Elbow fracture: Difference between revisions
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*Swelling laterally and tenderness of radial head | *Swelling laterally and tenderness of radial head | ||
==Differential Diagnosis== | ===Differential Diagnosis=== | ||
{{Elbow DDX}} | {{Elbow DDX}} | ||
Revision as of 18:36, 29 September 2014
Radial Head
Background
- Most common fractures of the elbow
- Caused by FOOSH leading to radial head being driven into the capitellum
- Associated injuries are common:
- Capitellum, olecranon, and coronoid fx, MCL injury, dislocation
Clinical Features
- Pain in the lateral elbow, esp w/ pronation/supination of forearm
- Swelling laterally and tenderness of radial head
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
- Imaging
- Fractures are often subtle
- Look for abnormal fat pad
- Look for radiocapitellar line disruption
- Fractures are often subtle
Management
- Sling immobilization in flexion, ice, elevation
- Nondisplaced fx w/ no mobility restrictions: ortho f/u within 1wk
- Displaced fx or mobility restricintons: ortho f/u within 24hr
Olecranon
Background
- Occurs via direct trauma or by fall w/ forced hyperextension of elbow
- Associated injuries are common:
- Dislocations, radial head fx, ulnar nerve injury
Clinical Features
- Pain, swelling, and occasionally over posterior elbow
- Forearm extension strength is reduced (triceps inserts at the olecranon)
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
Management
- Rule-out ulnar nerve injury
- Immobilize w/ long arm posterior mold w/ elbow in flexion and forearm neutral
- Refer to ortho w/in 24hr
See Also
Source
- Tintinalli