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Lateral epicondyle fracture (peds)
From WikEM
Contents
Background
- Salter-Harris type IV fracture
- Neurovascular injury uncommon
Evaluation
Clinical Findings
- Swelling and tenderness limited to lateral elbow
neurovascular injury is uncommon
Imaging
- Obtain oblique view if suspicion high despite neg AP/lat
- Radiocapitellar line will not intersect middle of capitellum in all views
- May be only sign of fracture if fracture is entirely through growth plate
- +Fat Pad Sign/"sail" sign
- May be only sign of nondisplaced fracture
Differential Diagnosis
Elbow Diagnoses
Radiograph-Positive
Radiograph-Negative
- Lateral epicondylitis
- Medial epicondylitis
- Olecranon bursitis (nonseptic)
- Septic bursitis
- Biceps tendon rupture/dislocation
Pediatric
- Nursemaid's elbow
- Supracondylar fracture
- Lateral epicondyle fracture
- Medial epicondyle fracture
- Olecranon fracture
- Radial head fracture
- Salter-Harris fractures
Management
- Often requires ORIF (ortho consult)
