The lateral elbow x-ray reveals an elevated anterior elbow fat pad, which is suggestive of an effusion.

The AP elbow x-ray shows an avulsed medial epicondyle.

This patient was referred to an orthopaedic specialist and underwent an open reduction and internal fixation of the medial epicondyle fracture.

Medial epicondyle fracture:

• Commonly affects those aged between 9-14 years.
• Can be an isolated injury or part of elbow dislocation.
• It is an important injury because the common flexor-pronator complex of the forearm is attached at the medial epicondyle.
• Can be associated with ulnar nerve injury in approx. 10-16% of cases.

All cases need a referral to an orthopaedician for operative management.

Reference: https://www.orthobullets.com/pediatrics/4008/medial-epicondylar-fractures–pediatric