Fractures around elbow

Supracondylar fracture

Supracondylar fracture

This is a transverse fracture of the distal end of the humerus Usually occur in children between the age of 5 to 9 years Mechanism:

Fall on an extended, outstretched arm:

Causes type I fracture in which the distal humeral fragment is displaced posteriorly Causes type II fracture in which the distal humeral fragment lies anterior to the humerus

Direct trauma to the posterior aspect of the elbow

Features:

Pain Swelling Deformity X-ray:

Undisplaced fractures are missed Shows displacements

Type I or Extension type fracture

Treatment:

Closed reduction and immobilization for 4 to 6 weeks long arm posterior splint with elbow at 90 degrees and forearm in neutral rotation or cuff and collar is used for immobilization ORIF

Complications:

Vascular injury

It produces Volkmanns ischemic contracture

Nerve injury Malunion Elbow stiffness

Cubitus varus or Gunstock deformity

Physiotherapy:

During immobilization:

Strengthening exercises for the contra lateral limb General body conditioning Active motion of hand, wrist, and shoulder of the injured limb Gentle active motion exercises preceded by the use of moist heat or a warm whirlpool Progressive active motion of elbow Resistance exercises

After immobilization:

Fractures of the radius and ulna

Both bone fractures

Mechanism:

Twisting force produces spiral fractures Direct blow or angulating force causes transverse fractures In children: closed reduction, full-length cast extending from axilla to the metacarpals with the elbow at 90 degrees Adults: ORIF

Treatment:

Both bone fractures- forearm

Long Arm Cast

Monteggia fracture dislocation

Fracture of the upper one third of the shaft of ulna associated with dislocation of proximal radioulnar joint Mechanism:

Fall on the hand and forced pronation of the forearm ORIF

Treatment:

Monteggia fracture dislocation

Galeazzi fracture dislocation of the radius

Fracture of the distal part of the radius and dislocation or subluxation of the distal radioulnar joint More common than Monteggia fracture Treatment :

Closed reduction in children ORIF in adults

Galeazzi fracture dislocation