- Etiology: trauma
- Imaging:
— 60% are supracondylar, 15% are lateral epicondyle, 10% are medial epicondyle
— Elbow ossification (CRITOE 1,5,7,10,10,11) – Capitellum – 1 year, Radial head – 5 years, Internal (medial) epicondyle – 7 years, Trochlea – 10 years, Olecranon – 10 years, External (lateral) epicondyle – 11 years
— Anterior humeral line through anterior cortex of humerus bisects middle third of capitellum on lateral view
— Radial capitellar line parallel to and bisecting radial head and neck should bisect capitellum on all views
— Anterior fat pad may be seen normally but not elevated, posterior fat pad should never be seen - Clinical: if fat pad elevation is present but fracture is not seen, treat as occult fracture + followup in 2 weeks
Supracondylar elbow fracture
- Etiology: 95% are due to fall on outstretched hand hyperextension
- Imaging: fracture line is above the condyles, joint effusion almost always present, see elevation of anterior or posterior fat pads, Gartland Type I is minimally displaced fracture, Gartland Type II is displaced distal fracture with intact posterior cortex, Gartland Type III has complete fracture fragment displacement
- DDX:
- Complications: malunion resulting in cubitus varus or fishtail deformity due to avascular necrosis of central portion of distal humeral physis and lateral trochlea
- Treatment:
- Clinical: most common elbow fracture type in children, 3-10 years old
Lateral epicondyle elbow fracture
- Etiology: varus stress causes avulsion of common extensor tendon or LCL, fall on outstretched hand causing axial load and impingement of radial head
- Imaging: often subtle, typically Salter Harris Type IV fracture, epiphyseal component may not be visible, Type 1 has < 2mm displacement, Type 2 has > 2 mm displacement, Type 3 has complete avulsion of fracture fragment
- DDX:
- Complications:
- Treatment:
- Clinical: second most common elbow fracture in children, 3-10 years old
Medial epicondyle elbow fracture
- Etiology: acute valgus stress with flexor-pronator muscle contraction, fall on outstretched hand, arm wrestling, chronic valgus overuse
- Radiograph: physeal widening and epicondylar rotation, up to 50% associated with elbow dislocation
- DDX:
- Complications: medial epicondyle entrapment due to a posterior elbow dislocation in 1/3rd to 1/2 of medial epicondyle fractures resulting in an “absent” ossification center
- Treatment:
- Clinical: third most common elbow fracture in children, 7-15 years old, most common acute fracture seen in adolescent throwing athlete, UCL is rarely ruptured
Radial head / neck elbow fracture
- Etiology: compression of radial head against capitellum on valgus force
- Imaging: radial neck fracture in children, radial head fracture in adults
- DDX:
- Complications:
- Treatment:
- Clinical:
Occult elbow fracture
- Etiology:
- Imaging: fat pad elevation is present and fracture is not seen
- DDX:
- Complications:
- Treatment:
- Clinical: if fat pad elevation present and fracture not seen, treat as occult fracture + followup in 2 weeks
Epiphyseal separation elbow fracture
- Etiology:
- Imaging: fracture through physis separates epiphysis from metaphysis, can look like posterior elbow dislocation on radiographs – epiphyseal separation more common in neonates and toddlers than traumatic joint dislocation
- DDX:
- Complications:
- Treatment:
- Clinical: in first few years of life – birth injury / accidental trauma / abuse
Radiology Cases of Elbow Fracture
Radiology Cases of Supracondylar Elbow Fracture

Radiology Cases of Lateral Epicondyle Elbow Fracture

Radiology Cases of Medial Epicondyle Elbow Fracture


Radiology Cases of Radial Head Elbow Fracture

Radiology Cases of Olecranon Elbow Fracture


Radiology Cases of Occult Elbow Fracture
