Lateral epicondyle fracture (peds)
Revisión del 20:31 11 jul 2016 de Neil.m.young (discusión | contribs.) (Text replacement - "won't" to "will not")
Background
- Salter-Harris type IV fracture
- Neurovascular injury uncommon
Diagnosis
Clinical Findings
- Swelling and tenderness limited to lateral elbow
neurovascular injury is uncommon
Imaging
- Obtain oblique view if suspicion high despite neg AP/lat
- Radiocapitellar line will not intersect middle of capitellum in all views
- May be only sign of fracture if fracture is entirely through growth plate
- +Fat Pad Sign/"sail" sign
- May be only sign of nondisplaced fracture
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
Management
- Often requires ORIF (ortho consult)