BRAN500 Pathology: Elbow Trauma and Clinical Conditions

Flashcards covering the types, mechanisms, imaging findings, and clinical presentations of elbow fractures and pathologies such as tennis elbow based on lecture notes.

Elbow fracture Prevalence

Fractures and dislocations of the elbow account for $6\%$ of all fractures.

Common Pediatric Elbow Fractures

In children, fractures typically involve the supracondylar area or the epicondyles.

Common Adult Elbow Fractures

In adults, the radial head & neck and the olecranon are the most frequently involved sites.

Olecranon fracture

The second most common fracture in adults after the radial head & neck, often caused by direct trauma or avulsion of the triceps.

Olecranon fracture (Imaging)

The fracture line is best seen on lateral projections, appearing as a lucent or sclerotic line across the olecranon.

Olecranon fracture (Acute Trauma causes)

Caused by a direct blow (more common in elderly) or distraction (extension against resistance).

Olecranon fracture (Repetitive Trauma causes)

Includes repetitive abutment into the olecranon fossa, triceps traction when throwing, or valgus stress in overhead throwers.

Olecranon fracture (Displacement Factor)

Traction from the triceps muscle affects the displacement of the fracture.

Olecranon fracture (Surgical Threshold)

Operative treatment is indicated if the fracture is displaced $> 2\,mm$.

Olecranon fracture (Complications)

Decreased range of motion (loss of $5^{\circ}$ to $15^{\circ}$ of extension), early osteoarthritis, heterotopic ossification, ulnar nerve paresthesia, nonunion, and infection.

Radial head fracture

The most common elbow fracture, typically caused by FOOSH (Fall On OutStretched Hand) with impaction into the capitulum.

Type I Radial head fracture

Non-displaced fractures with minimal cracks, usually treated with a sling or splint.

Type II Radial head fracture

Displaced fractures with larger bone fragments that may require surgical intervention.

Type III Radial head fracture

Severely displaced fractures with multiple fragments that often require surgical repair.

Epicondylar fracture

A common fracture, especially in children, often caused by a sudden pull on the flexor-pronator muscle group or elbow dislocation.

Lateral Epicondylitis (Tennis elbow)

Pain at the lateral elbow at the common extensor tendon insertion due to chronic tendonitis of the Extensor Carpi Radialis Brevis (ECRB).

C.R.I.T.O.L.

A mnemonic for components involved in elbow fractures: Capitellum, Radial head, Internal/medial epicondyle, Trochlea, Olecranon, and Lateral epicondyle.

Medial epicondyle fracture mechanism

Often involves avulsion from a sudden pull on the flexor-pronator muscle group or force transmitted through the ulnar collateral ligament.