Diferencia entre revisiones de «Medial epicondyle fracture (peds)»
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{{Proximal arm fracture DDX}} | {{Proximal arm fracture DDX}} | ||
==Clinical Features== | |||
==Differential Diagnosis== | |||
{{Elbow DDX}} | |||
==Evaluation== | ==Evaluation== | ||
*Displacement of medial epicondyle ossification center | *Displacement of medial epicondyle ossification center | ||
*May become entrapped within elbow joint | *May become entrapped within elbow joint | ||
*Use [[CRITOE]] to determine if bone in joint is medial epicondyle or | *Use [[CRITOE]] to determine if bone in joint is medial epicondyle or normal trochlear osseus center | ||
**If think is trochlear but cannot see medial epicondyle fragment is medial epicondyle | **If think is trochlear but cannot see medial epicondyle fragment is medial epicondyle | ||
***(Medial epicondyle normally ossifies before the trochlea) | ***(Medial epicondyle normally ossifies before the trochlea) | ||
*Fat pad sign not usually present because most injuries are extra-articular | *Fat pad sign not usually present because most injuries are extra-articular | ||
==Management== | ==Management== | ||
Revisión del 21:00 22 jun 2020
Background
- Not true Salter-Harris fracture (apophysis, not physis, is involved)
- 50% associated with elbow dislocation
Humerus Fracture Types
Clinical Features
Differential Diagnosis
Elbow Diagnoses
Radiograph-Positive
- Distal humerus fracture
- Radial head fracture
- Capitellum fracture
- Olecranon fracture
- Elbow dislocation
Radiograph-Negative
- Biceps tendon rupture/dislocation
- Lateral epicondylitis
- Medial epicondylitis
- Olecranon bursitis (nonseptic)
- Pronator teres syndrome
- Septic bursitis
Pediatric
- Nursemaid's elbow
- Supracondylar fracture
- Lateral epicondyle fracture
- Medial epicondyle fracture
- Olecranon fracture
- Radial head fracture
- Salter-Harris fractures
Evaluation
- Displacement of medial epicondyle ossification center
- May become entrapped within elbow joint
- Use CRITOE to determine if bone in joint is medial epicondyle or normal trochlear osseus center
- If think is trochlear but cannot see medial epicondyle fragment is medial epicondyle
- (Medial epicondyle normally ossifies before the trochlea)
- If think is trochlear but cannot see medial epicondyle fragment is medial epicondyle
- Fat pad sign not usually present because most injuries are extra-articular
Management
- Ortho consult
- Long arm cast with elbow flexed 90˚ vs operative management[1]