eMedicine Specialties > Radiology > Musculoskeletal

Elbow, Fractures and Dislocations - Adult: Multimedia

Author: Ricardo Riego de Dios, MD, Staff Physician, Department of Diagnostic Radiology, Naval Hospital Jacksonville, Naval Air Station
Coauthor(s): Burl Norris, MD, Consulting Staff, Department of Radiology, Naval Medical Center Portsmouth
Contributor Information and Disclosures

Updated: May 1, 2009

Multimedia

Elbow, fractures and dislocations. Anteroposterio...Media file 1: Elbow, fractures and dislocations. Anteroposterior (AP) radiograph of the elbow demonstrates the normal anatomy.
Elbow, fractures and dislocations. Anteroposterio...

Elbow, fractures and dislocations. Anteroposterior (AP) radiograph of the elbow demonstrates the normal anatomy.

Elbow, fractures and dislocations. Lateral radiog...Media file 2: Elbow, fractures and dislocations. Lateral radiograph of the elbow demonstrates the normal anatomy.
Elbow, fractures and dislocations. Lateral radiog...

Elbow, fractures and dislocations. Lateral radiograph of the elbow demonstrates the normal anatomy.

Elbow, fractures and dislocations. Oblique view o...Media file 3: Elbow, fractures and dislocations. Oblique view of the elbow demonstrates the normal anatomy.
Elbow, fractures and dislocations. Oblique view o...

Elbow, fractures and dislocations. Oblique view of the elbow demonstrates the normal anatomy.

Elbow, fractures and dislocations. Radial head...Media file 4: Elbow, fractures and dislocations. Radial head–capitellar view shows the normal anatomy. This view is used to assess occult fractures of the posterior half of the radial head, coronoid process, and capitellum.
Elbow, fractures and dislocations. Radial head...

Elbow, fractures and dislocations. Radial head–capitellar view shows the normal anatomy. This view is used to assess occult fractures of the posterior half of the radial head, coronoid process, and capitellum.

Elbow, fractures and dislocations. Lateral radiog...Media file 5: Elbow, fractures and dislocations. Lateral radiograph of the elbow shows the anterior humeral line drawn along the anterior humeral cortex. This line passes through the middle third of the capitellum. The radiocapitellar line bisects the proximal radial shaft and extends through the capitellum in every view.
Elbow, fractures and dislocations. Lateral radiog...

Elbow, fractures and dislocations. Lateral radiograph of the elbow shows the anterior humeral line drawn along the anterior humeral cortex. This line passes through the middle third of the capitellum. The radiocapitellar line bisects the proximal radial shaft and extends through the capitellum in every view.

Elbow, fractures and dislocations. Anteroposterio...Media file 6: Elbow, fractures and dislocations. Anteroposterior (AP) radiograph of the forearm demonstrates a posterior dislocation of the elbow. Note the discontinuity of the radiocapitellar line. Also note the overlap of the articular surfaces of the trochlea and ulna.
Elbow, fractures and dislocations. Anteroposterio...

Elbow, fractures and dislocations. Anteroposterior (AP) radiograph of the forearm demonstrates a posterior dislocation of the elbow. Note the discontinuity of the radiocapitellar line. Also note the overlap of the articular surfaces of the trochlea and ulna.

Elbow, fractures and dislocations. Lateral view o...Media file 7: Elbow, fractures and dislocations. Lateral view of the forearm demonstrates a posterior dislocation of the radius and ulna in relation to the distal humerus.
Elbow, fractures and dislocations. Lateral view o...

Elbow, fractures and dislocations. Lateral view of the forearm demonstrates a posterior dislocation of the radius and ulna in relation to the distal humerus.

Elbow, fractures and dislocations. Anteroposterio...Media file 8: Elbow, fractures and dislocations. Anteroposterior (AP) view of the elbow demonstrates a posterior-medial fracture-dislocation of the elbow.
Elbow, fractures and dislocations. Anteroposterio...

Elbow, fractures and dislocations. Anteroposterior (AP) view of the elbow demonstrates a posterior-medial fracture-dislocation of the elbow.

Elbow, fractures and dislocations. Lateral view o...Media file 9: Elbow, fractures and dislocations. Lateral view of the elbow demonstrates a posterior dislocation of the elbow. The patient also had a nondisplaced radial head fracture.
Elbow, fractures and dislocations. Lateral view o...

Elbow, fractures and dislocations. Lateral view of the elbow demonstrates a posterior dislocation of the elbow. The patient also had a nondisplaced radial head fracture.

Elbow, fractures and dislocations. Lateral view s...Media file 10: Elbow, fractures and dislocations. Lateral view shows an elbow with a subtle radial head fracture. The presence of the sail sign and the posterior fat pad suggest an associated fracture.
Elbow, fractures and dislocations. Lateral view s...

Elbow, fractures and dislocations. Lateral view shows an elbow with a subtle radial head fracture. The presence of the sail sign and the posterior fat pad suggest an associated fracture.

Elbow, fractures and dislocations. Lateral view o...Media file 11: Elbow, fractures and dislocations. Lateral view of the elbow demonstrates the posterior fat pad, the sail sign, and the comminuted radial head fracture.
Elbow, fractures and dislocations. Lateral view o...

Elbow, fractures and dislocations. Lateral view of the elbow demonstrates the posterior fat pad, the sail sign, and the comminuted radial head fracture.

Elbow, fractures and dislocations. Radial head...Media file 12: Elbow, fractures and dislocations. Radial head–capitellar view demonstrates a nondisplaced fracture of the radial head. This fracture was not seen on the lateral radiograph.
Elbow, fractures and dislocations. Radial head...

Elbow, fractures and dislocations. Radial head–capitellar view demonstrates a nondisplaced fracture of the radial head. This fracture was not seen on the lateral radiograph.

Elbow, fractures and dislocations. Lateral radiog...Media file 13: Elbow, fractures and dislocations. Lateral radiograph of the elbow demonstrates a superiorly displaced fracture of the capitellum.
Elbow, fractures and dislocations. Lateral radiog...

Elbow, fractures and dislocations. Lateral radiograph of the elbow demonstrates a superiorly displaced fracture of the capitellum.

Elbow, fractures and dislocations. Lateral view o...Media file 14: Elbow, fractures and dislocations. Lateral view of the elbow demonstrates a displaced olecranon fracture.
Elbow, fractures and dislocations. Lateral view o...

Elbow, fractures and dislocations. Lateral view of the elbow demonstrates a displaced olecranon fracture.

Elbow, fractures and dislocations. Lateral view o...Media file 15: Elbow, fractures and dislocations. Lateral view of the elbow demonstrates a displaced radial neck fracture.
Elbow, fractures and dislocations. Lateral view o...

Elbow, fractures and dislocations. Lateral view of the elbow demonstrates a displaced radial neck fracture.

Elbow, fractures and dislocations. Anteroposterio...Media file 16: Elbow, fractures and dislocations. Anteroposterior (AP) radiograph of the elbow demonstrates a T-type condylar fracture.
Elbow, fractures and dislocations. Anteroposterio...

Elbow, fractures and dislocations. Anteroposterior (AP) radiograph of the elbow demonstrates a T-type condylar fracture.

Elbow, fractures and dislocations. Lateral radiog...Media file 17: Elbow, fractures and dislocations. Lateral radiograph of the elbow demonstrates a comminuted supracondylar fracture.
Elbow, fractures and dislocations. Lateral radiog...

Elbow, fractures and dislocations. Lateral radiograph of the elbow demonstrates a comminuted supracondylar fracture.

Elbow, fractures and dislocations. Axial CT scan ...Media file 18: Elbow, fractures and dislocations. Axial CT scan of the elbow demonstrates a displaced capitellar fracture. This image was obtained for surgical planning.
Elbow, fractures and dislocations. Axial CT scan ...

Elbow, fractures and dislocations. Axial CT scan of the elbow demonstrates a displaced capitellar fracture. This image was obtained for surgical planning.

Elbow, fractures and dislocations. Axial T1-weigh...Media file 19: Elbow, fractures and dislocations. Axial T1-weighted MRI of the elbow demonstrates an ossific fragment from a prior injury that caused ulnar nerve impingement. Associated abnormal hyperintensity is depicted in the ulnar nerve. The patient presented with radicular pain in the ulnar distribution after a prior fracture-dislocation of the elbow.
Elbow, fractures and dislocations. Axial T1-weigh...

Elbow, fractures and dislocations. Axial T1-weighted MRI of the elbow demonstrates an ossific fragment from a prior injury that caused ulnar nerve impingement. Associated abnormal hyperintensity is depicted in the ulnar nerve. The patient presented with radicular pain in the ulnar distribution after a prior fracture-dislocation of the elbow.

More on Elbow, Fractures and Dislocations - Adult

Overview: Elbow, Fractures and Dislocations - Adult
Imaging: Elbow, Fractures and Dislocations - Adult
Follow-up: Elbow, Fractures and Dislocations - Adult
Multimedia: Elbow, Fractures and Dislocations - Adult
References
Further Reading

References

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  2. Hildebrand KA, Patterson SD, King GJ. Acute elbow dislocations: simple and complex. Orthop Clin North Am. Jan 1999;30(1):63-79. [Medline].

  3. Resnick D. Physical injury: extraspinal sites. In: Diagnosis of Bone and Joint Disorders. 3rd ed. 1992.

  4. Veillette CJ, Steinmann SP. Olecranon fractures. Orthop Clin North Am. Apr 2008;39(2):229-36, vii. [Medline].

  5. Cheung EV. Fractures of the capitellum. Hand Clin. Nov 2007;23(4):481-6, vii. [Medline].

  6. Mehdian H, McKee MD. Fractures of capitellum and trochlea. Orthop Clin North Am. Jan 2000;31(1):115-27. [Medline].

  7. Bryce CD, Armstrong AD. Anatomy and biomechanics of the elbow. Orthop Clin North Am. Apr 2008;39(2):141-54, v. [Medline].

  8. Darracq MA, Vinson DR, Panacek EA. Preservation of active range of motion after acute elbow trauma predicts absence of elbow fracture. Am J Emerg Med. Sep 2008;26(7):779-82. [Medline].

  9. Lennon RI, Riyat MS, Hilliam R, Anathkrishnan G, Alderson G. Can a normal range of elbow movement predict a normal elbow x ray?. Emerg Med J. Feb 2007;24(2):86-8. [Medline][Full Text].

  10. Appelboam A, Reuben AD, Benger JR, Beech F, Dutson J, Haig S, et al. Elbow extension test to rule out elbow fracture: multicentre, prospective validation and observational study of diagnostic accuracy in adults and children. BMJ. Dec 9 2008;337:a2428. [Medline][Full Text].

  11. Lamprakis A, Vlasis K, Siampou E, Grammatikopoulos I, Lionis C. Can elbow-extension test be used as an alternative to radiographs in primary care?. Eur J Gen Pract. 2007;13(4):221-4. [Medline].

  12. Sans N, Railhac JJ. [Elbow: plain radiographs]. J Radiol. May 2008;89(5 Pt 2):633-8; quiz 639. [Medline].

  13. Song KS, Kang CH, Min BW, Bae KC, Cho CH. Internal oblique radiographs for diagnosis of nondisplaced or minimally displaced lateral condylar fractures of the humerus in children. J Bone Joint Surg Am. Jan 2007;89(1):58-63. [Medline].

  14. Zeiders GJ, Patel MK. Management of unstable elbows following complex fracture-dislocations--the "terrible triad" injury. J Bone Joint Surg Am. Nov 2008;90 Suppl 4:75-84. [Medline].

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  17. [Best Evidence] McKee MD, Veillette CJ, Hall JA, Schemitsch EH, Wild LM, McCormack R, et al. A multicenter, prospective, randomized, controlled trial of open reduction--internal fixation versus total elbow arthroplasty for displaced intra-articular distal humeral fractures in elderly patients. J Shoulder Elbow Surg. Jan-Feb 2009;18(1):3-12. [Medline].

  18. Shahabpour M, Kichouh M, Laridon E, Gielen JL, De Mey J. The effectiveness of diagnostic imaging methods for the assessment of soft tissue and articular disorders of the shoulder and elbow. Eur J Radiol. Feb 2008;65(2):194-200. [Medline].

  19. Della-Giustina K, Della-Giustina DA. Emergency department evaluation and treatment of pediatric orthopedic injuries. Emerg Med Clin North Am. Nov 1999;17(4):895-922, vii. [Medline].

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  22. Itamura J, Roidis N, Mirzayan R, Vaishnav S, Learch T, Shean C. Radial head fractures: MRI evaluation of associated injuries. J Shoulder Elbow Surg. Jul-Aug 2005;14(4):421-4. [Medline].

  23. Lins RE, Simovitch RW, Waters PM. Pediatric elbow trauma. Orthop Clin North Am. Jan 1999;30(1):119-32. [Medline].

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  27. Pitt MJ, Speer DP. Imaging of the elbow with an emphasis on trauma. Radiol Clin North Am. Mar 1990;28(2):293-305. [Medline].

  28. Rogers LF. Radiology of Skeletal Trauma. 2nd ed. 1992.

  29. Rosen P. Humerus and elbow. In: Emergency Medicine: Concepts and Clinical Practice. 4th ed. 1998.

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Further Reading

Related eMedicine topics

Arthrocentesis, Elbow

Joint Reduction, Elbow Dislocation, Posterior

Elbow Trauma, Pediatric

Elbow, MRI

Elbow Dislocation

Medial Condylar Fracture of the Elbow

Clinical guidelines

Evidence-based care guideline for loss of elbow motion following surgery or trauma in children aged 4 to 18. Cincinnati Children's Hospital Medical Center - Hospital/Medical Center.  2007 Dec.  9 pages.  NGC:006291

Elbow (acute & chronic). Work Loss Data Institute - Public For Profit Organization.  2003 (revised 2008 May 28).  161 pages.  NGC:006555

ACR Appropriateness Criteria® chronic elbow pain. American College of Radiology - Medical Specialty Society.  1998 (revised 2005).  5 pages. [NGC Update Pending] NGC:004605

Clinical trials

Progressive Splinting Status Post Elbow Fractures and Dislocations

Treatment of Stable Both-Bone Midshaft Forearm Fractures in Children

Effect of Occupational Therapy on the Function and Mobility of Elbow Fractures

Discovery Elbow Multi-Center Prospective Study

Keywords

humerus fractures, distal humeral fractures, radial fractures, ulnar fractures, forearm trauma, neurovascular injuries, Monteggia fracture-dislocation, simple elbow dislocation, complex elbow dislocation, fall on an outstretched hand, FOOSH

Contributor Information and Disclosures

Author

Ricardo Riego de Dios, MD, Staff Physician, Department of Diagnostic Radiology, Naval Hospital Jacksonville, Naval Air Station
Ricardo Riego de Dios, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Phi Beta Kappa, and Radiological Society of North America
Disclosure: Nothing to disclose.

Coauthor(s)

Burl Norris, MD, Consulting Staff, Department of Radiology, Naval Medical Center Portsmouth
Disclosure: Nothing to disclose.

Medical Editor

Michael A Bruno, MD, Associate Professor, Departments of Radiology and Medicine, Pennsylvania State University College of Medicine; Director, Radiology Quality Management Services, Milton S Hershey Medical Center, Pennsylvania State University College of Medicine
Michael A Bruno, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Association of University Radiologists, Radiological Society of North America, Society of Nuclear Medicine, and Society of Skeletal Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Theodore E Keats, MD, Professor, Departments of Radiology and Orthopedics, University of Virginia School of Medicine
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Felix S Chew, MD, MBA, EdM, Professor, Department of Radiology, Vice Chairman for Radiology Informatics, Section Head of Musculoskeletal Radiology, University of Washington
Felix S Chew, MD, MBA, EdM is a member of the following medical societies: American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

 
 
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