- See: Pediatric Elbow Injuries 
- Discussion: 
- a traction apophysisitis of the medial epicondyle which needs to be distinguished from avulsion frx of the medial epicondyle 
- the medial epicondyle is an apophysis which is connected to the MCL as well as being connected to the flexor-pronator mass; 
- both of these structures will stress the apophysis w/ valgus stress; 
- radiographs: 
- medial epicondyle fuses at age 17 years; 
- look for fatigue fractures of the medial epicondyle: 
- enlargement and fragmentation of the apophysis may be seen; 
- treatment: 
- a true apophysisitis of the medial epicondyle is treated non-operatively w/ rest ands strict avoidance of throwing activities; 
- a displaced traction apophysisitis is more consistent w/ a avulsion frx of the medial epicondyle and may need to be treated operatively