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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2025, Number 6

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Acta Ortop Mex 2025; 39 (6)

Surgical treatment of the medial epicondyle fracture of the humerus using the ''Inside-out'' technique. Description of the technique and results

Valenza W, Faggion H, Lange G, Galvão B, Rampazzo M, Soni J

Language: Spanish
References: 26
Page: 386-393
PDF size: 1438.10 Kb.


ABSTRACT

Introduction: the "Inside-out" technique is one of the options for medial epicondyle fracture fixation of the humerus. It involves preparing the fixation from the internal portion of the fracture to the external portion. Then, the fracture is fixed with a cannulated screw from the external to the internal portion. This study aims to describe our experience with this technique, its outcomes, and its complications. Material and methods: this is a retrospective observational study describing a series of cases treated with the "Inside-out" technique for medial epicondyle fracture fixation from 2020 to 2024. We evaluated demographic data, follow-up duration, intraoperative events, postoperative complications, and functional outcomes. Results: we analyzed 21 patients, 61.9% of whom were male, with a mean age of 13 years and a mean follow-up period of 19 months. Among these, 71.4% had fractures in the right upper limb, with the most prevalent trauma mechanism being a ground-level fall. No open fractures were observed. A total of 38% had dislocated elbows with an incarcerated medial epicondyle, and one patient had an associated fracture. There were no intraoperative complications. One patient had a 5-degree extension limitation, all fractures achieved consolidation, and no postoperative neurological injuries or valgus instability were observed after fixation. Four patients reported discomfort at the site of the screw head insertion, and one patient complained of a hypertrophic scar. The functional assessment using the QuickDASH score yielded an average of 1.1. Conclusion: the "Inside-out" technique provided secure fixation of the medial epicondyle, preventing its fragmentation, ensuring fracture consolidation, allowing early mobility, and resulting in minimal complications.


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EVIDENCE LEVEL

IV




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