Suture Anchor Supplemental Fixation of Medial Epicondyle Fractures Surgical & Technical Tips

Abstract

Operative fixation of medial epicondyle fractures is becoming increasingly popular due to a rising concern for symptomatic valgus instability, stiffness, and long-term functional effects of nonunion in patients treated non-operatively. Damage to medial stabilizing structures is recognized as a risk for poor outcome and operative decision-making has shifted, with less emphasis on medial epicondyle displacement and more focus on operative fixation for valgus instability and desire to return to high-level athletics or employment. Expanding surgical indications and the desire to restore elbow stability has led to the development of a novel fixation method that stabilizes soft tissues, promotes bony healing, and does not necessitate a second implant removal surgery. This paper presents a novel, minimally traumatic technique for operative fixation of medial epicondyle fractures that restores ligamentous stability of the ulnar collateral ligament (UCL) and flexor-pronator mass utilizing a bone suture anchor to augment k-wire fixation without the need for operative implant removal and with reduced risk of avulsion fragment comminution and postoperative stiffness.