Elbow Fracture

• Etiology: trauma
• Imaging:
  — 50-70% are supracondylar, 10-15% are lateral condyle, 10% are medial epicondyle, 1-2% are medial condyle, occult elbow fracture
  — Supracondylar fracture – mechanism is FOOSH hyperextension, 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
  — Medial epicondyle avulsion – mechanism is acute valgus stress due to FOOSH or arm wrestling, chronic injuries in youth athletes
  — Lateral condyle fracture – Type 1 has < 2mm displacement, Type 2 has > 2 mm displacement, Type 3 has complete avulsion of fracture fragment
  — Radial head / neck fracture – mechanism is compression of radial head against capitellum on valgus force, radial neck fracture in kids, radial head fracture in adults,
  — 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
  — 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
  — Fat pad elevation due to hemarthrosis = occult fracture
• Clinical: if fracture not seen, treat as fracture + followup in 2 weeks

Cases of Elbow Fracture