11 year old female presenting with a posterolateral dislocation of her right elbow after landing on a one-handed handstand on a trampoline. This was a closed injury and had an intact neurovascular status. Advanced imaging demonstrated a medial epicondyle fracture that was within acceptable limits to be managed non-operatively. This injury was relocated under ketamine sedation in the Emergency Department. At the one-week follow-up, the patient examined to have a median nerve palsy. The medial epicondyle fracture examined to be in a good position and the patient was managed in an above-elbow cast for 6 weeks. There was no improvement of the palsy, 3 months post-injury when an MRI was performed which demonstrated a trapped median nerve between the medial epicondyle fragment and humerus with marked median nerve swelling. The patient proceeded to have and exploration and neurolysis of median nerve and open reduction and internal fixation of medial epicondyle fracture at this point. Intraoperative findings demonstrated a non-union of the medial epicondyle fracture with contusion of the median nerve with less calibre through the portion behind the medial epicondyle. The nerve was deemed to be 80-90% intact with no further repair required. The medial epicondyle was then secured with K-wires and a tension band suture. One-week postoperatively, there was a return of power (Grade 2) to the Right FPL and FDP of index finger. The patient had hand therapy on two-weeks postoperatively onwards. The patient had full recovery of the median nerve palsy one year post-injury and was discharged.