Elbow Trauma Logan Class of December 2013肘部创伤洛根十二月2013班.pptVIP

Elbow Trauma Elbow Trauma 6% of all fractures and dislocations involve elbow Most common fractures differ between adults and children M.C. in adults- radial head and neck fxs. M.C. in children- supracondylar fxs. Complex anatomy requires 4 views for adequate interpretation AP in extension, medial oblique, lateral and axial olecranon (Jones view) Normal Elbow Anatomy Very important to be aware of pediatric growth centers CRITOE http://med_/wp2/?p=21 http://www.radiologyassistant.nl/en/4214416a75d87 Normal Alignment Anterior humeral line- line drawn along anterior surface of humeral cortex should pass through the middle third of the capitellum Radiocapitellar line- Line drawn through the proximal radial shaft and neck should pass through to the articulating capitellum http://imageinterpretation.co.uk/elbow.html Signs of Fracture Usual signs may not be readily visible Fracture line, cortical disruption, etc. Soft tissue signs can indicate fracture Fat pad sign On lateral, might see fat pad parallel to anterior humeral cortex, but should never see posterior fat pad With effusion, anterior may be displaced and will be shaped like a sail (sail sign) Fat Pad Sign Posterior fat pad is normally buried in olecranon fossa and not visible Becomes elevated and visible with joint uffusion Effusion (acute capsular swelling) can be from any origin (hemorrhagic, inflammatory, infectious, traumatic, etc.) Ant. fat pad may be obliterated, so post. Fat pad is more reliable when visible Distal humerus fractures 95% extend to articular surface Classified according to relationship with condyle and shape of fracture line Supracondylar, intercondylar, condylar and epicondylar Supracondylar Fractures Most common elbow fracture in children (60%) Fracture line extends transversely or obliquely through distal humerus above the condyles Distal fragment usually displaces posteriorly Normal Intercondylar fracture Fracture line extends between medial