Radial head fracture (peds): Difference between revisions
Neil.m.young (talk | contribs) No edit summary |
|||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Radial neck fractures tend to be more common in the pediatric population than radial head fractures | |||
*Majority are Salter II fractures | |||
*Average age is approx 10 yrs | |||
- Physical Exam: | |||
- carefully assess the function of the posterior interosseous nerve; | |||
==Clinical Features== | ==Clinical Features== | ||
*Mechanism is typically FOOSH | |||
*Tenderness over the elbow | |||
*May include posterior interosseous nerve intrapment causing a finger drop | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Elbow DDX}} | {{Elbow DDX}} | ||
== | ==Diagnosis== | ||
[[File:Radial Head Fracture.png|thumb]] | |||
*AP and lateral elbow xray | |||
**Assess for anterior fat pad | |||
*Knowledge of ossification centers of the elbow can be helpful | |||
**Capitellum (1 yr.) | |||
**Radius (3 yr.) | |||
**Internal or medial epicondyle (5 yr.) | |||
**Trochlea (7 yr.) | |||
**Olecranon (9 yr.) | |||
**External or lateral epicondyle (11 yr.) | |||
==Management== | ==Management== | ||
| Line 13: | Line 32: | ||
==Disposition== | ==Disposition== | ||
*Consult ortho | |||
==See Also== | ==See Also== | ||
| Line 20: | Line 40: | ||
==External Links== | ==External Links== | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:Peds]] | [[Category:Peds]] | ||
[[Category:Ortho]] | [[Category:Ortho]] | ||
Revision as of 17:12, 6 March 2016
Background
- Radial neck fractures tend to be more common in the pediatric population than radial head fractures
- Majority are Salter II fractures
- Average age is approx 10 yrs
- Physical Exam:
- carefully assess the function of the posterior interosseous nerve;
Clinical Features
- Mechanism is typically FOOSH
- Tenderness over the elbow
- May include posterior interosseous nerve intrapment causing a finger drop
Differential Diagnosis
Elbow Diagnoses
Radiograph-Positive
- Distal humerus fracture
- Radial head fracture
- Capitellum fracture
- Olecranon fracture
- Elbow dislocation
Radiograph-Negative
- Biceps tendon rupture/dislocation
- Lateral epicondylitis
- Medial epicondylitis
- Olecranon bursitis (nonseptic)
- Pronator teres syndrome
- Septic bursitis
Pediatric
- Nursemaid's elbow
- Supracondylar fracture
- Lateral epicondyle fracture
- Medial epicondyle fracture
- Olecranon fracture
- Radial head fracture
- Salter-Harris fractures
Diagnosis
- AP and lateral elbow xray
- Assess for anterior fat pad
- Knowledge of ossification centers of the elbow can be helpful
- Capitellum (1 yr.)
- Radius (3 yr.)
- Internal or medial epicondyle (5 yr.)
- Trochlea (7 yr.)
- Olecranon (9 yr.)
- External or lateral epicondyle (11 yr.)
Management
- Ortho consultation to guide treatment
- ORIF indicated when angulation >60 degrees or displacement >50%
Disposition
- Consult ortho
See Also
- Elbow diagnoses
- Radial head fracture (Adult)