Nearly half of children with displaced medial epicondyle fractures undergo surgical fixation despite limited evidence to support this practice. To address this, a clinical trial compared surgical fixation with non-surgical care using a cast, splint, or sling in 335 children with a mean age of 11.7 years. At 12 months, Patient-Reported Outcomes Measurement System Upper Extremity scores were similar between the surgical and non-surgical groups (54.3 vs 53.1). Additional surgical procedures were more frequent in the surgical group than in the non-surgical group (24 vs 3).
Intraoperative and postoperative complications occurred in 9% and 5% of surgically treated children, respectively, whereas 2% of children managed non-surgically experienced complications, and another 2% required subsequent surgery. Surgical management also cost £2,435 more per patient than non-surgical care. Overall,…
