Elbow fracture (peds): Difference between revisions

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==Supracondylar Fracture==
{{Peds top}} [[elbow fracture]]
*See [[Supracondylar Fracture]]
==Differential Diagnosis==
{{Elbow DDX}}


==Lateral Epicondyle Fracture==
==Evaluation==
===Background===
{{Elbow ossification by age DDX}}
*Salter-Harris type IV Fx
*Neurovascular injury uncommon
===Diagnosis===
====Clinical Findings====
*Swelling and tenderness limited to lateral elbow
neurovascular injury is uncommon
====Imaging====
*Obtain oblique view if suspicion high despite neg AP/lat
*Radiocapitellar line won't intersect middle of capitellum in all views
**May be only sign of fracture if fracture is entirely through growth plate
*[[Elbow X-ray (Peds)|+Fat Pad Sign/"sail" sign]]
**May be only sign of nondisplaced fx
 
===Treatment===
*Often requires ORIF (ortho consult)
 
==Medial Epicondyle Fracture==
===Background===
*Not true Salter-Harris fx (apophysis, not physis, is involved)
*50% assoc w/ elbow dislocation
===Diagnosis===
*Displacement of medial epicondyle ossification center
*May become entrapped w/in elbow joint
*Use [[CRITOE]] to determine if bone in joint is medial epicondyle or nl trochlear oss center
**If think is trochlear but cannot see medial epicondyle fragment is medial epicondyle
***(Medial epicondyle normally ossifies before the trochlea)
*Fat pad sign not usually present because most injuries are extra-articular
 
===Treatment===
*Ortho consult
 
==Olecranon Fracture==
===Diagnosis===
*Often occur in a/w fx of radial head/neck
 
===Treatment===
*If displaced <5 mm immobilize in stable position (usually 45 degrees of elbow flexion)
*ORIF indicated for unstable fracture
*Orthopedic consultation is best to guide treatment
 
==Radial Head/Neck Fracture==
===Management===
*Ortho consultation to guide treatment
*ORIF indicated when angulation >60 degrees or displacement >50%


==See Also==
==See Also==
*[[Elbow Diagnoses]]
*[[Elbow diagnoses]]
 
==Source==
*Tintinalli
*UpToDate


[[Category:Peds]]
==References==
[[Category:Ortho]]
<references/>
[[Category:Pediatrics]]
[[Category:Orthopedics]]

Latest revision as of 23:03, 28 November 2019