What is a Medial Condyle Fracture?
A medial condyle fracture of the humerus is a break in the inner part of the lower end of the humerus, the bone in the upper arm. The humerus has two condyles at its distal (lower) end: the medial condyle on the inner side and the lateral condyle on the outer side. These condyles are part of the elbow joint and articulate with the bones of the forearm, the ulna and the radius.
Types of Medial Condyle Fractures
Medial condyle fractures can be classified based on their location, pattern, and articular surface involvement. The most commonly used classification for these fractures is the Milch classification, which categorises them into two types:
- Milch Type I Fracture:
- This type of fracture passes lateral to the trochlear groove and does not involve the trochlea itself.
- It is an extra-articular fracture, meaning the joint surface remains intact.
- These fractures are less likely to result in significant joint instability or deformity if managed appropriately.
- Milch Type II Fracture:
- This type of fracture passes through the trochlea and involves the trochlear groove.
- It is an intra-articular fracture, which means it affects the joint surface.
- Milch Type II fractures are more complex because they involve the joint, making them more challenging to treat and often requiring surgical intervention to restore joint congruity and function.
In addition to the Milch classification, fractures can also be described based on their displacement, comminution (the presence of multiple fracture fragments), and whether there is associated soft tissue injury, which may affect the treatment approach and prognosis.
Treatment for medial condyle fractures depends on the type, displacement, and the patient’s age and activity level. Non-displaced fractures may be treated conservatively with immobilisation, while displaced or intra-articular fractures often require surgical fixation to ensure proper alignment and healing.
Prevalence of Medial Condyle Fractures
Medial condyle fractures of the humerus are relatively rare, particularly compared to other elbow fractures. Here’s an overview of their prevalence:
- Paediatric Population:
- In children, medial condyle fractures account for a small percentage of all distal humerus fractures and about 1-2% of all elbow fractures. This low prevalence is partly due to the typical mechanism of injury, which usually involves falling onto a hand that is outstretched or a direct blow to the elbow.
- Adult Population:
- Medial condyle fractures are even less common in adults. Overall, distal humerus fractures represent a small portion of fractures in adults, with medial condyle fractures being a minority within this group. These injuries in adults are typically associated with high-energy trauma, for example, car accidents or falls from significant heights.
Overall, medial condyle fractures of the humerus are quite rare, especially compared to other types of elbow and upper extremity fractures. Their management often requires careful assessment and, on occasion, surgical intervention to ensure proper healing and restore function.

Symptoms and Causes
Causes of Medial Condyle Fractures of the Elbow
Medial condyle fractures of the elbow are primarily caused by trauma that impacts the medial side of the distal humerus. Common causes include:
- Direct Trauma: A direct blow to the inner side of the elbow can result in a medial condyle fracture. This type of trauma might occur during falls, sports injuries, or accidents.
- Indirect trauma occurs when a force is transmitted through the forearm to the elbow. For example, a fall onto an outstretched hand with the elbow partially flexed can create a valgus force (outward angulation), leading to a fracture of the medial condyle.
- High-Energy Injuries: In adults, high-energy mechanisms such as car accidents, sports injuries or falls are common causes. These injuries can lead to complex fractures involving both bone and joint surfaces.
Risk Factors for Medial Condyle Fractures of the Elbow
The following factors can increase the risk of sustaining a medial condyle fracture:
- Age: Younger children, especially those under 10, are more prone to medial condyle fractures due to the softer and more flexible nature of their bones.
- Participation in Sports: Engaging in sports with a high risk of falls or direct blows, such as football, gymnastics, and skateboarding, can increase the likelihood of these fractures.
- Osteoporosis and Bone Density Issues: In adults, particularly older individuals or those with osteoporosis, bones may be more brittle and prone to fractures from even low-energy trauma.
- Previous Elbow Injuries: A history of elbow fractures or dislocations can weaken the joint and make it more susceptible to subsequent injuries.
- Congenital Bone Conditions: Certain congenital conditions that affect bone strength or growth can predispose individuals to fractures.
Complications of Medial Condyle Fractures of the Elbow
Medial condyle fractures can lead to several complications if not properly managed:
- Non-union or Malunion: If the fracture does not heal correctly, it can result in non-union (failure to heal) or malunion (healing in an incorrect position). Both conditions can lead to functional impairment and pain.
- Elbow Stiffness: Due to prolonged immobilisation or inadequate rehabilitation, patients may experience stiffness and loss of range of motion in the elbow joint.
- Ulnar Nerve Injury: The ulnar nerve, which runs near the medial condyle, can be injured during the fracture or during surgery. This may result in numbness, tingling, or weakness in the hand and fingers.
- Joint Instability: If the fracture involves the articular surface and is not adequately reduced or fixed, it can lead to chronic elbow instability.
- Post-Traumatic Arthritis: Fractures that extend into the joint surface or those that are not properly aligned during healing can lead to uneven joint surfaces, increasing the risk of developing arthritis in the elbow.
It is essential to seek an early diagnosis and appropriate treatment to minimise these complications and ensure a good functional outcome for patients with medial condyle fractures of the elbow. Access Ortho offers rapid appointments for limb injuries and provides specialist orthopaedic care.
Diagnosis and Tests
How are Medial Condyle Fractures Diagnosed?
Diagnosing a medial condyle fracture of the elbow involves a physical examination, patient history, and imaging studies. The goal is to accurately determine the fracture’s location, type, and extent to guide appropriate treatment.
- Patient History:
- The healthcare provider will ask about the mechanism of injury, including how the trauma occurred, the direction of the force, and any previous elbow injuries. They may also inquire about the patient’s symptoms, such as pain, swelling, and the ability to move the elbow or arm.
- Physical Examination:
- The provider will examine the elbow for signs of swelling, deformity, bruising, and tenderness over the medial condyle area. They will assess the range of motion, checking for any limitations or pain during movement.
- A neurovascular assessment is crucial to evaluating potential nerve injuries, particularly those to the ulnar nerve, which runs close to the medial condyle. The ulnar nerve’s sensory and motor functions will be tested.

Which Tests Do Providers Use to Diagnose Medial Condyle Fractures?
Imaging is essential for confirming the diagnosis of a medial condyle fracture, assessing the fracture’s pattern, and planning treatment. The most common imaging tests used include:
- X-Rays (Radiographs):
- Standard X-rays: The first line of imaging for suspected fractures. These views can help visualise the fracture line, displacement, and involvement of the articular surface.
- Computed Tomography (CT) Scan:
- A CT scan may be ordered if the X-rays do not clearly show the fracture or if there is a suspected intra-articular extension (fracture involving the joint surface). CT scans offer cross-sectional images of the bone and can help assess the degree of comminution (multiple fracture fragments) and exact alignment, which is critical for surgical planning.
- Magnetic Resonance Imaging (MRI):
- MRI is less commonly used for initial fracture diagnosis but may be helpful in specific situations, such as when soft tissue injuries (e.g., ligament tears, muscle damage, or nerve injuries) are suspected. MRI provides images of both bone and soft tissue structures, which can be useful for comprehensive evaluation.
- Ultrasound:
- Ultrasound is not typically used to diagnose fractures but can be helpful in paediatric cases to assess the cartilaginous structures that are not visible on X-rays. It can also be useful to evaluate the soft tissues around the elbow.
Seeking a proper diagnosis is essential to developing a treatment plan and ensuring optimal recovery. Access Ortho is staffed by orthopaedic practitioners and offers urgent appointments for limb injuries.
Specific Considerations for Medial Condyle Fractures
Medial condyle fractures of the elbow require special attention due to their location, potential involvement of the growth plate (in pediatric cases), and proximity to important neurovascular structures like the ulnar nerve. Access Ortho staff are trained in orthopaedic injuries, ensuring you receive specialist care for your injury.
Pediatric Medial Condyle Fractures
- Anatomy and Vulnerability in Children:
- In children, the bones are still developing, with the presence of growth plates (physes) at the ends of long bones. The medial condyle, located at the distal end of the humerus, is partially formed by cartilage in growing children, making it more susceptible to fractures.
- Due to the elasticity of young bones, fractures can occur with relatively low-impact injuries, such as falls while playing. This elasticity also means that the bone may not break completely, leading to unique fracture patterns.
Growth Plate Involvement
- Importance of the Growth Plate (Physis):
- The growth plate is a critical area responsible for longitudinal bone growth. In the distal humerus, the medial condyle’s growth plate contributes significantly to the development of the elbow joint.
- Fractures involving the growth plate are more concerning in children because they can disrupt normal bone growth and lead to long-term complications.
Ulnar Nerve Considerations
- Anatomy of the Ulnar Nerve:
- The ulnar nerve is on the medial side of the arm and passes behind the medial epicondyle. It runs through the cubital tunnel. This close anatomical relationship with the medial condyle makes the nerve susceptible to injury during a fracture.
- During a medial condyle fracture, the ulnar nerve can be injured directly by the fracture fragments, or indirectly due to swelling and hematoma. The nerve is also at risk during the manipulation and reduction of the fracture, particularly in cases requiring surgical intervention.
Access Ortho will tailor treatment decisions to the individual patient, considering the specifics of the fracture, the patient’s age, and the risk factors for complications.
Management and Treatment
How are Medial Condyle Fractures Treated?
The treatment of medial condyle fractures of the elbow depends on several factors, including the age of the patient, the type and severity of the fracture, the degree of displacement, the involvement of the growth plate (in pediatric cases) and any associated injuries or complications, such as ulnar nerve involvement. The aim of treatment for this injury is to restore the normal anatomy of the elbow, ensure proper healing, and maintain joint function.
Non-Surgical Treatment
Non-surgical treatment is generally considered for non-displaced or minimally displaced fractures, especially in children where the potential for bone remodelling is greater.
- Immobilisation:
- Casting or Splinting: For non-displaced fractures, a long arm cast can be applied to immobilise the elbow joint, allowing the bone to heal. The elbow is typically placed in a flexed position, with the forearm in neutral or slight supination.
- Duration: Immobilisation usually lasts 4-6 weeks, depending on the fracture’s healing progress. Regular follow-up X-rays may be necessary to ensure the fracture remains stable and is healing properly.
- Activity Restriction:
- It is important to avoid activities that could stress the healing fracture. This includes refraining from lifting, sports, and other activities that involve the elbow until the fracture has adequately healed.
- Physiotherapy:
- After immobilisation, a structured rehabilitation program is often initiated to restore the elbow’s range of motion, strength, and function. Physical therapy is essential to prevent stiffness and promote full recovery.
Surgical Treatment
Surgical treatment is indicated for displaced fractures, intra-articular fractures, fractures with significant angulation, fractures involving the growth plate in children (Salter-Harris fractures), and fractures associated with neurovascular injury.
- Closed Reduction and Percutaneous Pinning:
- Indications: This technique is often used in pediatric patients with displaced fractures that can be reduced (realigned) without making a large incision. It is also used when there is minimal growth plate involvement.
- Procedure: Under anesthesia, the fracture is manually reduced, and small metal pins (K-wires) are inserted percutaneously (through the skin) to hold the bones in proper alignment. The pins are usually left in place for about 4-6 weeks and are removed once the fracture has healed.
- Open Reduction and Internal Fixation (ORIF):
- Indications: ORIF is typically required for severely displaced fractures, fractures with joint involvement (intra-articular), those that cannot be adequately aligned with closed reduction, or those with associated injuries (e.g., ulnar nerve entrapment).
- Procedure: A surgical incision is made to directly visualise the fracture. The bones are then realigned, and hardware (such as screws and plates) is used to secure the fracture fragments in place. This approach allows precise anatomical reduction, which is especially important in intra-articular fractures, to restore joint congruity and prevent future arthritis.
- Nerve Decompression or Repair:
- Indications: If the ulnar nerve is injured or compressed due to the fracture or its treatment, surgical exploration and decompression or repair of the nerve may be necessary.
- Procedure: The nerve is carefully freed from any compressive forces or repaired if it has been damaged. This procedure is often done simultaneously with fracture fixation.
The treatment of medial condyle fractures of the elbow ranges from conservative management with immobilisation for non-displaced fractures to surgical intervention for displaced or complicated fractures. An accurate early assessment is important to ensure the most appropriate treatment plan is implemented. Access Ortho offers orthopaedic specialist care for fractures and sprains.
Prevention
How Can I Prevent Medial Condyle Fractures?
To reduce the risk of medial condyle fractures of the elbow:
- Use Protective Gear: Wear elbow pads during activities like skateboarding or cycling, and always use seat belts or appropriate car seats.
- Strengthen Muscles and Maintain Flexibility: Engage in strength training and stretching exercises to improve joint stability and flexibility, reducing the risk of fractures.
- Ensure Safe Play and Environments: Supervise children during play, encourage the use of safe play areas, and educate on safe sports techniques to prevent falls and injuries.
- Maintain Bone Health: Eat a balanced diet and avoid smoking and excessive alcohol to keep bones strong.
Following these tips can help prevent medial condyle fractures and protect overall joint and bone health.

Outlook / Prognosis
Recovery from a medial condyle fracture of the elbow depends on the fracture, the treatment, and individual factors such as age and overall health. Here’s what you can generally expect:
- Immobilisation:
- If the fracture is non-displaced or minimally displaced, the elbow will be immobilised in a cast or splint for about 4-6 weeks to allow the bone to heal.
- For fractures requiring surgery, the elbow may also be immobilised post-operatively, but the duration depends on the stability of the fixation and the surgeon’s recommendations.
- Pain and Swelling:
- It is normal to experience pain, swelling, and bruising around the elbow after a fracture. Pain may be managed with prescribed or over the counter medications, and swelling can be reduced with ice and elevation.
- Limited Mobility:
- Initially, movement of the elbow will be restricted, either due to immobilisation or pain. Limited mobility is expected during the early stages of recovery.
Recovery Time from a Medial Condyle Fracture
General Timeline:
- Bone Healing typically takes 6-8 weeks. Children may heal faster due to their higher bone remodelling potential.
- Full Recovery: Complete recovery, including regaining full strength and range of motion, may take several months, depending on the severity of the injury and the individual’s compliance with rehabilitation.
- Physical Therapy:
- After immobilisation or surgery, physical therapy is essential to restore the elbow’s mobility, strength, and function. Therapy may start with gentle range-of-motion exercises and gradually progress to strengthening exercises.
- Follow-Up Appointments:
- Regular follow-up visits are required to check the healing progress, ensure proper alignment, and detect any complications early, such as non-union or joint stiffness.
- Return to Activities:
- Most patients may return to normal activities within 3-6 months, but high-impact or contact sports may require longer to ensure the elbow is fully healed and stable.
Early assessment and appropriate treatment are important to minimise recovery times. Access Ortho offers expert care for fractures.
When Should I Seek Medical Attention?
Signs that Require Immediate Care
If you experience a medial condyle fracture of the elbow, it’s important to watch for signs that require immediate medical attention. These signs could suggest complications or a more severe injury requiring urgent care.
- Severe Pain or Inability to Move the Elbow that doesn’t improve with medication or immobilisation, or an inability to move the elbow despite initial treatment, may indicate complications or severe injury.
- Rapidly increasing swelling or extensive bruising around the elbow could signal internal bleeding or worsening injury.
- Visible deformity or abnormal position of the elbow joint suggests a severe fracture or dislocation and requires immediate evaluation.
- Persistent numbness, tingling, or weakness, particularly in the ring and little fingers, could indicate ulnar nerve injury or compression.
- Significant loss of function or inability to perform basic movements, such as gripping or bending the elbow, may require urgent reassessment.
- If the fracture results in an open wound with visible bone or if there is a break in the skin, seek immediate medical care to prevent infection and manage the injury.
- Developing a fever, redness, warmth, or discharge from the wound site could indicate an infection requiring prompt treatment.
- Signs of Compartment Syndrome: Severe pain, swelling, and tightness in the forearm, combined with symptoms like numbness or weakness, could indicate compartment syndrome, a serious condition that requires emergency treatment.
Prompt medical attention can help address complications and ensure proper healing. Access Ortho offers rapid appointments for acute limb injuries. Contact us today for an appointment.
Understanding Fracture Clinics
Role of Fracture Clinics in Medial Condyle Fracture Management
Fracture clinics, such as Access Ortho, play a crucial role in managing medial condyle fractures, which are fractures of the distal humerus in the elbow region. Access Ortho will offer comprehensive orthopaedic care, including follow-up care. Emergency departments and Urgent Care centres do not always offer this.
Key Roles of Fracture Clinics in Medial Condyle Fracture Management:
- Initial Assessment and Diagnosis: Fracture clinics are responsible for initial assessment of patients presenting with a suspected medial condyle fracture. This involves a detailed medical history, conducting a physical examination, and using imaging techniques such as X-rays, CT scans, or MRI to confirm the fracture type and severity.
- Treatment Planning: Based on the type and severity of the fracture, fracture clinics develop a tailored treatment plan. This can range from conservative management, such as immobilisation in a cast or brace, to surgical intervention. The treatment plan also depends on the patient’s age, activity level, and overall health. Access Ortho has consultant orthopaedic surgeons on staff to ensure you get a specialist opinion on your injury.
- Surgical Management: Fractures that require surgery are typically referred out of the fracture clinics. If you require surgery, Access Ortho will ensure we find a suitable surgeon and help arrange an appointment and referral.
- Follow-up and Monitoring: Regular follow-up appointments at fracture clinics are essential for monitoring the healing progress through clinical assessments and imaging. These follow-ups allow for the early detection and management of any complications, such as malunion, non-union, or hardware failure, and adjust the treatment plan if necessary. It is important to check with the clinic what follow-up care they offer. Access Ortho provides all non-surgical follow-ups with orthopaedic specialists until you fully recover.
Frequently Asked Questions About Medial Condyle Fractures
What are the main symptoms of a medial condyle fracture?
The main symptoms of a medial condyle fracture include:
- Tenderness: Tenderness over the medial condyle of the elbow.
- Pain: Severe pain in the elbow, especially on the inner side.
- Swelling: Swelling around the elbow joint.
- Bruising: Bruising may develop around the elbow and down the arm.
- Deformity: The elbow may appear misshapen if the fracture is displaced.
- Limited Range of Motion: Difficulty moving the elbow due to pain and swelling.
How is a medial condyle fracture different from other elbow fractures?
A medial condyle fracture specifically involves the inner part of the distal humerus at the elbow joint. It is different from other elbow fractures because:
- Location: Medial condyle fractures occur on the inside of the elbow, while other fractures, such as lateral condyle fractures, involve the outer part.
- Mechanism of Injury: Medial condyle fractures are often caused by a fall on the hand with the elbow slightly bent, whereas other fractures might result from direct trauma or different types of falls.
- Complications: Medial condyle fractures can affect the ulnar nerve due to their proximity, potentially leading to nerve damage, which is less common in other types of elbow fractures.
Are medial condyle fractures more common in children or adults?
Medial condyle fractures are more common in children. This is because children have growth plates (physes) that are more susceptible to fractures. In adults, the bones are more fully developed and tend to fracture in different patterns due to stronger ligaments and tendons.
What imaging studies are used to diagnose medial condyle fractures?
The imaging studies used to diagnose medial condyle fractures include:
- X-rays: The primary imaging method to identify the fracture and determine its type and severity.
- CT Scans: Used in complex cases to provide detailed images of the bone fragments and the extent of the fracture, especially if surgery is being considered.
- MRI: Occasionally used to assess soft tissue damage or if there is a suspicion of associated ligament or cartilage injury.
How long does it typically take for a medial condyle fracture to heal?
The healing time for a medial condyle fracture will vary depending on the fracture and the patient’s age, but it typically takes 6 to 12 weeks. Children tend to heal faster than adults. Full recovery, including the restoration of strength and range of motion, may take longer, especially if the fracture requires surgery.
Will I need surgery for a medial condyle fracture?
Whether you need surgery for a medial condyle fracture depends on the type of fracture and how severe it is:
- Non-displaced Fractures: If the bone fragments are still in their normal positions, the fracture may be managed conservatively with immobilisation in a cast or splint.
- Displaced or Unstable Fractures: Surgery is often required to realign and stabilise the bones, especially if there is significant displacement or the fracture involves the joint surface.
What are some long-term effects of a medial condyle fracture?
Potential long-term effects of a medial condyle fracture can include:
- Reduced Range of Motion: Stiffness in the elbow joint, leading to a limitation in range of motion.
- Arthritis: Post-traumatic arthritis due to damage to the joint surface.
- Nerve Damage: Ulnar nerve injury can occur, leading to numbness, tingling, or weakness. This will be in the hand.
- Malunion or Non-union: Improper healing of the fracture, which may require additional treatment.
How can I manage pain and swelling after a medial condyle fracture?
To manage pain and swelling after a medial condyle fracture, you can:
- Rest: Avoid using the affected arm to allow healing.
- Ice: Apply ice packs to the elbow for 15-20 minutes every few hours to reduce swelling.
- Elevation: Keep the elbow elevated above heart level to help reduce swelling.
- Medication: Use over-the-counter pain relievers like panadol or NSAIDs, as your healthcare provider advises.
When can I return to normal activities after a medial condyle fracture?
The time taken to return to normal activities will vary depending on the fracture and the treatment chosen. You must always follow the advice of your medical team:
- Conservative Management: You may begin light activities within a few weeks, but it could take 2 to 3 months before resuming more strenuous activities.
- Post-surgery: Recovery may take longer, with a gradual return to normal activities as healing progresses. It’s essential to follow your healthcare provider’s advice to avoid complications.
What exercises help in recovering from a medial condyle fracture?
Exercises that help in recovering from a medial condyle fracture include:
- Range of Motion Exercises: Gentle stretching exercises to maintain and gradually increase the flexibility of the elbow joint.
- Strengthening Exercises: Once healing is underway, exercises to strengthen the muscles around the elbow, such as wrist curls, forearm rotations, and grip strengthening exercises.
- Functional Exercises: Activities that mimic daily tasks to restore normal arm function.
It is essential to consult your medical team before doing any exercises to ensure it is safe and appropriate for your stage of recovery.