13-M/7M   Avulsion of the epicondyle (extraarticular)

The pattern of this fracture is characterized by a ligament avulsion of the medial epicondyle. The classification does not take into account displacement of the fragment. Therefore, an elbow dislocation with the fragment still trapped in the elbow joint after reduction is also classified in the same way.

Young child (3-6 years):

• Completely displaced epicondylar avulsion fracture
• In the normal AP x-ray we can see the malalignment of the elbow with a faint fragment on the medial side.
• The image shown was taken under valgus stress.

Older child (older than 6 years):

• This child is approaching skeletal maturity
• Persistent elbow dislocation with a dense shadow overlapping the medial edge of the olecranon fossa. This shadow is the displaced medial epicondyle
• In the lateral view the epicondylar fragment can be seen posterior to the humerus