Get a quick overview of children's elbow injuries and how to examine the child with a painful elbow injury. Find out more about hand and arm problems at http://www.noelhenley.com.
Ozark Orthopaedic: Henley C Noel MD
3317 North Wimberly Drive, Fayetteville, AR 72703
(479) 521-2752
12. Radiographic Anatomy
• Multiple ossification centers may be
mistaken for a fracture
• Radiographs of the opposite elbow may
help
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16. Radiographic Anatomy
• Relationships to look for
- capitellum should always line up with
radial head - if not...
• lateral condyle fracture
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17. Radiographic Anatomy
• Relationships to look for
- capitellum should always line up with
radial head - if not...
• lateral condyle fracture
• Monteggia fracture
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18. Radiographic Anatomy
• Relationships to look for
- capitellum should always line up with
radial head - if not...
• lateral condyle fracture
• Monteggia fracture
• elbow dislocation
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23. Radiographic Anatomy
• Relationships to look for
- anterior humeral line
• should bisect the capitellum on a lateral
radiograph - if not...
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24. Radiographic Anatomy
• Relationships to look for
- anterior humeral line
• should bisect the capitellum on a lateral
radiograph - if not...
- suspect a supracondylar humerus
fracture
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35. Examination
• Tips on examining the painful child
- palpation (joint above, joint below, too)
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36. Examination
• Tips on examining the painful child
- palpation (joint above, joint below, too)
• start with other side
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37. Examination
• Tips on examining the painful child
- palpation (joint above, joint below, too)
• start with other side
• lateral, medial “bones” + olecranon
process + radial head/neck
http://www.noelhenley.com
38. Examination
• Tips on examining the painful child
- palpation (joint above, joint below, too)
• start with other side
• lateral, medial “bones” + olecranon
process + radial head/neck
• pain worse with pro/sup than with flex/
extension?
http://www.noelhenley.com
39. Thanks!
Find out more at
http://www.noelhenley.com
www.noelhenley.com
Editor's Notes
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- capitellum usually by 1yo\n- lateral condyle usually last (10yo)\n
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- capitellum and radial head line up on all views\n
- fat pad may be helpful but...\n- small anterior fat pad on lateral may be normal; posterior fat pad should not be visible (indicates an intra-articular injury 90% of the time)\n
- fat pad may be helpful but...\n- small anterior fat pad on lateral may be normal; posterior fat pad should not be visible (indicates an intra-articular injury 90% of the time)\n
- fat pad may be helpful but...\n- small anterior fat pad on lateral may be normal; posterior fat pad should not be visible (indicates an intra-articular injury 90% of the time)\n
- fat pad may be helpful but...\n- small anterior fat pad on lateral may be normal; posterior fat pad should not be visible (indicates an intra-articular injury 90% of the time)\n
- capitellum and radial head line up on all views\n
- capitellum and radial head line up on all views\n
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- tenderness often well-localized in elbow fractures. \n- radial neck fractures may be subtle (no fat pad [extra-capsular], xrays look OK)\n
- tenderness often well-localized in elbow fractures. \n- radial neck fractures may be subtle (no fat pad [extra-capsular], xrays look OK)\n
- tenderness often well-localized in elbow fractures. \n- radial neck fractures may be subtle (no fat pad [extra-capsular], xrays look OK)\n
- tenderness often well-localized in elbow fractures. \n- radial neck fractures may be subtle (no fat pad [extra-capsular], xrays look OK)\n
- tenderness often well-localized in elbow fractures. \n- radial neck fractures may be subtle (no fat pad [extra-capsular], xrays look OK)\n