![]() These are mostly associated with radial head and neck fractures. Olecranon fractures are uncommon in children. This usually occurs between the ages of nine to ten years. Most commonly these are Salter-Harris type II fractures that transect the physis and extend into the metaphysis for a short distance. These fractures comprise about 1% to 5% of all pediatric elbow fractures. One term for this is “little league elbow.”Ĭommon presentation is medial elbow pain, tenderness over the medial epicondyle, and valgus instability. An example is throwing a baseball repeatedly. The common mechanisms of injury are a posterior elbow dislocation and repeated valgus stress. It is more common in boys and occurs during athletic activities such as football, baseball, or gymnastics. It commonly occurs in early adolescence, between the ages of nine to 14 years of age. It involves fracture of the medial epicondyle apophysis, which is located on the posteromedial aspect of the elbow. These fractures are the third most common type of elbow fracture in children. Type 3: Wide displacement, the articular surface is disrupted. Beware that a nondisplaced fracture may be subtle and may only be recognized by one of the following: The typical mechanism is falling on an outstretched hand with the elbow in full extension. In an extension type of fracture, which happens more than 95% cases, the elbow displaces posteriorly. The fracture is usually transverse or oblique and above the medial and lateral condyles and epicondyles.This fracture pattern is relatively rare in adults, but is the most common type of elbow fracture in children. Based on the mechanism of injury and the displacement of the distal fragment, professionals classify these as either extension or flexion type fractures. A supracondylar humerus fracture is a fracture of the distal humerus just above the elbow joint. It is considered an injury of the immature skeleton and occurs in young children between 5 to 10 years of age. It is the most common type of elbow fracture and accounts for approximately 60% of all elbow fractures. ![]() This type of fracture involves the distal humerus just above the elbow. ![]() The following are the types of elbow fractures in pediatrics: Prompt assessment and management of elbow fractures are critical, as these fractures carry the risk of neurovascular compromise. Most commonly, individuals fall on their outstretched hand. A small anterior fat pad is a normal finding on many pediatric elbow x-rays, while a posterior fat pad sign often indicates an occult fracture about the elbow ( Table 8-4).The most common type of fracture in the pediatric population is elbow fractures. With injury (or sepsis) and elbow swelling, the fat is pushed away from the bone and may be visible on a high-quality lateral view. In the fat pad sign (often referred to as a sail sign), a small amount of fat overlies the elbow joint both anteriorly and posteriorly. A decrease in this angle suggests hyper-extension through the fracture site ( Table 8-3). Also, in the lateral view, the shaft-condylar angle should be about 40 degrees. In a very young child, in whom much of the distal humerus remains cartilaginous, this is a less accurate test. The anterior humeral line of an extension-type supracondylar fracture will intersect the capitellum more anteriorly or may not intersect it at all. The anterior humeral line on the lateral view passes through the middle third of the ossification center of the capitellum for most normal elbows.
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