Elbow fracture (peds)

Supracondylar Fracture

• See 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 does NOT intersect middle of capitelum in all views
  • May be only sign 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% a/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

See Also

Ortho: Elbow Fracture

Ortho: Elbow (Minor)

Peds: Supracondylar

Rads: Elbow Xray Peds

Source

Tintinalli, UpToDate