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No Difference in Return to Sport and Other Outcomes Between Operative and Nonoperative Treatment of Medial Epicondyle Fractures in Pediatric Upper-Extremity Athletes.

Authors
  • Axibal, Derek Paul1, 2
  • Carry, Patrick2
  • Skelton, Anne2
  • Mayer, Stephanie Watson1, 2
  • 1 Department of Orthopaedic Surgery, University of Colorado Hospital, Aurora, Colorado.
  • 2 Department of Orthopedic Surgery, Children's Hospital of Colorado, Aurora, Colorado.
Type
Published Article
Journal
Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine
Publication Date
Nov 01, 2020
Volume
30
Issue
6
Identifiers
DOI: 10.1097/JSM.0000000000000666
PMID: 30277893
Source
Medline
Language
English
License
Unknown

Abstract

Compare outcomes of operative and nonoperatively managed medial epicondyle fractures in upper-extremity athletes. Retrospective chart review and phone survey. Level 1, tertiary-referral pediatric hospital. Propensity scores (probability of operative treatment) were estimated from a logistic regression model that included sex, age, displacement, limb dominance, and injury severity (presence of an additional fracture, nerve injury, or elbow dislocation). These were used to match subjects in the operative group to the nonoperative group. Return to sport, duration of time required to return to sport, pain, range of motion (ROM), need for physical therapy, and complications were recorded for both groups. Twenty-eight nonoperative subjects were matched to 14 operative subjects. There was no significant difference in the proportion of subjects who returned to the same sport (92.9% in each group), performance at preinjury level of competition, or median time to return to play (P = 0.7106). There was no significant difference in functional limitations in social-/work-related activities (P > 0.9999), pain in the past 30 days (P = 0.0640), need for physical therapy (P = 0.5680), ROM limitations (P = 0.0988), difficulty in sleeping (P = 0.4773), or complications (P = 0.4081). Our study found no statistical difference in outcomes or complications between operative and nonoperatively treated moderately displaced medial epicondyle fractures in adolescent upper-extremity athletes. Our data show that similar outcomes may be achieved with both treatment groups for medial epicondyle fractures in upper-extremity athletes.

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