Length of post-treatment immobilization following medial humeral epicondyle avulsion fracture predicts return of full range of motion

Medial epicondyle fractures of the distal humerus are common pediatric fractures, which are increasing in frequency among pediatric and adolescent athletes. Residual elbow stiffness is a feared complication of both surgical and nonoperative treatment. The purpose of this study is to investigate the association of the relevant variables with the ability of patients to regain full elbow range of motion (ROM). Patients 8-18 years old enrolled in the Medial Epicondyle Multicenter Outcomes prospective cohort with ≥3 mm of displacement, and >1 year of follow-up data were included. Bilateral elbow range of motion (ROM), complications, length of immobilization following definitive treatment (surgical vs. nonoperative), participation in formal physical or occupational therapy (PT/OT), and weeks from injury to treatment were recorded. The study cohort consisted of 202 patients (aged 12.7 ± 2.3 years; 59% male). A greater proportion of surgically managed patients regained full ROM compared to nonoperatively managed patients (71% vs 56%, P = .05). Immobilization time was significantly shorter in surgical than in nonoperative patients (2.0 ± 1.1 weeks vs. 3.0 ± 1.2 weeks, P