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Semin Musculoskelet Radiol 2000; 4(2): 171-191
DOI: 10.1055/s-2000-13011
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Fractures of the Elbow and Forearm

Andrew Sonin
  • American Radiology Services, Timonium, Maryland
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Publication History

Publication Date:
31 December 2000 (online)

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ABSTRACT

Fractures and dislocations of the elbow usually occur secondary to indirect trauma. In the adult, fractures of the distal humerus almost always involve the condyles. Fractures of the radial head and neck may be subtle, and the appearance of secondary signs, such as the elevated fat pads from an elbow joint effusion, may be diagnostically useful. Dislocations of the elbow can be associated with fractures, such as those involving the ulnar coronoid process. In children, the presence of epiphyseal and apophyseal ossification centers can confuse the inexperienced observer in the setting of elbow trauma. Osteochondral injury may be difficult to identify without adjunctive imaging techniques, such as magnetic resonance (MR) imaging. Soft tissue injury at the elbow is also well characterized by MR imaging. Fractures of a single forearm bone may occur in isolation, usually due to a direct blow, but these are usually associated with fracture or displacement of the other bone in that forearm.

KEYWORD

Elbow - trauma - imaging

REFERENCES

  • 1 Resnick D, Goergen T G. Physical injury: Extraspinal sites. In: Resnick D (ed), Diagnosis of bone and joint disorders, 3rd ed. Philadelphia: WB Saunders 1995: 2722-2732
    Google Scholar
  • 2 Rogers L F. Radiology of skeletal trauma, 2nd ed. New York: Churchill Livingstone 1992: 749-836
    Google Scholar
  • 3 Gabel G T, Hanson G, Bennett J B. Intraarticular fractures of the distal humerus in the adult.  Clin Orthop . 1987;  216 99-108
    PubMedGoogle Scholar
  • 4 Milch H. Fractures of the external humeral condyle.  JAMA . 1956;  160 641-646
    PubMedGoogle Scholar
  • 5 Gore R M, Rogers L F, Bowerman J. Osseous manifestations of elbow stress associated with sports activities.  AJR . 1980;  134 971-977
    CrossrefPubMedGoogle Scholar
  • 6 Mitsunaga M M, Adishian D A, Bianco A J. Osteochondritis dissecans of the capitellum.  J Trauma . 1982;  22 53-55
    CrossrefPubMedGoogle Scholar
  • 7 Jobe F W, Nuber G. Throwing injuries of the elbow.  Clin Sports Med . 1986;  5 621-635
    PubMedGoogle Scholar
  • 8 Murphy B J. MR imaging of the elbow.  Radiology . 1992;  184 525-529
    PubMedGoogle Scholar
  • 9 Patten R M. Overuse syndromes and injuries involving the elbow: MR imaging findings.  AJR . 1995;  164 1205-1211
    PubMedGoogle Scholar
  • 10 Sonin A H, Fitzgerald S W. MR imaging of sports injuries in the adult elbow: A tailored approach.  AJR . 1996;  167 325-331
    PubMedGoogle Scholar
  • 11 Sonin A H, Tutton S M, Fitzgerald S W, Peduto A J. MR imaging of the adult elbow.  Radiographics . 1996;  16 1323-1336
    PubMedGoogle Scholar
  • 12 Panner H J. An affection of the capitulum humeri resembling Calve-Perthes's disease of the hip.  Acta Radiol . 1929;  10 234-242
    PubMedGoogle Scholar
  • 13 John S D, Wherry K, Swischuk L E, Phillips W A. Improving detection of pediatric elbow fractures by understanding their mechanisms.  Radiographics . 1996;  16 1443-1460
    CrossrefPubMedGoogle Scholar
  • 14 Smith L. Deformity following supracondylar fractures of the humerus.  J Bone Joint Surg [Am] . 1960;  42 235-252
    PubMedGoogle Scholar
  • 15 Rogers L F, Malave S, White H, Tachdijan M O. Plastic bowing, torus and greenstick supracondylar fractures of the humerus: Radiographic clues to obscure fractures of the elbow in children.  Radiology . 1978;  128 145-150
    PubMedGoogle Scholar
  • 16 Norell H G. Roentgenologic visualization of the extracapsular fat. Its importance in the diagnosis of traumatic injuries to the elbow.  Acta Radiol . 1954;  42 205-210
    PubMedGoogle Scholar
  • 17 Donnelly L F, Klostermeier T T, Klosterman L A. Traumatic elbow effusions in pediatric patients: Are occult fractures the rule?.  AJR . 1998;  171 243-245
    PubMedGoogle Scholar
  • 18 Hunter R D. Swollen elbow following trauma.  JAMA . 1974;  230 1573-1574
    CrossrefPubMedGoogle Scholar
  • 19 Thonell S, Mortensson W, Thomasson B. Prediction of the stability of minimally displaced fractures of the lateral condyle.  Acta Radiol . 1988;  29 367-370
    PubMedGoogle Scholar
  • 20 Harrison R B, Keats T E, Frankel C J. Radiographic clues to fractures of the unossified medial humeral condyle in young children.  Skeletal Radiol . 1984;  11 209-212
    CrossrefPubMedGoogle Scholar
  • 21 Brogdon B G, Crow N E. Little leaguer's elbow.  Am J Roentgenol . 1960;  83 671-675
    PubMedGoogle Scholar
  • 22 DeLee J C, Wilkins K E, Rogers L F, Rockwood C A. Fracture-separation of the distal humeral epiphysis.  J Bone Joint Surg [Am] . 1980;  62 46-51
    PubMedGoogle Scholar
  • 23 Protzman R R. Dislocation of the elbow joint.  J Bone Joint Surg [Am] . 1978;  60 539-541
    PubMedGoogle Scholar
  • 24 Feldman D R, Schabel S I, Friedman R J, Young J W. Translational injuries in posterior elbow dislocation.  Skeletal Radiol . 1997;  26 134-136
    CrossrefPubMedGoogle Scholar
  • 25 Hallett J. Entrapment of the median nerve after dislocation of the elbow.  J Bone Joint Surg [Br] . 1981;  63 408-412
    PubMedGoogle Scholar
  • 26 Kerin R. Elbow dislocation and its association with vascular disruption.  J Bone Joint Surg [Am] . 1969;  51 756-758
    PubMedGoogle Scholar
  • 27 Hamilton W, Parkes J C. Isolated dislocation of the radial head without fracture of the ulna.  Clin Orthop . 1973;  97 94-96
    PubMedGoogle Scholar
  • 28 Schwab G H, Bennott J B, Woods G W, Tullos H S. Biomechanics of elbow instability: The role of the medial collateral ligament.  Clin Orthop . 1980;  146 42-52
    PubMedGoogle Scholar
  • 29 Morrey B F, An K N. Articular and ligamentous contributions to the stability of the elbow joint.  Am J Sports Med . 1983;  11 315-319
    CrossrefPubMedGoogle Scholar
  • 30 Indelicato P A, Jobe F W, Kerlan R K. Correctable elbow lesions in professional baseball players: A review of 25 cases.  Am J Sports Med . 1979;  7 72-80
    PubMedGoogle Scholar
  • 31 Mirowitz S A, London S L. Ulnar collateral ligament injury in baseball pitchers: MR imaging evaluation.  Radiology . 1992;  185 573-576
    PubMedGoogle Scholar
  • 32 Glajchen N, Schwartz M L, Andrews J R, Gladstone J. Avulsion fracture of the sublime tubercle of the ulna: A newly recognized injury in the throwing athlete.  AJR . 1998;  170 627-628
    PubMedGoogle Scholar
  • 33 O'Driscoll S W, Bell D F, Morrey B F. Posterolateral rotatory instability of the elbow.  J Bone Joint Surg [Am] . 1991;  73 440-446
    PubMedGoogle Scholar
  • 34 Potter H G, Weiland A J, Schatz J A. Posterolateral rotatory instability of the elbow: Usefulness of MR imaging in diagnosis.  Radiology . 1997;  204 185-189
    CrossrefPubMedGoogle Scholar
  • 35 Agins H J, Chess J L, Hoekstra D V, Teitge R A. Rupture of the distal insertion of the biceps brachii tendon.  Clin Orthop . 1988;  234 34-39
    PubMedGoogle Scholar
  • 36 Fitzgerald S W, Curry D R, Erickson S J. Distal biceps tendon injury: MR imaging diagnosis.  Radiology . 1994;  191 203-206
    PubMedGoogle Scholar
  • 37 Falchook F S, Zlatkin M B, Erbacher G E. Rupture of the distal biceps tendon: Evaluation with MR imaging.  Radiology . 1994;  190 659-663
    PubMedGoogle Scholar
  • 38 Sonin A H. Tendon disorders.  Sem Musculoskel Radiol . 1998;  2 163-173
    PubMedGoogle Scholar
  • 39 Tarsney F F. Rupture and avulsion of the triceps.  Clin Orthop . 1972;  83 177-183
    PubMedGoogle Scholar
  • 40 Bennett J B. Lateral and medial epicondylitis.  Hand Clin . 1994;  10 157-163
    PubMedGoogle Scholar
  • 41 Potter H G, Hannafin J A, Morwessel R M. Lateral epicondylitis: Correlation of MR imaging, surgical, and histopathologic findings.  Radiology . 1995;  196 43-46
    CrossrefPubMedGoogle Scholar
  • 42 Radin E L, Riseborough E J. Fractures of the radial head. A review of eighty-eight cases and analysis of the indications for excision of the radial head and non-operative treatment.  J Bone Joint Surg [Am] . 1966;  48 1055-1064
    PubMedGoogle Scholar
  • 43 Essex-Lopresti P. Fractures of the radial head with distal radio-ulnar dislocation.  J Bone Joint Surg [Br] . 1951;  33 244-247
    PubMedGoogle Scholar
  • 44 Regan W, Morrey B. Fractures of the coronoid process of the ulna.  J Bone Joint Surg [Am] . 1989;  71 1348-1354
    PubMedGoogle Scholar
  • 45 Maylahn D J, Fahey J J. Fractures of the elbow in children. Review of 300 consecutive cases.  JAMA . 1958;  166 220-228
    PubMedGoogle Scholar
  • 46 Pavlov H, Torg J S, Jacobs B, Vigorita V. Nonunion of olecranon epiphysis: Two cases in adolescent baseball pitchers.  AJR . 1981;  136 819-820
    PubMedGoogle Scholar
  • 47 Smith H, Sage F P. Medullary fixation of forearm fractures.  J Bone Joint Surg [Am] . 1957;  39 91-98
    PubMedGoogle Scholar
  • 48 Bado J L. The Monteggia lesion.  Clin Orthop . 1967;  50 71-86
    PubMedGoogle Scholar
  • 49 Bruce H E, Harvey J P, Wilson J C. Monteggia fractures.  J Bone Joint Surg [Am] . 1974;  56 1563-1576
    PubMedGoogle Scholar
  • 50 Mikic Z D. Galeazzi fracture-dislocations.  J Bone Joint Surg [Am] . 1975;  57 1071-1080
    PubMedGoogle Scholar
  • 51 Goldberg H D, Young J R, Reiner B I. Double injuries of the forearm: A common occurrence.  Radiology . 1992;  185 223-227
    PubMedGoogle Scholar
  • 52 Greene W. Traumatic bowing of the forearm in an adult.  Clin Orthop . 1982;  168 31-34
    PubMedGoogle Scholar
  • 53 Sclamberg J, Sonin A H, Sclamberg E, D'Sonza N. Acute plastic bowing deformation of the forearm in an adult.  AJR . 1998;  170 1259-1260
    PubMedGoogle Scholar
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