$supracondylar fracture xray$ $supracondylar fracture xray$

#Supracondylar fracture xray series

Lateral radiograph of the elbow demonstrates a Gartland type III supracondylar fracture, with posterior displacement of the distal fracture fragment (white arrow) compared to the proximal fracture fragment (black arrow), as well as overriding of fracture fragments. Selected images are seen here, demonstrating a severely displaced supracondylar fracture ( Figs. ,Īfter administration of intranasal fentanyl, plain radiography is obtained of the elbow and the forearm. This imaging modality does have the ability to detect soft tissue and cartilage injuries. Routine use of MRI is not indicated for suspected pediatric supracondylar fractures. , CT may be utilized if there is a complex injury but subspecialty consultation is appropriate prior to obtaining such a study. However, this modality has excellent sensitivity and specificity for the detection of these injuries. Routine use of CT is not indicated for suspected pediatric supracondylar fractures. This modality has a reported sensitivity of up to 96% and specificity up to 90% for detecting pediatric elbow fractures when performed by providers in the emergency setting who are specifically trained in sonographic musculoskeletal imaging. Ultrasonography has the advantage of lacking ionizing radiation and general availability, but skill is required in order to produce a meaningful study. The anterior fat pad is normally visualized on a lateral flexed elbow view but can be elevated due to the presence of an elbow joint effusion.

#Supracondylar fracture xray series

One series reported that the presence of a posterior fat pad was associated with a supracondylar fracture in 53% of cases, proximal ulna in 26% of cases, lateral condyle in 12% of cases, or radial-neck in 9% of cases. The presence of a posterior fat pad is not exclusive to supracondylar fractures, however. , The presence of a posterior fat pad is associated with an occult elbow fracture in 76% of cases when no fracture is identified on the initial radiographs. , The posterior fat pad is always associated with a joint effusion when it is seen on the lateral view with the elbow flexed (hence the importance of the 90-degree lateral elbow radiograph). Fat pads may be seen in either a posterior location or anterior location. The elbow fat pads are an important element, as they may be the only indication of a fracture.

$supracondylar fracture xray$

Tangential line joining the anterior coronoid edge with the front edge of the lateral condyleĪ The anterior humeral line in children: when <4 years can pass through the anterior third (31%), middle third (52%), or posterior third (18%) of the capitellum without any pathology. Runs from the anterior cortex of the humerus and usually passes through the middle third of the capitellum exceptions under age 5 aĪngle between humeral and humeral condyle axes, normally 30–45 degrees Visualization associated with joint effusion Normally visualized but elevated with joint effusion The lateral view is particularly important for this purpose:

$supracondylar fracture xray$

There are several key elements to address when evaluating a plain radiograph for supracondylar fractures, as not all are readily evident. Therefore, when a supracondylar fracture is present, one should have a low threshold to image other sites of clinical concern, such as the wrist or forearm, when clinically indicated by physical examination, or when physical examination is difficult, especially in young children. Associated fractures of the wrist and forearm are most common, but fractures of the proximal humerus or clavicle also occur. The clinician should bear in mind the possibility of additional associated fractures with a supracondylar fracture. , Oblique views are not typically required but can be used to further identify minimally displaced fractures if there is strong clinical suspicion for a fracture. , The lateral view is obtained with the elbow in flexion at a true 90-degree angle, or at least as close to this as possible. Proper evaluation of suspected supracondylar fractures requires anterior-posterior and lateral views of the elbow. He is grossly neurovascularly intact and there is no other apparent injury. His physical examination is remarkable for impressive right elbow swelling and pain. He complains of right elbow pain but denies neck or back pain. The fall was witnessed by several teachers and friends, who reported no loss of consciousness or other injuries. A 5-year-old male is brought for right elbow pain and swelling after falling while playing on the monkey bars at school.

$supracondylar fracture xray$