Elbow fracture (peds): Difference between revisions
No edit summary |
No edit summary |
||
| Line 11: | Line 11: | ||
neurovascular injury is uncommon | neurovascular injury is uncommon | ||
====Imaging==== | ====Imaging==== | ||
*Obtain oblique view if suspicion high despite neg AP/ | *Obtain oblique view if suspicion high despite neg AP/lat | ||
*Radiocapitellar line | *Radiocapitellar line won't intersect middle of capitellum in all views | ||
**May be only sign if fracture is entirely through growth plate | **May be only sign of fracture if fracture is entirely through growth plate | ||
*+Fat Pad Sign | *+Fat Pad Sign | ||
**May be only sign of nondisplaced fx | **May be only sign of nondisplaced fx | ||
| Line 22: | Line 22: | ||
===Background=== | ===Background=== | ||
*Not true Salter-Harris fx (apophysis, not physis, is involved) | *Not true Salter-Harris fx (apophysis, not physis, is involved) | ||
*50% | *50% assoc w/ elbow dislocation | ||
===Diagnosis=== | ===Diagnosis=== | ||
*Displacement of medial epicondyle ossification center | *Displacement of medial epicondyle ossification center | ||
| Line 49: | Line 49: | ||
==See Also== | ==See Also== | ||
[[Elbow (Minor)]] | *[[Elbow (Minor)]] | ||
*[[Supracondylar Fracture]] | |||
[[Supracondylar Fracture]] | *[[Elbow Xray (Peds)]] | ||
[[Elbow Xray (Peds)]] | |||
==Source== | ==Source== | ||
Tintinalli | *Tintinalli | ||
*UpToDate | |||
[[Category:Peds]] | [[Category:Peds]] | ||
[[Category:Ortho]] | [[Category:Ortho]] | ||
Revision as of 17:01, 1 May 2012
Supracondylar Fracture
Lateral Epicondyle Fracture
Background
- 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
- +Fat Pad 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)
- If think is trochlear but cannot see medial epicondyle fragment is medial epicondyle
- 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
Source
- Tintinalli
- UpToDate