Fractures of the Elbow

Abstract

Fractures of the elbow joint in children may occur at any age. They usually result from indirect violence, such as a fall onto the outstretched hand. The force may act axially on the joint, or it may be directed obliquely and thus tend to produce valgus or varus angulation, flexion, or hyperextension. The nature of the resulting injury is also determined by the angle of the elbow and the position of the forearm during the accident. Thus, for example, pronation abolishes the physiological valgus angulation of the elbow and changes the direction of the force from valgus to varus. An axial impact drives the capitulum and the trochlea apart, producing a T(Y)-shaped fracture. The fracture gapes proximally and the fragments are tilted in the frontal plane owing to the pull of the collateral ligaments and that of the flexor and extensor muscles (Fig. 1).