CincyKidsRad

Cincinnati Children's Radiology

Complex elbow fracture/dislocation

AP (image 1) and lateral (image 2) radiograph of the elbow shows a complex fracture dislocation at the elbow. The forearm is rotated 90 degrees clockwise from the humerus. Ossific fragments are present adjacent to the head of the radius. The medial epicondyles (arrow) is avulsed and displaced within the elbow joint. This type of complex injury places the patient at risk for neurovascular injury.

Similar cases

35 years old lady resulting injury to elbow after falling on flexed elbow.On arrival, marked swelling of left elbow, can't flex or extend elbow well due to tenderness.

On x ray, such a poor fracture that made her enough to moaning.I discussed the patient about urgency of operation to reduce that dislocated radial head and need to fix the fractured ulna by some sort of plate.But patient reject the operation for many reasons.So I did the MUA under sedation and reduce and hold with POP Above elbow cast.

What would be future management?

AP (image 1) and lateral (image 2) radiographs of the right elbow show dislocation of the elbow joint and a fracture of the olecranon process (arrow). Elbow dislocations are uncommon and caused by a fall onto an outstretched hand with hyperextension, valgus stress, and supination.

AP and lateral radiograph of the forearm (image 1) and lateral radiograph of the elbow (image 2) show a Monteggia fracture dislocation complex with a transverse fracture of the mid ulna and dislocation (arrow) of the radial head. Monteggia fractures occur after a fall onto an outstretched hand. They occur almost exclusively in children.

AP (image 1) and lateral (image 2) radiographs of the elbow show radial side and posterior dislocation of the elbow. Small osseous fragments (arrow) project over the elbow joint. 90 percent of elbow dislocations are posterior or posterolateral.

"Elbow dislocation occurs after falling on outstretched hand with the elbow in hyperextension. Up to half of elbow dislocations are associated with a fracture."