Paediatric elbow injuries including the SCIENCE study

Elbow fractures account for approximately 15% of childhood fractures and are the most common indication for operative intervention in paediatric orthopaedics. The appearance of growing bone complicates the diagnosis of elbow fractures in children, with the developing elbow having six secondary ossification centres. Supracondylar fractures are the most common injury pattern, followed by lateral condyle and medial epicondyle fractures. Each injury carries distinct risks of neurovascular injury, growth disturbance, deformity, and long-term functional impairment. High-quality evidence to guide treatment in children's elbow injuries has historically been limited, driving considerable variation in practice. Recent trials are beginning to address this, most notably the SCIENCE study, which has redefined management of displaced medial epicondyle fractures by demonstrating non-operative treatment to achieve equivalent outcomes to surgery. This article provides junior trainees with a concise, evidence-based overview of the assessment and management of common paediatric elbow fractures.