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高尔夫球肘

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Golfer’s elbow (medial epicondylitis) — causes, symptoms, and conservative treatment options.

Updated Aug 2026
一幅手绘插图，描绘了一个无脸的人正在打高尔夫球挥杆的瞬间。
高尔夫球肘：屈腕和屈指的肌腱附着于肘部内侧的骨性突起上，过度使用会导致这些肌腱与骨骼连接处出现疼痛和退行性变。 Kieran Hirpara 4.0

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

您可能会感到肘部内侧疼痛。该区域是前臂肌肉附着于骨骼的位置。不适感通常逐渐出现。疼痛可能表现为钝痛或刺痛。您可能会注意到疼痛向前臂、手腕和手部放射。

疼痛在使用手臂时通常会加重。抓握物体变得困难。握手或拿咖啡杯等简单任务可能引起不适。涉及前臂旋转的活动可能会遇到困难。将手伸到背后扣内衣或塞衬衫下摆可能诱发疼痛。即使提起轻物也可能感觉沉重或费力。

您的症状常在活动后发作。您可能会在第二天感到酸痛。疼痛也可能在夜间将您痛醒，尤其是如果您侧卧在该侧。休息通常有助于缓解疼痛。然而，当您恢复日常活动时，疼痛可能会复发。

高尔夫球肘是一个常见问题。在大多数情况下，无论是否接受治疗，症状都会在 6 个月内缓解。这意味着您的身体通常会随着时间和护理自行愈合。对于少数对非手术治疗无反应的患者，手术满意度接近 90%。这表明对于需要进一步帮助的患者，该手术通常有效。

需要注意的是，孤立的肘部损伤很少见。如果您近期受过伤，骨折应被视为伴随软组织损伤的标志。这意味着骨骼损伤常伴有肌肉或肌腱问题。充分的肘部评估对于准确诊断和启动适当治疗至关重要。对肘部进行全面的体格检查，包括特殊测试，可能有助于提高肘部病变的诊断准确性。

肘部创伤后骨关节炎是一种不常见的疾病，其临床表现常与影像学发现不一致。这意味着您的 X 光结果可能无法完全解释您的疼痛程度。内侧髁嵌顿于关节内通常与肘关节脱位同时发生，在考虑时应予以重视，以避免诊断错误。

无症状的小联盟棒球运动员中，优势肘部的 MRI 异常很常见，并且在三年内通常会进展，尤其是在继续打棒球的球员中。棒球和垒球运动员经常主诉肘部、手腕和手部不适。这些因素可能会影响您症状的表现和进展。

实际情况

高尔夫球肘是肘部内侧肌腱的磨损性损伤。这些肌腱将前臂肌肉连接到肘部内侧的骨性突起，即肱骨内上髁。可以将这些肌腱视为帮助弯曲手腕和抓握物体的强韧绳索。

当您反复进行举、扭或抓握动作时，这些绳索会被拉伸并产生应变。随着时间的推移，肌腱纤维中可能出现微小撕裂。这会导致附着点出现炎症和疼痛。组织变得易激惹，且承受正常负荷的能力下降。

您的外科医生会解释，这不是突然的断裂，而是应力的逐渐累积。共同屈肌起点是这些肌腱附着的具体位置。当该区域超负荷时，其修复速度跟不上损伤速度。这会导致您在抬起或旋转手部时感到酸痛。

经皮松解共同屈肌起点是治疗该病症的一种安全且有效的方法。它涉及轻柔地松解紧张的肌腱组织以减轻压力。患者在1年的随访期间通常会看到疼痛和功能的显著且持久的改善。该手术有助于在不进行大手术的情况下恢复正常活动。

我们专注于恢复您舒适使用手臂的能力。通过解决肌腱附着处的紧张状态，我们帮助减轻肘关节的应变。这使得组织能够安定并正确愈合。我们的目标是让您以更少的疼痛和更好的功能回归日常生活。

我们能做什么

基兰·希尔帕拉（Kieran Hirpara）医生是麦特私人医院（Mater Private Hospital Rockhampton）的上肢外科医生，他在我们诊所采取的方法反映了您清晰的诊疗路径。您可以通过全科医生或物理治疗师转诊至我们诊所。诊所评估包括病史采集、体格检查以及必要的影像学检查，以确立诊断。对于退行性或长期存在的问题，我们通常首先尝试非手术治疗。这包括活动调整、物理治疗或手部治疗、夹板固定和注射治疗。当非手术治疗未能带来足够改善时，我们会考虑手术。对于结构性或急性问题，可能会直接建议手术，而无需先进行非手术治疗试验。

自我管理和物理治疗是大多数病例的第一步。保守治疗是简单肘部问题的标准起始方案。您的物理治疗师将指导您进行恢复活动和力量的练习。目标是安全地让您恢复高水平的过头活动。对于网球肘等常见疾病，无论采用何种治疗，大多数病例的症状在6个月内均可缓解。我们请您给予这种方法一定的时间。如果您患有肘关节不稳定症，我们可能会使用铰链式外固定装置。这是一种位于手臂外部的框架，可在关节愈合过程中将其固定，从而实现早期活动。

药物治疗侧重于减轻疼痛和炎症。如果自我护理不足以缓解症状，我们可能会讨论注射治疗。这些注射可能包括可的松、透明质酸或富血小板血浆（PRP）。可的松可快速减轻肿胀和疼痛，但效果是暂时的。透明质酸作为润滑剂，以改善平滑运动。PRP利用您自身的血细胞来促进愈合。对于极少数对这些非手术方法无反应的患者，手术可提供近90%的满意度。我们将此作为共同决策提出，让数据说话。

当保守治疗达到极限或肘关节结构不稳定时，会考虑手术。我们进行手术以恢复稳定性、移除受损组织或替换磨损的关节表面。例如，经皮屈肌总腱起点松解术是高尔夫球肘的一种安全有效的选择，在1年随访中显著改善了疼痛和功能。在严重关节炎病例中，半关节置换术（部分关节置换）可提供可预测的活动度改善，57%的患者获得良好至优秀评分。我们将手术方案根据您的具体损伤和目标进行定制。

预期情况

高尔夫球肘是一种影响肘部内侧肌腱的磨损性疾病。如果选择非手术治疗，症状往往会波动。您可能会发现有一段缓解期，随后在抓握或提举物品时出现症状加重。如果不进行治疗，这种循环可能会持续数月甚至数年，使日常活动和爱好变得困难。

当您接受常见的屈肌起点松解术时，目标是打破这种循环。证据表明，在1年的随访期内，该手术能显著且持续地改善疼痛和功能。随着肌腱愈合，大多数人会注意到不适感逐渐减轻。改善并非总是立竿见影，但如果遵循康复计划，效果往往是持久的。

康复是一个过程，而非单一事件。您可以预期在前几个月内肘关节活动范围会有可预测的改善。对许多人来说，最快的进步发生在最初的2到4个月内。此后，进展会更加缓慢。我们在手术后立即开始您的康复计划，因为运动能力的显著改善主要发生在这个早期阶段。您需要继续进行这些锻炼至少6个月，以维持这些成果。

保持现实的期望很重要。虽然大多数患者能获得良好的疼痛缓解和功能恢复，但结果因人而异。在涉及更复杂的关节问题的情况下，例如创伤后关节炎，拥有存活植入物的患者中，约57%的患者获得了良好至优秀的功能评分。这意味着虽然许多人恢复得很好，但部分患者仍可能经历某些限制或不适。

如果您有复杂的肘部损伤，长期预后则不太确定。复杂肘部损伤的手术管理长期结果尚不清楚。然而，对于标准的高尔夫球肘，康复路径通常很明确。起初您需要避免用力抓握和重复性的手腕动作。对于年轻运动员，预防性的至少1个月的休赛期是最低要求，但对于成年人，逐步恢复活动是关键。

您的外科医生会指导您何时可以安全地恢复特定活动。过早恢复可能会导致肱骨内上髁的形态异常或延缓愈合。耐心至关重要。大多数接受该条件治疗的肘部都能实现功能性活动范围和合理的患者报告结果。您应该有信心，通过适当的护理，您可以以较少的疼痛回归正常生活。

何时就医

高尔夫球肘通常在休息后6个月内改善。然而，如果疼痛持续超过此期限，您应寻求专科医生评估。如果出现突然加重、无力或不稳定，请立即就医。关节锁定或突然无力也需要及时评估。这些症状可能提示需要准确诊断的伴随软组织损伤。如果非手术治疗无效，手术可提供近90%的满意度。您的外科医生将检查您的肘部以确定最佳治疗方案。不要忽视影响睡眠或日常工作的症状。早期评估有助于预防长期并发症，并确保您获得针对特定病情的适当治疗。

Reviewed by Dr Kieran Hirpara · 7 August 2026.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Fragment excision and ligament repair for valgus instability due to medial epicondyle nonunion is associated with rapid restoration of elbow stability, minimal surgical morbidity, high patient satisfaction, and improved objective elbow scores [1].
  • Percutaneous common flexor origin release of the medial humeral epicondyle for golfer's elbow is a safe and effective treatment option that provides significant and sustainable improvements in pain and function during a 1-year follow-up period [2].
  • Fluoroscopy evaluation of elbow joint instability during surgery is valuable for understanding pathology and assessing treatment effectiveness in pediatric medial epicondyle fractures with collateral ligament injuries [4].
  • Surgical management is successful for adolescent athletes with medial epicondyle fractures who sustain significant trauma, have elbow laxity or instability, or have significant fracture fragment displacement [5].
  • Arthroscopic debridement and focused rehabilitation for posterolateral elbow impingement from lateral synovial plicae in throwing athletes and golfers is highly successful and allows return to previous levels of play, provided other elbow problems are excluded [9].
  • Most pediatric patients with proximal bony UCL avulsion fractures of the medial epicondyle return to activities at about 3 months without surgery, demonstrating excellent elbow range of motion and Timmerman-Andrews's scores regardless of union or nonunion [12].
  • Arthroscopic surgical treatment for medial epicondylitis provides good outcomes and is safe and effective [14].
  • Posterior oblique medial epicondylectomy for cubital tunnel syndrome may offer advantages over traditional medial epicondylectomy by preserving elbow stability and enabling early active range of motion during the postoperative period [21].
  • Success rates for medial epicondylectomy are between 72% and 94%, as confirmed by 12 studies [23].
  • Surgical intervention for refractory medial epicondylitis often has a high success rate, with patients generally demonstrating improvement in patient-reported outcomes and an encouraging number returning to work with limited complications [24].
  • Distal medial epicondylectomy for cubital tunnel syndrome yields preliminary results comparable with other epicondylectomy techniques but with lower complication rates [28].
  • Open reduction and internal fixation (ORIF) of displaced medial epicondyle fractures is a reliable and successful procedure in adolescent overhead athletes, with relatively low risk of major complications, reinjury, or reoperation [50].

Anatomy & Pathophysiology

Bony Anatomy and Fracture Patterns

  • Medial epicondyle nonunion can cause valgus instability of the elbow [1].
  • Pediatric medial epicondyle fractures may be associated with medial and lateral collateral ligament injuries [4].
  • MRI-based investigations have identified specific fracture patterns in pediatric humeral medial epicondyle injuries [13].
  • Fragmentation of the medial epicondyle may compromise medial elbow dynamic stability in adult baseball players [40].
  • An osteotomy of the medial epicondyle allows for dislocation of the elbow joint and provides good exposure for procedures such as total elbow prosthesis placement [48].
  • Displaced medial epicondyle fractures of the humerus are treated surgically, with stiffness being rare even with postoperative immobilization [26].

Ligamentous and Dynamic Stability

  • The flexor-pronator mass dynamically stabilizes the elbow against valgus torque [32].
  • Isometric forearm pronation reduces valgus stress–induced widening of the medial joint space and medial elbow pain in patients with medial ulnar collateral ligament (MUCL) insufficiency [39].
  • Ultrasonographic assessment demonstrates that flexor-pronator muscles contribute to elbow valgus stability [47].
  • Repetitive baseball pitching reduces elbow valgus stability, attributed to decreased flexor-pronator mass contractile function [43].
  • Increased flexor carpi ulnaris (FCU) elasticity is a risk factor for medial elbow injury in young baseball players [46].
  • Incorporating the pronator teres into contraction tasks significantly reduces the medial joint space, emphasizing its important role in elbow joint stability [34].
  • The medial elbow joint space is significantly reduced under 60-N valgus stress plus 50% MVC compared to 60-N valgus stress alone [33].

Pathophysiology and Risk Factors

  • High elbow varus torque increases the risk of medial elbow disorder in Little League pitchers [37].
  • Pitch velocity is significantly associated with abnormality of the medial epicondyle and elbow pain among youth baseball players [49].
  • Golf injuries of the hand and wrist are common and most are related to overuse, requiring understanding of golf swing kinematics for diagnosis and management [15].
  • Accurate diagnosis of medial epicondylitis requires distinguishing it from other elbow conditions, with treatment guided by the specific pathologic stage of the tendon [6].
  • The treatment rationale for medial epicondyle (ME) injuries is often predicated on restoring elbow biomechanics through anatomical restoration of the ulnar collateral ligament (UCL) [13].

Classification

  • Valgus instability of the elbow can result from medial epicondyle nonunion [1].
  • Medial epicondyle apophyseal avulsion fractures in youth throwers represent a severe variant of Little League elbow [3].
  • Pediatric medial epicondyle fractures can be associated with medial and lateral collateral ligament injuries [4].
  • Medial epicondyle fractures account for up to 20% of elbow fractures in the pediatric population [54].
  • 60% of pediatric medial epicondyle fractures are associated with elbow dislocation [54].
  • Elbow dislocations associated with medial epicondyle fractures with intra-articular entrapment can be difficult to diagnose in the acute phase [11].
  • Medial elbow pain requires a broad differential diagnosis that includes ulnar nerve disorders, cervical radiculopathy, and ligament injuries [8].
  • Accurate diagnosis of medial epicondylitis requires distinguishing it from other elbow conditions [6].
  • Golf injuries of the hand and wrist are common and most are related to overuse [15].
  • Proximal bony UCL avulsion fractures of the pediatric medial epicondyle are a distinct injury pattern [12].
  • Fracture patterns in pediatric humeral medial epicondyle injuries can be identified via MRI [13].

Clinical Presentation

  • A large majority of patients with medial epicondyle apophyseal avulsion fractures in youth throwers reported medial elbow pain prior to the fracture [3].
  • Evaluation of elbow joint instability using fluoroscopy during surgery is valuable for understanding pathology and assessing treatment effectiveness in cases of pediatric medial epicondyle fracture with collateral ligament injury [4].
  • Surgical management is indicated for athletes with medial epicondyle fractures who sustain significant trauma, have elbow laxity or instability, or have significant fracture fragment displacement [5].
  • Treatment of medial epicondylitis is guided by the specific pathologic stage of the tendon [6].
  • Bone union of medial epicondylar fragmentation in young baseball players is associated with a decreased prevalence of elbow pain at 1 year after initial presentation [7].
  • Medial elbow pain is uncommon and requires a broad differential diagnosis that includes ulnar nerve disorders, cervical radiculopathy, and ligament injuries [8].
  • Arthroscopic treatment of posterolateral elbow impingement from lateral synovial plicae is highly successful in throwing athletes and golfers when other elbow problems are excluded [9].
  • Patients with medial epicondyle fracture and concomitant flexor-pronator mass avulsion can achieve pain-free status, symmetric range of motion, elbow stability, and function compared to the contralateral extremity at 1-year follow-up [10].
  • Elbow dislocations associated with medial epicondyle fractures with intra-articular entrapment can be difficult to diagnose in the acute phase, requiring a high level of suspicion [11].
  • Identification of fracture patterns in pediatric humeral medial epicondyle injuries is a key step in understanding variability in clinical outcomes for medial elbow injuries [13].
  • Understanding the kinematics of the golf swing is essential for diagnosis and management of hand and wrist injuries in golfers [15].
  • Medial elbow pain during the return-to-throwing period after ulnar collateral ligament reconstruction is not uncommon, with up to half of pitchers potentially experiencing pain [17].
  • A combined approach with ultrasound and MR arthrography shows higher accuracy than each modality alone for the assessment of medial elbow pain in baseball players [18].
  • Mini-open muscle resection procedure under local anesthesia successfully manages medial or lateral epicondylitis unresponsive to long-term conservative treatments in 97.6% of cases [19].
  • The prognosis for medial epicondylitis in occupational settings is good, with a 3-year recovery rate of 81% [20].
  • Incarceration of the medial epicondyle in the joint often occurs in association with an elbow dislocation and is important to consider to avoid diagnostic mistakes [22].
  • Posterior shoulder instability with secondary impingement is a possible cause of shoulder pain in elite golfers [36].

Investigations

  • Treatment for medial epicondylitis is guided by the specific pathologic stage of the tendon [6].
  • A combined approach using ultrasonography (US) and MR arthrography shows higher accuracy than either modality alone for assessing medial elbow pain [18].
  • Ultrasonography is recommended as an initial imaging method for the diagnosis of clinical medial epicondylitis [55].
  • Ultrasonography provides good positive predictive value for medial epicondyle lesions among adolescent baseball players [56].
  • Magnetic resonance imaging (MRI) findings may help distinguish between patients with medial epicondylitis and those with asymptomatic senescent changes of the common flexor tendon [58].
  • There is substantial variation in imaging practices across the United States when diagnosing a medial epicondyle fracture [51].
  • CT scans are more likely to be used for diagnosing medial epicondyle fractures in smaller cities and in older children [51].
  • MRI is more likely to be used for diagnosing medial epicondyle fractures in smaller hospitals and in younger children [51].
  • Evaluation of elbow joint instability using fluoroscopy during surgery is valuable for understanding the pathology and assessing treatment effectiveness [4].
  • Elbow dislocations associated with fractures of the medial epicondyle with intra-articular entrapment can be difficult to diagnose in the acute phase, requiring a high level of suspicion [11].

Treatment

Non-Operative Management

  • Percutaneous common flexor origin release of the medial humeral epicondyle provides significant and sustainable improvements in pain and function during a 1-year follow-up period [2].
  • Nonoperative treatment may be appropriate for minimally displaced pediatric medial epicondyle apophyseal avulsion fractures [53].

Operative Management

  • Surgical management is successful in adolescent athletes with medial epicondyle fractures who sustain significant trauma, have elbow laxity or instability, or have significant fracture fragment displacement [5].
  • Arthroscopic debridement and focused rehabilitation are highly successful in treating posterolateral elbow impingement from lateral synovial plicae in throwing athletes and golfers, allowing return to previous levels of play [9].
  • Arthroscopic surgical treatment for medial epicondylitis is safe, effective, and provides good outcomes [14].
  • At an average of 6.3 years after surgery, clinical outcomes for operatively treated pediatric and adolescent medial epicondyle fractures are excellent [16].
  • Mini-open muscle resection under local anesthesia successfully manages medial or lateral epicondylitis unresponsive to long-term conservative treatments, with 97.6% of elbows (41 of 42) managed successfully [19].
  • Medial epicondylectomy has confirmed success rates between 72% and 94% across 12 studies [23].
  • Surgical intervention for refractory medial epicondylitis often has a high success rate, with patients demonstrating improved patient-reported outcomes and an encouraging number returning to work with limited complications [24].
  • Operative treatment of recalcitrant medial epicondylitis is effective in restoring patient function and strength [35].
  • Operative treatment affords a significantly higher union rate compared to non-operative management of medial epicondyle fractures [41].
  • Open and arthroscopic techniques are very effective and comparable for treating chronic medial epicondylitis [44].
  • Partial medial epicondylectomy achieves good postoperative objective results in cubital tunnel syndrome [45].
  • Distal medial epicondylectomy, a modification of partial medial epicondylectomy for cubital tunnel syndrome, yields preliminary results comparable to other epicondylectomy techniques with lower complication rates [28].
  • The outcome of non-operative treatment for medial epicondyle fractures is usually satisfactory, as even fibrous union is compatible with excellent function [52].

Diagnostic Considerations in Treatment Planning

  • Accurate diagnosis of medial epicondylitis requires distinguishing it from other elbow conditions, and treatment is guided by the specific pathologic stage of the tendon [6].
  • Medial elbow pain requires a broad differential diagnosis including ulnar nerve disorders, cervical radiculopathy, and ligament injuries [8].
  • Evaluation of elbow joint instability using fluoroscopy during surgery is valuable for understanding pathology and assessing treatment effectiveness in pediatric medial epicondyle fractures with collateral ligament injury [4].
  • A large majority of patients with medial epicondyle apophyseal avulsion fractures in youth throwers reported medial elbow pain prior to fracture, suggesting this severe presentation of Little League elbow may be preventable [3].
  • Carefully designed randomized prospective studies using standardized diagnostic measurement techniques and outcome measures are needed to determine the most optimal treatment strategies for pediatric medial epicondyle fractures [27].

Complications

  • Medial epicondyle apophyseal avulsion fractures in youth throwers are a severe variant of Little League elbow [3].
  • A large majority of patients with medial epicondyle apophyseal avulsion fractures reported medial elbow pain prior to the fracture [3].
  • Bone union of medial epicondylar fragmentation is associated with a decreased prevalence of elbow pain at 1 year after initial presentation in young baseball players [7].
  • Medial epicondyle fracture with concomitant flexor-pronator mass avulsion from the fracture fragment is a documented complication pattern [10].
  • Most patients with proximal bony UCL avulsion fractures of the pediatric medial epicondyle return to activities at about 3 months without surgery, regardless of union or nonunion [12].
  • Medial elbow pain during the return-to-throwing period after ulnar collateral ligament reconstruction (UCLR) is not uncommon, with up to half of pitchers potentially experiencing pain [17].
  • There was no ulnar nerve palsy, no ulnar nerve subluxation, or medial elbow instability following partial medial epicondylectomy for cubital tunnel syndrome [25].
  • 45% of patients reported mild pain at the 6-month follow-up after partial medial epicondylectomy for cubital tunnel syndrome [25].
  • Stiffness is rare even with postoperative immobilization of the elbow (mean of 4 weeks) following surgical treatment of displaced medial epicondyle fractures [26].
  • 73.3% of professional pitchers with a history of UCLR were able to return to sport after open reduction internal fixation (ORIF) of the medial epicondyle [29, 31].
  • Only 55% of professional pitchers with a history of UCLR returned to sport at the same level or higher after ORIF of the medial epicondyle [29, 31].
  • Chronic medial epicondyle apophysitis treatment involves rest and education, with no long-term complications reported [38].
  • Heavy smoking, elbow flexion contracture, and preoperative disease severity are associated with persistently increased disability after minimal medial epicondylectomy for cubital tunnel syndrome [42].
  • Modified oblique medial epicondylectomy for cubital tunnel syndrome minimizes complications previously associated with the original technique [57].
  • Conservative treatment without prohibiting tennis play resulted in an 83% rate of spontaneous bone union for medial epicondylar fragmentation in male junior tennis players [30].
  • Elbow pain persisted in 50% of subjects with medial epicondylar fragmentation at re-examination despite conservative treatment [30].

Recovery

  • Fragment excision and ligament repair for valgus instability due to medial epicondyle nonunion is associated with rapid restoration of elbow stability [1].
  • Fragment excision and ligament repair for valgus instability due to medial epicondyle nonunion is associated with minimal surgical morbidity [1].
  • Fragment excision and ligament repair for valgus instability due to medial epicondyle nonunion is associated with a high rate of patient satisfaction [1].
  • Fragment excision and ligament repair for valgus instability due to medial epicondyle nonunion is associated with an improvement in objective elbow scores [1].
  • Percutaneous common flexor origin release of the medial humeral epicondyle for golfer's elbow provides significant and sustainable improvements in pain and function during a 1-year follow-up period [2].
  • Percutaneous common flexor origin release of the medial humeral epicondyle for golfer's elbow is a safe and effective treatment option [2].
  • Patients with medial epicondyle fracture and concomitant flexor-pronator mass avulsion were pain free at 1-year follow-up [10].
  • Patients with medial epicondyle fracture and concomitant flexor-pronator mass avulsion had symmetric range of motion, elbow stability, and function compared with the contralateral extremity at 1-year follow-up [10].
  • Most patients with proximal bony UCL avulsion fractures of the pediatric medial epicondyle return to activities at about 3 months without surgery [12].
  • Patients with proximal bony UCL avulsion fractures of the pediatric medial epicondyle have excellent elbow range of motion and Timmerman-Andrews's score at return to activity, regardless of union or nonunion [12].
  • Clinical outcomes for operatively treated medial epicondyle fractures in pediatric and adolescent patients are excellent at an average of 6.3 years after surgery [16].
  • Up to half of pitchers experience medial elbow pain during the return-to-throwing period after ulnar collateral ligament reconstruction (UCLR) [17].
  • 97.6% (41 out of 42) of elbows with medial or lateral epicondylitis unresponsive to long-term conservative treatments were managed successfully with mini-open muscle resection under local anesthesia [19].
  • Posterior oblique medial epicondylectomy for cubital tunnel syndrome may preserve elbow stability and enable early active range of motion during the postoperative period [21].
  • Partial medial epicondylectomy for cubital tunnel syndrome results in no ulnar nerve palsy, no ulnar nerve subluxation, or medial elbow instability [25].
  • 45% of patients reported mild pain at 6-month follow-up after partial medial epicondylectomy for cubital tunnel syndrome [25].
  • Return to sport after ORIF of the medial epicondyle in professional pitchers with a history of UCLR occurs without a significant decline in most performance variables compared with preoperative performance or matched controls [29].
  • 73.3% of professional pitchers with a history of UCLR were able to return to sport following medial epicondyle ORIF [31].
  • Return to sport following medial epicondyle ORIF in professional pitchers with a history of UCLR occurs without a significant decline in most performance variables compared to pre-operative performance levels or matched controls [31].
  • Conservative treatment without prohibiting tennis play for medial epicondylar fragmentation in male junior tennis players resulted in an 83% rate of spontaneous bone union [30].

Key Evidence

  • [L4] The procedure is associated with rapid restoration of elbow stability, minimal surgical morbidity, a high rate of patient satisfaction, and an improvement in objective elbow scores. [1] (10.1067/mse.2002.126206)
  • [L4] Percutaneous common flexor origin release of medial humeral epicondyle in golfer's elbow appears to be a safe and effective treatment option and provides significant and sustainable improvements in pain and function during a 1-year follow-up period. [2] (10.1016/j.rboe.2016.06.007)
  • [L3] A large majority of patients reported medial elbow pain prior to fracture, suggesting this severe presentation of Little League elbow may be preventable. [3] (10.1177/2325967121s00275)
  • [Case_report] The evaluation of elbow joint instability using fluoroscopy during surgery proved to be valuable for both understanding the pathology and assessing the effectiveness of treatments. [4] (10.1016/j.jseint.2024.05.014)
  • [L4] Surgical management can be successful in athletes who sustain more significant trauma, who have elbow laxity or instability, or who have significant fracture fragment displacement. [5] (10.1177/0363546513480797)
  • [L5] Accurate diagnosis requires distinguishing it from other elbow conditions, and treatment is guided by the specific pathologic stage of the tendon. [6] (10.1016/j.csm.2004.04.011)
  • [L3] At 1 year after initial presentation, bone union of the medial epicondylar fragmentation was associated with a decreased prevalence of elbow pain. [7] (10.1177/0363546512443807)
  • [L5] Medial elbow pain is uncommon and requires a broad differential diagnosis including ulnar nerve disorders, cervical radiculopathy, and ligament injuries. [8] (10.1302/2058-5241.2.160006)
  • [L4] With careful diagnosis and exclusion of other elbow problems, treatment with arthroscopic debridement and focused rehabilitation is highly successful and allows these athletes to return to their previous level of play. [9] (10.1177/0363546505281917)
  • [L5] At the 1-year follow-up visit, the patient was pain free and had symmetric range of motion, elbow stability, and function when compared with his contralateral extremity. [10] (10.2106/jbjs.cc.19.00417)
  • [L4] Elbow dislocations associated with fractures of the medial epicondyle with intra-articular entrapment can be difficult to diagnose in the acute phase, and thus a high level of suspicion is required. [11] (10.1016/j.jse.2012.11.009)
  • [L4] Most patients return to activities at about 3 months without surgery with excellent elbow range of motion and Timmerman-Andrews's score, regardless of union or nonunion. [12] (10.1177/2325967125s00095)
  • [L4] As the treatment rationale for ME injuries is often predicated on restoring elbow biomechanics through anatomical restoration of the UCL, identification of these injury patterns is potentially a key first step in understanding the variability in clinical outcomes with different management strategies for medial elbow injuries. [13] (10.1177/2325967125s00159)
  • [L4] Arthroscopic surgical treatment for medial epicondylitis of the elbow provides good outcomes and is safe and effective. [14] (10.1016/j.jse.2017.08.019)
  • [L5] Golf injuries of the hand and wrist are common and most are related to overuse; understanding the kinematics of the golf swing is essential for diagnosis and management. [15] (10.1016/j.hcl.2016.08.012)
  • [L4] At an average of 6.3 years after surgery, the clinical outcomes for medial epicondyle fracture were excellent. [16] (10.1016/j.jhsg.2021.02.006)
  • [L3] Medial elbow pain during the return-to-throwing period after UCLR is not uncommon, with up to half of pitchers potentially experiencing pain. [17] (10.1177/2325967118808782)
  • [L2] The combined approach with both MR arthrography and US shows higher accuracy than each modality alone for the assessment of medial elbow pain. [18] (10.1148/radiol.2015151256)
  • [L4] Overall, 41 (97.6%) out of 42 elbows with medial or lateral epicondylitis, which were unresponsive to long-term conservative treatments, were managed successfully. [19] (10.4055/cios.2009.1.3.123)
  • [L2] The prognosis for medial epicondylitis in this population was good with a 3-year recovery rate at 81%. [20] (10.1097/01.jom.0000085888.37273.d9)
  • [L4] This technique may offer advantages over traditional medial epicondylectomy by preserving elbow stability and enabling early active range of motion during the postoperative period. [21] (10.1016/j.jhsg.2025.100809)
  • [Case_report] Incarceration of the medial epicondyle in the joint often occurs in association with an elbow dislocation and is important to consider to avoid diagnostic mistakes. [22] (10.1016/j.jse.2011.09.030)
  • [L5] The article outlines indications and a technique for medial epicondylectomy, noting that 12 studies have confirmed success rates between 72% and 94%. [23] (10.1016/j.hcl.2007.06.002)
  • [L4] Surgical intervention for refractory medial epicondylitis often has a high success rate with patients generally demonstrating an improvement in patient-reported outcomes and an encouraging number returning to work with limited complications. [24] (10.1177/03635465221095565)
  • [L4] There was no ulnar nerve palsy, no ulnar nerve subluxation, or medial elbow instability, although 45% of patients reported mild pain at the 6-month followup. [25] (10.1097/01.blo.0000201153.36948.29)
  • [L4] Even with postoperative immobilization of the elbow (mean of 4 weeks), stiffness is rare. [26] (10.1007/s00402-009-1009-3)
  • [L4] Carefully designed randomized prospective studies using standardized diagnostic measurement techniques, and standardized outcome measures are needed to determine the most optimal treatment strategies for pediatric medial epicondyle fractures. [27] (10.1097/bpo.0000000000001532)
  • [L4] The preliminary results are comparable with other epicondylectomy techniques with lower complication rates. [28] (10.1007/s00402-012-1599-z)
  • [L4] After ORIF of the medial epicondyle in professional pitchers with a history of UCLR, 73.3% were able to return to sport (only 55% at the same level or higher) without a significant decline in most performance variables when compared with their preoperative performance or matched controls. [29] (10.1177/2325967119852896)
  • [L2] Although conservative treatment without prohibiting tennis play resulted in an 83% rate of spontaneous bone union, elbow pain persisted in 50% of subjects at re-examination. [30] (10.1016/j.jse.2014.06.044)
  • [L4] Following medial epicondyle ORIF of professional pitchers with a history of UCLR, 73.3% were able to RTS without a significant decline in most performance variables when compared to their pre-operative performance levels, or when compared to matched controls. [31] (10.1016/j.jse.2020.01.038)
  • [L5] The flexor-pronator mass dynamically stabilizes the elbow against valgus torque. [32] (10.2106/00004623-200410000-00020)
  • [L5] The medial elbow joint space was significantly reduced under 60-N valgus stress plus 50% MVC compared to 60-N valgus stress alone. [33] (10.1016/j.jse.2022.03.027)
  • [L4] Incorporating the pronator teres into contraction tasks significantly reduced the medial joint space, emphasizing the important role of the PT in elbow joint stability. [34] (10.1016/j.jse.2024.12.025)
  • [L4] Operative treatment of recalcitrant medial epicondylitis is effective in restoring patient function and strength. [35] (10.1308/003588413x13629960048479)
  • [L4] Clinicians should be aware of posterior shoulder instability and the associated secondary diagnosis of rotator cuff impingement as a possible cause of shoulder pain in elite golfers. [36] (10.1177/03635465020300062101)
  • [L3] High elbow varus torque would increase the risk of medial elbow disorder. [37] (10.1177/2325967121s00748)
  • [L4] Isometric forearm pronation reduces valgus stress–induced widening of the medial joint space and medial elbow pain in patients with MUCL insufficiency. [39] (10.1016/j.jse.2021.10.015)
  • [L2] Fragmentation of the medial epicondyle may contribute to compromised medial elbow dynamic stability in adult baseball players. [40] (10.1016/j.xrrt.2026.100680)
  • [L4] Operative treatment affords a significantly higher union rate over the non-operative management of medial epicondyle fractures. [41] (10.1007/s11832-009-0192-7)
  • [L4] Heavy smoking, elbow flexion contracture, and preoperative disease severity are associated with persistently increased disability after minimal medial epicondylectomy for CuTS. [42] (10.1016/j.bjps.2018.05.038)
  • [L5] Repetitive baseball pitching reduced elbow valgus stability, attributed to decreased flexor-pronator mass contractile function. [43] (10.1016/j.jse.2023.03.026)
  • [L3] Open and arthroscopic techniques were very effective and comparable for treating chronic medial epicondylitis. [44] (10.1016/j.jse.2022.09.018)
  • [L4] Good postoperative objective results were reached by partial medial epicondylectomy. [45] (10.1007/s00402-010-1160-x)
  • [L2] Increased flexor carpi ulnaris (FCU) elasticity is a risk factor for medial elbow injury. [46] (10.1177/03635465231202028)
  • [L4] Ultrasonographic assessment demonstrated that flexor-pronator muscles contribute to elbow valgus stability. [47] (10.1016/j.jses.2019.10.003)
  • [L4] An osteotomy of the medial epicondyle of the elbow allows dislocation of the joint, provides a good exposure of the elbow, and allows proper placement of a total elbow prosthesis. [48] (10.1016/j.jse.2013.11.021)
  • [L3] Pitch velocity was significantly associated with abnormality of the medial epicondyle and elbow pain. [49] (10.1177/0363546520914911)
  • [L4] ORIF of displaced medial epicondyle fractures is a reliable and successful procedure in adolescent overhead athletes with high demands, with relatively low risk of major complications, reinjury, or reoperation. [50] (10.1177/2325967120976573)
  • [L3] There is substantial variation in imaging practices across the United States when diagnosing a medial epicondyle fracture, with CT scans more likely in smaller cities and older children, and MRI more likely in smaller hospitals and younger children. [51] (10.1177/2325967119s00071)
  • [L4] The outcome of non-operative treatment is usually satisfactory as even a fibrous union is compatible with excellent function. [52] (10.1016/0020-1383(88)90109-x)
  • [L4] Nonoperative treatment may be appropriate for minimally displaced cases. [53] (10.1177/23259671251365974)
  • [L5] Medial epicondyle fractures account for up to 20% of elbow fractures in the pediatric population, with 60% associated with elbow dislocation. [54] (10.5435/jaaos-20-04-223)
  • [L2] Therefore, ultrasonography is recommended as an initial imaging method for the diagnosis of clinical medial epicondylitis. [55] (10.1016/j.apmr.2007.09.048)
  • [L4] Ultrasonography provides good positive predictive value for medial epicondyle lesions, and decreased shoulder external rotation may relate to these lesions. [56] (10.1007/s00167-018-5178-x)
  • [L4] This medial collateral ligament sparing technique minimized complications previously associated with the original technique. [57] (10.1016/j.jhsa.2012.11.006)
  • [L4] These MR imaging findings may be helpful to distinguish between patients with medial epicondylitis and patients with asymptomatic senescent changes of the common flexor tendon. [58] (10.1007/s00256-005-0896-9)

References

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j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.