Lateral epicondyle fracture (peds): Difference between revisions
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*Neurovascular injury uncommon | *Neurovascular injury uncommon | ||
==Clinical Features== | |||
*Swelling and tenderness limited to lateral elbow | *Swelling and tenderness limited to lateral elbow | ||
neurovascular injury is uncommon | *neurovascular injury is uncommon | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Elbow DDX}} | {{Elbow DDX}} | ||
===Evaluation=== | |||
*[[Elbow x-ray]] | |||
**Obtain oblique view if suspicion high despite neg AP/lat | |||
**Radiocapitellar line will not intersect middle of capitellum in all views | |||
***May be only sign of fracture if fracture is entirely through growth plate | |||
**[[Elbow X-ray (Peds)|+Fat Pad Sign/"sail" sign]] | |||
***May be only sign of nondisplaced fracture | |||
==Management== | ==Management== | ||
Revision as of 22:50, 5 October 2019
Background
- Salter-Harris type IV fracture
- Neurovascular injury uncommon
Clinical Features
- Swelling and tenderness limited to lateral elbow
- neurovascular injury is uncommon
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
Evaluation
- Elbow x-ray
- Obtain oblique view if suspicion high despite neg AP/lat
- Radiocapitellar line will not intersect middle of capitellum in all views
- May be only sign of fracture if fracture is entirely through growth plate
- +Fat Pad Sign/"sail" sign
- May be only sign of nondisplaced fracture
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Specific Management
- Often requires ORIF (ortho consult)