A 5-year-old child presents with an elbow injury. Radiographs show an avulsion of the medial epicondyle. The fragment is trapped within the elbow joint. Which important associated injury must be excluded?

• A Anterior interosseous nerve palsy
• B Radial head fracture requiring radial head replacement
• C Ulnar artery injury requiring vascular repair
• D Elbow dislocation — medial epicondyle avulsion is commonly associated with and can occur with elbow reduction ✓

Explanation

Medial epicondyle avulsion in children is strongly associated with posterior elbow dislocation; the epicondyle fragment is avulsed by the common flexor origin and medial collateral ligament, and can become trapped in the elbow joint following reduction of the dislocation. This is a frequent examination scenario: a fragment within the joint space following elbow dislocation requires surgical removal and fixation. The anterior interosseous nerve is at risk in Galeazzi fractures; the ulnar nerve (not artery) may be injured with medial epicondyle injuries.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.