Elbow fracture (peds): Difference between revisions

Latest revision as of 23:03, 28 November 2019

This page is for pediatric patients. For adult patients, see: elbow fracture

Differential Diagnosis

Elbow Diagnoses

Radiograph-Positive

Radiograph-Negative

Pediatric

Evaluation

Elbow Ossification by Age (CRITOE)

Ossification Center	Age of Appearance (add 1yr for boys)
Capitellum	1yr
Radial head	3yr
Internal epicondyle	5yr
Trochlea	7yr
Olecranon	9yr
External epicondyle	11yr

References

Authors:

@@ Line 1: / Line 1: @@
-==Supracondylar Fracture==
+{{Peds top}} [[elbow fracture]]
-* 7% have nerve injury (median & radial most common)
+==Differential Diagnosis==
-* Can get ischemia due to brachial artery compression from increased compartment pressure
+{{Elbow DDX}}
-===Diagnosis===
+==Evaluation==
-* Anterior humeral line does NOT intersect middle third of capitellum
+{{Elbow ossification by age DDX}}
-* 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
-==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
-==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==
-Ortho:  Elbow Fracture
+*[[Elbow diagnoses]]
-Ortho:  Elbow (Minor)
-Peds: Supracondylar
-Rads: Elbow Xray Peds
-==Source==
-UpToDate
-[[Category:Peds]]
+==References==
-[[Category:Ortho]]
+<references/>
+[[Category:Pediatrics]]
+[[Category:Orthopedics]]