Surgery for Displaced Medial Epicondyle Fractures in Children

Displaced medial epicondyle fractures typically result from valgus stress to the elbow, often during a fall on an outstretched arm or with throwing-related injuries in children and adolescents. The central question is whether surgical realignment and fixation provide meaningful benefit over nonsurgical stabilization and casting.

The SCIENCE trial aimed to determine which approach leads to better patient-centered outcomes and is more cost-effective. In 59 hospitals in the United Kingdom, Australia, and New Zealand, some 300 children ages 7 to 15 years with confirmed displaced medial epicondyle fracture were randomized to surgical fixation or nonsurgical care.