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Elbow fracture

Elbow fractures involve fractures of the distal humerus, radial head, and olecranon. These are among the most common fractures in the paediatric population, but also occurs in adults. They may occur due to fall on outstretched arm or direct trauma to elbow. Radial head fractures are classified according to Manson, olecranon according to Mayo, and distal humeral fractures according to AO/ASIF. Extraarticular undislocated fractures are treated conservatively.

Etiology

Radial head fractures occur due to trying to break a fall.

Olecranon fractures occur due to fall on elbow.

Distal humeral fractures are caused by fall on outstretched arm, direct trauma, or fall on elbow.

Classification

Radial head fractures are classified according to the Manson classification. Olecranon fractures are classified according to the Mayo classification. Distal humeral fractures are classified according to the AO/ASIF classification:

  • Type A – supracondylar (extraarticular)
  • Type B – simple condylar (intraarticular)
  • Type C – transcondylar (intraarticular)

Clinical features

Elbow pain, swelling.

Diagnosis and evaluation

X-ray. CT may be necessary before surgery.

Treatment

Radial head fractures are managed conservatively in case of type I fractures, and with ORIF for type II – IV.

Olecranon fractures are treated conservatively in case of type I fractures, and with ORIF for type II and III.

Type A distal humeral fractures are managed with functional reduction followed by and cast or ORIF. Type B and C distal humeral fractures are managed with anatomical reduction followed by cast or ORIF.