These fractures represent avulsion of the humeral origin of the medial collateral ligamentous complex of the elbow joint, resulting from a valgus overload of the elbow.
At the moment of valgus opening of the medial side of the joint, the avulsed fragment may be pulled into the joint and become trapped (incarcerated), as the valgus deformity tends to reduce.
All incarcerated fragments require surgical reduction and fixation.
Internal fixation of these fragments helps to restore elbow stability.
Take particular note to exclude valgus compression fracture of the radial head or the capitellum.
Pediatric fractures are considered in Pediatric trauma of Surgery Reference.
|ORIF - Screw fixation|
|Surgery always indicated|
In these fractures surgery is always indicated.
- Unacceptable surgical risk
- Noncompliant patient
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|