An MRI-based Comparative Study of Pediatric Medial Epicondyle Fractures with and without Concomitant Elbow Dislocation

Objectives To investigate and compare the Magnetic Resonance Imaging (MRI) characteristics of pediatric medial humeral epicondyle fractures (MHEFs) with and without concomitant elbow dislocation, delineating the extent and complexity of associated injuries to inform clinical management and prognostic assessment. Methods Preoperative MRI data from 58 pediatric patients undergoing surgery were retrospectively analyzed. 26 cases were classified as the dislocation group and 32 as the non-dislocation group. The differences in age, gender, and other factors were statistically analyzed. Injury to the ulnar collateral ligament (UCL), radial collateral ligament (RCL), common flexor tendon (CFT), common extensor tendon (CET), ulnar nerve was systematically evaluated. Results The mean age of the dislocation group was 10.0 ± 3.1 years and 11.5 ± 3.1 years of the non-dislocation group (P > 0.05). The incidence of UCL complete tear in the dislocation group (61.5%, 16/26) was significantly higher than in the non-dislocation group (9.4%, 3/32) (p < 0.001). RCL and CET injury were observed exclusively in the dislocation group (16 cases), with no such injury in the non-dislocation group. CFT injury were relatively common in both groups, occurring in 22 cases in the dislocation group and 30 cases in the non-dislocation group, with no significant difference (p > 0.05). The incidence of ulnar nerve injury was higher in the dislocation group (11.5%, 3/26) compared to the non-dislocation group (3.1%, 1/32), but the difference was not statistically significant (p > 0.05). Conclusions MRI precisely elucidates the fundamental differences between pediatric MHEFs with and without elbow dislocation. Consequently, MRI is an indispensable tool for comprehensive injury assessment, guiding personalized treatment strategies, and predicting long-term functional outcomes.