Approximately half of all pediatric medial epicondyle fractures are associated with elbow dislocations Intra-articular incarceration of the epicondylar fragment occurs in 5% to 18% of all cases of medial epicondyle fracture and is an indication for operative management Medial epicondyle fractures may be complicated by paresis of the ulnar nerve, a relative indication for operative management A child presenting with acute onset of pain over the medial elbow after throwing may have an avulsion fracture of the medial epicondyle, a variant of Little League elbow