Elbow fracture (peds): Difference between revisions

(Created page with "==1. Supracondylar Fracture== * 7% have nerve injury (median & radial most common) * Can get ischemia due to brachial artery compression from increased compartment pressure ...")
 
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==1. Supracondylar Fracture==
{{PediatricPage|elbow fracture}}
==Differential Diagnosis==
{{Elbow DDX}}


 
==Evaluation==
* 7% have nerve injury (median & radial most common)
{{Elbow ossification by age DDX}}
* Can get ischemia due to brachial artery compression from increased compartment pressure
 
Diagnosis
 
* Anterior humeral line does NOT intersect middle third of capitellum
* Small anterior fat pad sometimes normal, posterior fat pad always abnormal
 
Classificiation
 
* Type I - Nondisplaced
* Type II - Displaced w/ intact posterior cortex
* Type III - no cortical contact
*On XR look @ development of secondary ossification centers (must occur in following order, age not as important, ie if see ossification of trochlea you MUST also see CRI as well!)
 
 
Treatment
 
* Type I
* Immobilize using a posterior splint and sling (extend from wrist to axilla)
* Refer to ortho within 1 week 
* Type II & III 
* Orthopedic consultation regarding closed versus open reduction w/ percutaneous pinning
* Admit
 
==2. Lateral Condylar Fracture==
 
 
 
Diagnosis
 
* Radiocapitellar line does NOT intersect the middle of the capitelum in all views
* May be only sign if fracture is entirely through the growth plate
* Fat Pad Sign
* May be only sign of nondisplaced fx
 
==3. Medial Epicondylar Fractures==
 
 
 
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 vs. normal 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


==See Also==
==See Also==
*[[Elbow diagnoses]]


 
==References==
Ortho:  Elbow Fracture
<references/>
 
[[Category:Pediatrics]]
Ortho:  Elbow (Minor)
[[Category:Orthopedics]]
 
Peds: Supracondylar
 
Rads: Elbow Xray Peds
 
 
Source: UpToDate
 
 
 
 
 
[[Category:Peds]]

Latest revision as of 17:08, 17 January 2026