Elbow Fracture: Difference between revisions

Revision as of 08:13, 8 February 2012

ADULT INJURIES

Radial Head/Neck Fractures

50% of elbow injury in adults
see Elbow Fx lect

Olecranon Fx

2nd most common
20%
direct blow
pain,swelling, can't extend elbow
OR if > 2 mm stepoff

Elbow D/L

3rd most common jt D/L
90% post or postlateral
50% have assoc injuries, most common is med epicondylar fx that can often get entrapped
prox radius & coronoid also Fxed
ulnar injury - 8-21% in post D/L
higher rate of neurovasc injury in anterior D/L
Long arm post splint

Monteggia Fx/D/L

Type I - prox 1/3 of ulna, ant displ of distal ulna & ant disl of radial head
1. 80%
Type II - post displ of distal ulna & post D/L or radial head (20%)
Dislocation of radial head requires ORIF

Source

Tintinalli

Authors:

@@ Line 1: / Line 1: @@
-==Four Questions==
-# Are the fat pads normal?
-## A visible ant. fat pad is normal but if displaced anteriorly (Sail sign) it is abnormal
-## A visible post. fat pad is always abnormal
-## What if have fat pad displacement but no fx or displacement is identified?
-### Adults: Treat as radial head fx
-### Peds: Be certain that neither an undisplaced supracondylar fx nor a displaced internal epicondyle fx is overlooked!
-# Is the radiocapitellar line normal?
-## A line drawn along the longitudinal axis of the radial head and neck should pass through the capitellum
-### If line does not pass through capitellum then dislocation of radial head is probable
-## Whenver there is a fx of the ulnar shaft must evaluate the radiocapitellar line for poss  radial head dislocation (Monteggia fx dislocation)
-## This rule is always valid on a true lateral film
-### In peds cases the AP view may be misleading
-# Is the anterior humeral line normal?
-## A line drawn along the ant cortex of the humerus will have at leats 1/3 of the capitellum anterior to it
-### If less than 1/3 then strong probability of supracondylar fx w/ distal fragment displaced posteriorly
-# Are the ossification centers normal?
-## CRITOE (Capitellum, Radial head, Internal epicondyle, Trochlea, Olecranon, Lateral Epicondyle)
-### Dislocated elbow may result in avulsion of internal epicondyle
-#### Because the trochlea ossifies after the internal epicondyle if you see the trochlea you must find the epicondyle!
 ==ADULT INJURIES==
 ===Radial Head/Neck Fractures===
@@ Line 48: / Line 27: @@
 ==See Also==
-[[Elbow (Minor)]]
+*[[Elbow (Minor)]]
+*[[Supracondylar]]
-[[Supracondylar]]
+*[[Elbow Xray Peds]]
-[[Elbow Xray Peds]]
 ==Source==
-Whiting lect 2001- By Lampe
+*Tintinalli
 [[Category:Ortho]]