Definition
Medial epicondyle apophysitis
Etiology
Adolescents aged up to 15 when growth plate fuses
Repetitive valgus overload - pitching / tennis / volleyball
Microtrauma to the growth plate - traction injury / separation / fracture
Clinical
Medial pain and tenderness
May describe a pop in the setting of an acute avulsion
Xray
Widening of the medial epicondyle growth plate +/- displacement
Sclerotic appearance of the border of the apophysis
Fragmentation
CT
MRI
Edema around medial epicondyle
UCL injuries
Nonoperative management
Technique
Rest 4 - 6 weeks
Strengthening
Gradual return
Limit pitch counts / avoid throwing all year round / avoid curveballs & sliders
Operative management
Indications
? Acute displaced medial epicondyle fractures
Results
www.boneschool.com/pediatrics/medial-epicondle-fractures
Axibal et al Clin J Sport Med 2020
- medial epicondyle fractures in athletes
- 28 operative v 14 nonoperative
- no difference in outcomes
- 92% return to sport in both groups
Zheng et al Orthop J Sports Med 2025
- 50 adolescent throwing athletes with acute medial epicondyle fracture
- 46% ORIF, 54% nonoperative care
- no difference in return to sport