management.
Narrative review by Patel and Ganley (2012) addressing how to evaluate pediatric medial epicondyle fractures and when to operate, with focus on the reliability of plain radiographic displacement measurement and evolving operative indications for fractures that don't meet classic surgical criteria.
When you see a pediatric elbow injury with medial-sided tenderness, don't rely solely on plain-film displacement measurements to rule out significant fracture — 3D CT may reveal >1 cm displacement in cases that look minimally displaced on x-ray.
For fractures outside the classic operative indications, weigh elbow stability, patient age, and athletic demands (especially overhead throwers) before defaulting to nonoperative management.