Medial Epicondyle Fractures: Evidence from the SCIENCE study
A displaced medial epicondyle fracture is a type of broken bone on the inside of the elbow. It happens when a small piece of bone breaks off, often because the strong muscles and tendons that attach there pull it away. Around 1,000 children in the UK get this injury each year, usually after a fall while playing or doing sport.
Treatment before the study
Every year, many children suffer this injury, yet doctors have never agreed on the best way to treat it. Some chose surgery to fix the bone, while others used a cast or splint to let the elbow heal on its own.
The SCIENCE study
The SCIENCE study was set up to find out which treatment works best – to see whether having surgery, to fix the broken piece of bone back in place was better than resting the arm in a plaster cast, allowing it to heal naturally.
Before we started the study, families told us that pain and getting back to normal function were the most important things to them.
The study included 334 children aged 7 to 15 from hospitals across the UK, Australia, and New Zealand, all of whom had a displaced medial epicondyle fracture. In about a quarter of cases, the injury was more severe, with the elbow coming out of joint (dislocating) when the fracture happened. Half of the children were treated with a cast for four weeks. The other half had surgery to fix the bone. Each child’s treatment was decided fairly using a process called randomisation - to make sure the comparison between treatments was as fair as possible.
We asked children and their families about pain, how well they could use their arm in everyday life and during sports or musical activities, their quality of life, any problems during recovery, and how much time they took off school. We also looked at the cost to families and to the NHS.
Results
Was surgery better than resting the arm in a plaster cast?
Toolkit
Turn the SCIENCE findings into everyday practice.
