Elbow Trauma

Question 1

what trauma is associated with the elbow?

Answer 1

• elbow dislocation
• radial head/neck fractures
• olecranon fractures

Question 2

describe an elbow dislocation

Answer 2

• a high impact injury causes the radius and/or ulna to move out of their normal alignment with the capitulum and/or trochlea of the humerus
• can be simple (no fracture) or complex (with fracture)
• posterior is more common

Question 3

MOI for an elbow dislocation

Answer 3

hyperextension injury – high impact /
FOOSH (fall on outstretched hand)

Question 4

describe the radiographic appearance of an elbow dislocation

Answer 4

ulnar coronoid process and/or radial
head not in normal alignment with the humerus

Question 5

what helps identify an elbow dislocation from a radiograph?

Answer 5

• the radiocapitellar line (an imaginary line drawn along the longitudinal axis of the proximal radius, and passing through the capitulum of the humerus)
• misalignment of the radiocapitellar line identifies a dislocation

Question 6

describe the treatment for an elbow dislocation

Answer 6

• reduction under local or general anaesthetic for simple dislocation
• surgery (open reduction) may be required especially for complex dislocation

Question 7

describe the prognosis for an elbow dislocation

Answer 7

simple - good prognosis after closed reduction
complex - accurate realignment and fixation during surgery is important for a good prognosis
- physiotherapy may be required

Question 8

describe a radial head/neck fracture

Answer 8

intra-articular fractures as they effect the articular surface. can be:
- non-displaced
- displaced
- comminuted

Question 9

MOI for a radial head/neck fracture

Answer 9

usually via FOOSH – high impact applies force along the radius leading to impaction of the radial head against the capitulum, causing fracture
rarely - caused during reduction of an elbow dislocation

Question 10

describe the radiographic appearance of a radial head/neck fracture

Answer 10

• undisplaced fracture of the radial
  head visible as a lower density
  line within the high density bone
• displaced fracture are more obvious and usually lower density soft tissue areas are another sign that a fracture is present (fat pads)

Question 11

describe the treatment for a radial head/neck fracture

Answer 11

non-displaced - immobilisation in a
splint/cast, with sling for comfort
displaced - may require open
reduction and internal fixation (ORIF)
depending on extent of displacement
severely comminuted - may
require artificial replacement of the
radial head

Question 12

describe the prognosis for a radial head/neck fracture

Answer 12

non-displaced fractures have a very good prognosis
comminuted/displaced fractures require more physiotherapy to regain full range of movement and more healing time

Question 13

describe an olecranon fracture