Elbow Fracture
Xrays - 4 things to check
1. Anterior Humeral Line - intersects
middle third of capitellum
- abnl in SCH Fx
2. Radiocapitellar Line - center of
shaft of proximal radius passes
through the capitellum.
- abnl in radial head D/L
3. Bauman's Angle - nl range 9-26 deg
in 95%. May be abnl in SCH Fx
4. Post fat pad or Ant sail sign
ADULT INJURIES
1. Radial Head/Neck Fractures
- 50% of elbow injury in adults
- see Elbow Fx lect
2. Olecranon Fx - 2nd most common
20%
- direct blow
- pain,swelling, can't extend elbow
- OR if > 2 mm stepoff
3. 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
80%
Type II - post displ of distal ulna &
post D/L or radial head (20%)
- Dislocation of radial head requires ORIF
See Also
Ortho: Elbow Fracture
Ortho: Elbow (Minor)
Peds: Supracondylar
Rads: Elbow Xray Peds
Source
Whiting lect 2001- By Lampe