The SCIENCE trial is a multicenter, randomized, controlled superiority trial and economic evaluation comparing surgical fixation with nonsurgical care in children with a displaced fracture of the medial epicondyle of the elbow. Surgical fixation offers no clinical benefit compared with nonsurgical care. Moreover, it is not cost-effective. Children undergoing surgical treatment are exposed to avoidable surgical risks. The study findings suggest that nonsurgical care should become the default management strategy for these injuries. This is true regardless of the initial condition of the elbow dislocation.