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Elbow Injuries, Emergency Medicine

Christian M. Sloane Reviewed 06/2017
 


Basics

Description

Bony Injuries

  • Supracondylar fracture:

    • Most common in children

    • Peak ages 5–10 yr, rarely occurs >15 yr

    • Extension type (98%): Fall on outstretched hand (FOOSH) with fully extended or hy...

Diagnosis

Signs and Symptoms

How patient carries arm may give clues to diagnosis. 

Bony Injuries

Supracondylar fracture: 
  • Flexion type:

    • Patient supports injured forearm with other arm and elbow in 90° flex...

Treatment

Pre-Hospital

Appropriate splinting 

Initial Stabilization/Therapy

Immobilization to prevent further injury before taking radiographs is essential. 

Ed Treatment/Procedures

  • Orthopedic consultation...

Follow-Up

Disposition

Admission Criteria

  • Vascular injuries, open fractures

  • Fractures requiring operative reduction or internal fixation

  • Admit all patients with extensive swelling or ecchymosis for overnig...

Pearls and Pitfalls

  • Failure to appreciate that a posterior fat pad sign is abnormal.

  • Always check for neurovascular injury with injuries about the elbow, especially with dislcoations, pre- and postredu...

Additional Reading

  • Carson  S, Woolridge  DP, Colletti  J, et al. Pediatric upper extremity injuries. Pediatr Clin North Am.  2006;53(1):41–67.

  • Carter  SJ, Germann  CA, Dacus  AA, et al. Orthopedic...

Codes

ICD9

  • 812.41 Closed supracondylar fracture of humerus

  • 813.05 Closed fracture of head of radius

  • 959.3 Elbow, forearm, and wrist injury

  • 832.00 Closed dislocation of elbow, unspecified

  • 726.31 Medial epic...

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