Medial epicondyle fractures account for approximately 10% of elbow injuries in children, and their treatment has long been a subject of debate among surgeons.[5] The SCIENCE trial was the first large randomized controlled trial to compare surgical fixation with nonoperative treatment (casting) in 334 children aged 7 to 15 years from hospitals in the United Kingdom, Australia, and New Zealand.[4][5] The primary objective was to measure upper extremity function at 12 months using the PROMIS score. Results showed that at 12 months there was no significant functional difference between the groups, with scores of 53.1 in the cast group and 54.3 in the surgery group.[4] The study found that one in seven children who underwent surgery required a second operation, usually to remove the screw, while only one in 45 children treated with a cast needed surgery later.[5] The researchers concluded that surgical fixation should no longer be considered necessary for displaced medial epicondyle fractures in children, as nonoperative treatment provides comparable results without the risks associated with surgery.[5]