The _medial epicondyle_ may be chipped off by a fall on the edge of a table or kerbstone, or it may be forcibly avulsed by traction through the ulnar collateral (internal lateral) ligament, as an accompaniment of dislocation. It is usually displaced downwards and forwards by the flexor muscles attached to it, and may thus come to exert pressure on the ulnar nerve. The fragment may be grasped and made to move on the shaft, producing crepitus. Fibrous union is the usual result. Up to the age of seventeen or eighteen the epiphysis of the epicondyle may be separated. #Treatment of Fractures in Region of Elbow.#--The administration of a general anæsthetic is a valuable aid to accurate reduction and fixation of fractures in this region. Much discussion has taken place as to the best position in which to treat these fractures. In our experience the best approximation of the fragments, as shown by the X-rays, is obtained when the limb is fixed in the position of full flexion with supination. American surgeons favour the position of flexion at a right angle. In the region of the elbow there is a risk of promoting too much callus formation by early and vigorous massage, with the result that the movements of the joint are restricted by locking of the bony projections. This is probably due to bone cells being forced into the surrounding tissues, where they multiply and form new bone on an exaggerated scale. The _supra-condylar fracture_ is reduced by first extending the elbow to free the lower fragment from the triceps, and then, while making traction through the forearm, manipulating the fragments into position, and finally flexing the elbow to an acute angle and supinating the forearm. In this way the triceps is put upon the stretch and forms a natural posterior splint. A layer of wadding is placed in the bend of the elbow to separate the apposed skin surfaces, the arm placed in a sling so arranged as to support the elbow, and fixed to the side by a body bandage. This position is maintained for three weeks, with daily massage and movement. The last movement to be attempted is that of complete extension. Operative treatment is rarely called for. _Separation of the epiphysis_ and _fracture of the medial epicondyle_ are treated on the same lines as supra-condylar fracture.