Medial epicondyle fractures are common in pediatric and adolescent patients and are rare in adults. The mechanism of injury may be secondary to excessive valgus stress or direct trauma to the elbow. The medial epicondyle is displaced anteriorly and distally with the flexor pronator mass and the ulnar collateral ligament. Patients report medial elbow pain and may have associated ulnar nerve dysfunction. Plain radiographs of the elbow usually are sufficient for visualization of medial epicondyle fractures. CT can be obtained if concern for fragment incarceration in the joint, joint incongruity, or joint involvement of the fracture exists.

Nonsurgical management of medial epicondyle fractures involves a period immobilization followed by progressive range of motion exercises. Surgical management of closed, displaced medial epicondyle fractures is controversial; however, surgical fixation is indicated in patients with an open fracture, associated elbow joint dislocation, incarcerated fracture fragments in the joint, ulnar nerve injury, or symptomatic displaced nonunion. Surgical treatment options include fragment excision or open reduction and internal fixation with the use of Kirschner wires, cannulated screws, or sutures. A few case series on the fixation of medial epicondyle fractures in pediatric patients are available in the literature; however, a paucity of studies are available on the surgical management of medial epicondyle fractures in adults. This video demonstrates the surgical technique for open reduction and suture fixation of a medial epicondyle fracture in an adult who sustained direct trauma. Relevant literature, patient presentation, physical examination findings, imaging studies, technical pearls, and the postoperative rehabilitation protocol are reviewed.