Elbow Fracture Treatment & Management
- Author: Daniel K Nishijima, MD, MAS; Chief Editor: Trevor John Mills, MD, MPH more...
Emergency Department Care
Emergency physicians need to do a thorough neurovascular examination as well as evaluate for concurrent injuries.
Provide adequate analgesia to achieve patient comfort in the ED.
Proper immobilization for the various types of elbow fractures is indicated.
Assess whether the patient needs orthopedic evaluation in the ED, admission to the hospital for observation, or if discharge and follow up with an orthopedic surgeon is adequate.
All elbow fractures should be referred for orthopedic follow-up.
Urgent orthopedic consultation in the ED is required in the following situations:
- If an open fracture or an open joint is suspected
- If the injury poses a significant risk of neurovascular injury such as a displaced supracondylar fracture
Geiderman JM. Humerus and elbow. Marx JA. Marx: Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia: Mosby; 2006. Chap 49.
Roust AF, Bredenkamp JH, Uehara DT. Injuries to the elbow and forearm. Tintinalli JE, Kelen GD, Stapczynski JS, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York: McGraw Hill Text; 2003. 1691-1694.
Goldflam K. Evaluation and treatment of the elbow and forearm injuries in the emergency department. Emerg Med Clin North Am. 2015 May. 33 (2):409-21. [Medline].
Gupta R. Intercondylar fractures of the distal humerus in adults. Injury. 1996 Oct. 27(8):569-72. [Medline].
Wilkins KE. Fractures and dislocations of the elbow region. Rockwood CA, Wilkins KE, King RE, ed. Fractures in Children. 4th ed. Philadelphia: JB Lippincott; 1996. 653.
Brown IC, Zinar DM. Traumatic and iatrogenic neurological complications after supracondylar humerus fractures in children. J Pediatr Orthop. 1995 Jul-Aug. 15(4):440-3. [Medline].
Harris IE. Supracondylar fractures of the humerus in children. Orthopedics. 1992 Jul. 15(7):811-7. [Medline].
Nicholson DA, Driscoll PA. ABC of emergency radiology. The elbow. BMJ. 1993 Oct 23. 307(6911):1058-62. [Medline].
Skaggs D, Pershad J. Pediatric elbow trauma. Pediatr Emerg Care. 1997 Dec. 13(6):425-34. [Medline].
Shearman C, el-Khoury GY. Pitfalls in the radiologic evaluation of extremity trauma: Part 1. The upper extremity. Am Fam Physician. 1998. 58:1298. [Medline].
Vinson DR, Kann GS, Gaona SD, Panacek EA. Performance of the 4-way range of motion test for radiographic injuries after blunt elbow trauma. Am J Emerg Med. 2015 Oct 24. [Medline].
Rabiner JE, Khine H, Avner JR, Friedman LM, Tsung JW. Accuracy of point-of-care ultrasonography for diagnosis of elbow fractures in children. Ann Emerg Med. 2013 Jan. 61 (1):9-17. [Medline].
Rabiner JE, Khine H, Avner JR, Tsung JW. Ultrasound findings of the elbow posterior fat pad in children with radial head subluxation. Pediatr Emerg Care. 2015 May. 31 (5):327-30. [Medline].
Kuntz DG Jr, Baratz ME. Fractures of the elbow. Orthop Clin North Am. 1999 Jan. 30(1):37-61. [Medline].
Karlsson MK, Hasserius R, Karlsson C, et al. Fractures of the olecranon: a 15- to 25-year followup of 73 patients. Clin Orthop. 2002 Oct. 205-12. [Medline].
Steinberg G, Adkins C, Baran D. Orthopaedics in Primary Care. 2nd ed. Williams & Wilkins; 1992. 62-85.