Information for Medical Professionals

Observer variation in assessment of medial epicondyle fractures 'is common'

Variation in intra-observer assessment of displacement in medial epicondyle fractures of the humerus does occur and is common, new research has found.

According to the research paper Intra-observer and Inter-observer Agreement in the Measurement of Displaced Humeral Medial Epicondyle Fractures in Children, which was published in the February issue of the Journal of Bone and Joint Surgery, inter-observer agreement was better when it came to assessing anteroposterior radiographs, but this was also low overall.

The researchers behind the paper claimed that their findings cast doubt on the use of perceived displacement as a means of deciding whether to pursue operative or non-operative management of fractures to the humeral medial epicondyle.

"Agreement may be improved to acceptable levels by adopting a standard set of measurement guidelines, which include use of the anteroposterior radiograph when possible and consistently measuring at the point of maximal displacement," they said.

Last year, specialists from the department of orthopaedics and the department of radiology at the Malmo University Hospital in Sweden showed that Mason type IV fractures of the elbow tend to have good long-term outcomes.

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