Other Injuries

Lateral condyle fracture

Fractures of the lateral humeral condyle are the second most common elbow fracture seen in children, usually between the ages of four and ten [4].

The x-ray shows a displaced lateral condyle fracture.
It results from a varus force applied through the extended elbow, normally due to a fall onto an outstretched hand. It is commonly displaced by the action of the forearm extensors.

Appearance on x-ray may be subtle so an awareness of the possibility of this injury is necessary when interpreting films.

Learning bite

The radiographic appearance of lateral condyle fractures may be subtle.

Medial epicondyle avulsion injury

Medial epicondyle avulsion injuries tend to occur in adolescents due to valgus stress during a fall on an outstretched hand. There may be associated ulna nerve damage and sometimes dislocation.

The x-ray shows an avulsion of the medial epicondyle.

Radial neck fracture

Radial neck fractures are more common in children due to weak metaphyseal bone and, as with radial head fractures, may be difficult to spot on an x-ray [4].

The x-ray shows a radial neck fracture

Pulled elbow

Pulled elbow is also sometimes known as ‘nursemaid’s elbow’.
This injury is seen most commonly in children aged one to five years [4]. There is often a history of traction on the arm of the child although this is not always the case. In some cases the parent may not be willing to volunteer the history or may not have been present when the injury occurred. The child will not be using the arm.

Pulled elbow results from subluxation of the radial head from its normal position encircled by the annular ligament.

Learning bite

A pulled elbow should be suspected following a history of traction to the arm.