Skip to main content
SpringerLink
Log in
SpringerLink
Log in

Paediatric Elbow Fractures and Rehabilitation

  • Chapter
  • First Online:
The Elbow

  • 1828 Accesses

Abstract

Upper-extremity fractures account for 65–75% of all fractures in children (fall on outstretched arm mechanism). The most common area injured is the distal forearm; 7–9% of upper-extremity fractures involve the elbow.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abbott MD, Buchler L, Loder RT, Caltoum CB (2014) Gartland type III supracondylar humerus fractures: outcome and complications as related to operative timing and pin configuration. J Child Orthop 8:473–477

    Article  Google Scholar 

  • Abzung JM, Herman MJ (2012) Management of supracondylar humerus fractures in children: current concepts. J Am Acad Orthop Surg 20(2):69–77

    Google Scholar 

  • Babal JC, Mehlman CT, Klein G (2010) Nerve injuries associated with pediatric supracondylar humeral fracture: a meta-analysis. J Pediatr Orthop 30(3):253–263

    Article  Google Scholar 

  • Bales JG, Spencer HT, Wong MA, Fong YJ, Zionts LE, Silva M (2010) The effects of surgical delay on the outcome of pediatric supracondylar humeral fractures. J Pediatr Orthop 30(8):785–791

    Article  Google Scholar 

  • Bauer S, Bae DS, Brustowicz KA, Walters PM (2013) Intra-articular corrective osteotomy of humeral lateral condyle malunions in children: early clinical and radiographic results. J Pediatr Orthop 33(1):20–25

    Article  Google Scholar 

  • Beaty JH, Kasser JR (2006) The elbow: physeal fractures, apophyseal injuries of the distal humerus, osteonecrosis of the trochlea, and T-condylar fractures. In: Rockwood & Wilkins’s – fractures in children, vol 15, 6th edn. Lippincott Williams & Wilkins, Philadelphia, PA, pp 593–611

    Google Scholar 

  • Benedetti Valentini M, Farsetti P, Martinelli O, Laurito A, Ippolito E (2013) The value of ultrasonic diagnosis in the management of vascular complications of supracondylar fractures of the humerus in children. Bone Joint J 95-B:694–698

    Article  CAS  Google Scholar 

  • Bernstein SM, King JD, Sanderson RA (1981) Fractures of the medial epicondyle of the humerus. Contemp Orthop 12:637–641

    Google Scholar 

  • Bernstein SM, McKeever P, Bernstein L (1993) Percutaneous reduction of displaced radiale head fracture in children. J Pediatr Orthop 13:85–88

    Article  CAS  Google Scholar 

  • Bernthal NM, Hoshino CM, Dichter D, Wong M, Silva M (2011) Recovery of elbow motion following pediatric lateral condylar fractures of the humerus. J Bone Joint Surg Am 93(9):871–877

    Article  Google Scholar 

  • Blount W (1955) Fracture in children. Baltimore Williams e Wilkins

    Google Scholar 

  • Brauer CA, Lee BM, Bae DS, Waters PM, Kocher MS (2007) A systematic review of medial and lateral entry pinning versus lateral entry pinning for supracondylar fractures of the humerus. J Pediatr Orthop 27(2):181–186

    Article  Google Scholar 

  • Brogdon B (1960) Little leaguer’s elbow. Am J Roentgenol 83:671–675

    CAS  Google Scholar 

  • Choi PD, Melikian R, Skaggs DL (2010) Risk for vascular repair and compartment syndrome in the pulseless supracondylar humerus fracture in children. J Pediatr Orthop 30(1):50–56

    Article  Google Scholar 

  • D’Souza S, Vaishya R, Klenerman L (1993) Management of radiale neck fracture in children: a retrospective analysis of 100 patients. J Pediatr Orthop 13:232–238

    Article  Google Scholar 

  • Davids JR, Maguire MF, Mubarak SJ, Wenger DR (1994) Lateral condylar fracture of the humerus following posttraumatic cubitus varus. J Pediatr Orthop 14(4):466–470

    Article  CAS  Google Scholar 

  • Dodds SD, Flanagin BA, Bohl DD, DeLuca PA, Smith BG (2014) Incarcerate medial epicondyle fracture following pediatric elbow dislocation: 11 cases. J Hand Surg [Am] 39(9):1739–1745

    Article  Google Scholar 

  • Dunn P, Ravn P, Hansen L et al (1994) Osteosynthesis of medial humeral epicondyle fractures in children: 8-year follow-up of 33 cases. Acta Orthop Scand 654:439

    Article  Google Scholar 

  • Eilert RE, Erickson MA (2006a) Fractures of the proximal radius and ulna. In: Rockwood & Wilkins’s - fractures in children, 6th edn. Lippincot Williams & Wilkins, Philadelphia, PA, pp 443–466

    Google Scholar 

  • Eilert RE, Erickson MA (2006b) Fractures of the proximal radius and ulna, vol 11. Lippincott Williams & Wilkins, Philadelphia, PA, pp 444–467

    Google Scholar 

  • Evans M, Graham K (1998) Fractures of the proximal ulna and radius in children. In: D. Stanley, N. R. M. Kay – surgery of the elbow: practical and scientific aspects, Arnold edn, pp 129–148

    Google Scholar 

  • Farsetti P, Potenza V, Caterini R, Ippolito RE (2001) Long-term results of treatment of fractures of the medial humeral epicondyle in children. J Bone Joint Surg Am 83:1299–1305

    Article  Google Scholar 

  • Feray C (1969) Methode originale de reduction “peu sanglante” des fractures graves de la tete radiale chez l’enfant. Presse Med 27(77):2155–2156

    Google Scholar 

  • Ferrari A, Cioni G (2005) Le forme spastiche della paralisi cerebrale infantile. Springer, Milano

    Google Scholar 

  • Finnbogason T, Karlsson G, Lindberg L et al (1995) Nondisplaced and minimally displaced fractures of the lateral humeral condyle in children: a prospective radiographic investigation of fracture stability. J Pediatr Orthop 15:422–425

    Article  CAS  Google Scholar 

  • Fusaro I, Orsini S, Sforza T, Rotini R, Benedetti MG (2014) The use of braces in the rehabilitation treatment of the post-traumatic elbow. Joints 2(2):81–86

    Article  Google Scholar 

  • Gaston SR, Smith FM, Boab OD (1953) Epiphyseal injuries of the radial head and neck. Am J Surg 85:266–276

    Article  CAS  Google Scholar 

  • Gilchrist AD, McKee MD (2002) Valgus instability of the elbow due to medial epicondyle nonunion: treatment by fragment excision and ligament repair- a report of 5 cases. J Shoulder Elb Surg 11:493–497

    Article  Google Scholar 

  • Gillingham B, Hadden DM (1998) Fracture of the distal humerus in children. In: D. Stanley, N. R. M. Kay – surgery of the elbow: practical and scientific aspects, Arnold edn, pp 97–128

    Google Scholar 

  • Gindele A, Schwamborn D, Tsironis K, Benz-Bohm G (2000) Myositis ossificans traumatica in young children: report of three cases and review of the literature. Pediatr Radiol 30:451–459

    Article  CAS  Google Scholar 

  • Gosens T, Bongers KJ (2003) Neurovascular complication and functional outcome in displaced supracondylar fractures of the humerus in children. Injury 34(4):267–273

    Article  Google Scholar 

  • Gupta N, Kay RM, Leitch KK, Femino JD, Tolo VT, Skaggs DL (2004) Effect of surgical delay on perioperative complications and need for open reduction in supracondylar humerus fractures in children. J Pediatr Orthop 24(3):245–248

    Article  Google Scholar 

  • Han QL, Wang YH, Liu F (2011) Comparison of complications and results of early versus delayed surgery for Gartland type III supracondylar humeral fractures in pediatric patients. Orthop Surg 3(4):242–246

    Article  Google Scholar 

  • Horn BD, Herman MJ, Crisci K, Pizzutillo PD, MacEwen GD (2002) Fractures of the lateral humeral condyle: role of the cartilage hinge in fracture stability. J Pediatr Orthop 22:8–11

    PubMed  Google Scholar 

  • Howard A, Mulpuri K, Abel MF, Broun S, Beuche M, Epps H, Hosalkar H, Mehlman CT, Scherl S, Goldberg M, Turkelson CM, Weis JL, Boyer K (2012) The treatment of pediatric supracondylar humerus fractures. J Am Acad Orthop Surg 20(5):320–327

    Article  Google Scholar 

  • Iyengar SR, Hoffinger SA, Townsend DR (1999) Early versus delayed reduction and pinning of type III displaced supracondylar fractures of the humerus in children: a comparative study. J Orthop Trauma 13(1):51–55

    Article  CAS  Google Scholar 

  • Jakob R, Fowles JV, Rang M, Kassab MT (1975) Observations concerning fractures of the lateral humeral condyle in children. J Bone Joint Surg (Br) 57:430–436

    Article  CAS  Google Scholar 

  • Jeon IH, Oh CW, Kyung HS, Park IH, Kim PT (2006) Tardy ulnar nerve palsy in cubitus varus deformity associated with ulnar nerve dislocation in adults. J Shoulder Elb Surg 15(4):474–478

    Article  Google Scholar 

  • Josefsson PO, Danielsson LG (1986) Epicondylar fractures in children: 35-year follow-up of 56 unreduced cases. Acta Orthop Scand 57:313–315

    Article  CAS  Google Scholar 

  • Kalenderer O, Reisoglu A, Surer L, Aqus H (2008) How should one treat iatrogenic ulnar injury after closed reduction and percutaneous pinning of pediatric supracondylar humeral fractures? Injury 39(4):463–466

    Article  Google Scholar 

  • Kamegaya M, Shinohara Y, Kurokawa M, Ogata S (1999) Assessment of stability in children’s minimally displaced lateral humeral condyle fracture by magnetic resonance imaging. J Pediatr Orthop 19(5):570–572

    CAS  PubMed  Google Scholar 

  • Kasser JR, Beaty JH (2006a) Supracondylar fracture of the distal humerus. In: Rockwood & Wilkins’s fractures in children, 6th edn. Lippincot Williams & Wilkins, Philadelphia, PA, pp 544–586

    Google Scholar 

  • Kasser JR, Beaty JH (2006b) Supracondylar fracture of the distal humerus. In: Rockwood & Wilkins’s–fractures in children, vol 14, 6th edn. Lippincott Williams & Wilkins, Philadelphia, PA, pp 593–643

    Google Scholar 

  • Keppler P, Salem K, Schwarting B, Kinzl L (2005) The effectiveness of physiotherapy after operative treatment of supracondylar humeral fractures in children. J Pediatr Orthop 25:314–316

    Article  Google Scholar 

  • Kronner JM Jr, Legakis JE, Kovacevic N, Thomas RL, Reynolds RAK, Jones ET (2013) An evaluation of supracondylar humerus fractures: is there a correlation between postponing treatment and the need for open surgical intervention? J Child Orthop 7:131–137

    Article  Google Scholar 

  • Lee HH, Shen HC, Chang JH, Lee CH, Wu SS (2005) Operative treatment of displaced medial epicondyle fractures in children and adolescents. J Shoulder Elb Surg 14:178–185

    Article  Google Scholar 

  • Leitch KK, Kay RM, Femino JD, Tolo VT, Storer SK, Skaggs DL (2006) Treatment of multidirectionally unstable supracondylar humeral fractures in children – a modified Gartland type-IV fracture. J Bone Joint Surg Am 88(A)(5):980–985

    Article  Google Scholar 

  • Lim KB, Lim CT, Twang DK (2013) Supracondylar humeral fractures in children: beware the medial spike. Bone Joint J 95(B):1290–1294

    Article  Google Scholar 

  • Mangat KS, Martin AG, Bache CE (2009) The ‘pulseless pink’ hand after supracondylar fracture of the humerus in children. The predictive value of nerve palsy. J Bone Joint Surg (Br) 91B(11):1521–1525

    Article  Google Scholar 

  • Marzo JM, D’Amato C, Strong M, Gillespie R (1990) Usefulness and accuracy of arthrography in management of lateral humeral condyle fractures in children. J Pediatr Orthop 10(3):317–321

    Article  CAS  Google Scholar 

  • Mehlman CT, Strub WM, Roy DR, Wall EJ, Crawford AH (2001) The effect of surgical timing on the perioperative complications of treatment of supracondylar humeral fractures in children. J Bone Joint Surg 83A(3):323–327

    Article  Google Scholar 

  • Metaizeau JP (1980) Reduction et fixation des fractures et decollements epiphysaires de la tete radiale par broche centro-medullaire. Technique originale. Rev Chir Orthop Reparatrice Appar Mot 66:47–99

    CAS  PubMed  Google Scholar 

  • Metaizeau JP (2005) Reduction and osteosynthesis of radial neck fractures in children by centromedullary pinning. Injury 36(Supp 1):A75–A77

    Article  Google Scholar 

  • Metaizeau JP, Lascombes P, Lemelle JL et al (1993) Reduction and fixation of displaced radial neck fractures by closed intramedullary pinning. J Pediatr Orthop 13:355–360

    Article  CAS  Google Scholar 

  • Milch H (1964) Fractures and fracture dislocations of humeral condyles. J Trauma 4:592–607

    Article  CAS  Google Scholar 

  • Morrey BF (2005) The posttraumatic stiff elbow. Clin Orthop Relat Res 431:26–35

    Google Scholar 

  • Mubarak S, Davis JR (2002) Close reduction and percutaneous pinning of supracondylar fractures of the distale humerus in child. In: B.F. Morrey-master techniques in orthopaedic surgery – the elbow, 2nd edn. Lippincot Williams & Wilkins, Philadelphia, PA, pp 49–64

    Google Scholar 

  • Mulpuri K, Wilkins K (2012) The treatment of displaced supracondylar humerus fractures: evidence-based guideline. J Pediatr Orthop 32(2 Suppl):S143–S152

    Article  Google Scholar 

  • Neher CG, Torch MA (2003) New reduction technique for severely displaced pediatric radial neck fractures. J Pediatr Orthop 23:626–628

    Article  Google Scholar 

  • O’Brien P (1965) Injuries involving the proximal radial epiphysis. Clin Orthop Relat Res 41:51–58

    PubMed  Google Scholar 

  • O’Hara LJ, Barlow JW, Clarke NM (2000) Displaced supracondylar fractures of the humerus in children. Audit changes practice. J Bone Joint Surg 82(2):204–210

    Article  Google Scholar 

  • O'Driscoll SW, Spinner RJ, McKee MD, Kibler WB, Hastings H II, Morrey BF, Kato H, Takayama S, Imatani J, Toh S, Kerr Graham H (2001) Tardy posterolateral rotatory instability of the elbow due to cubitus varus. J Bone Joint Surg Am 83:1358–1369

    Article  Google Scholar 

  • Pimpalnerkar AL, Balasubramaniam G, Young SK, Read L (1998) Type four fracture of the medial epicondyle: a true indication for surgical intervention. Injury 29(10):751–756

    Article  CAS  Google Scholar 

  • Price CT, Flynn JM (2006) Management of fracture. In: R.T. Morrissy, L.S. Weinstein-Lovell & Winters’s–pediatric orthopaedic, 6th edn. Lippincot Williams & Wilkins, Philadelphia, PA, pp 1448–1461

    Google Scholar 

  • Radomisli TE, Rosen AL (1998) Controversies regarding radial neck fractures in children. Clin Orthop Relat Res 353:30–39

    Article  Google Scholar 

  • Rodriguez-Merchan EC (1994) Percutaneous reduction of displaced radial neck fractures in children. J Trauma 37:812–814

    Article  CAS  Google Scholar 

  • Roye DP, Bini SA, Infosino A (1991) Late surgical treatment of laterale condylar fractures in children. J Pediatr Orthop 11(2):195–199

    Article  Google Scholar 

  • Rutherford AJ (1985) Fractures of the lateral humeral condyle in children. J Bone Joint Surg Am 67:851–856

    Article  CAS  Google Scholar 

  • Sankar WN, Hebela NM, Skaggs DL, Flynn JM (2007) Loss of pin fixation in displaced supracondylar humeral fractures in children: causes and prevention. J Bone Joint Surg Am 89:713–717

    PubMed  Google Scholar 

  • Schmale GA, Mazor S, Mercer LD, Bompadre V (2014) Lack of benefit of physical therapy on function following supracondylar humeral fracture. J Bone Joint Surg Am 96(11):944–950

    Article  Google Scholar 

  • Scullion JE, Miller JH (1985) Fracture of the neck of the radius in children: prognostic factors and recommendations for management. J Bone Joint Surg (Br) 67:491

    Google Scholar 

  • Silberstein JJ, Brodeur AE, Graviss ER et al (1981) Some vagaries of the medial epicondyle. J Bone Joint Surg 63:524–528

    Article  CAS  Google Scholar 

  • Skaggs DL (1997) Elbow fractures in children. Diagnosis and management. J Am Acad Orthop Surg 5:303–312

    Article  CAS  Google Scholar 

  • Skaggs DL, Hale JM, Bassett J, Kaminsky C, Kay RM, Tolo VT (2001) Operative treatment of supracondylar fractures of the humerus in children – the consequence of pin placement. J Jone Boint Surg 83(A):735–740

    Article  Google Scholar 

  • Smith F (1950) Medial epicondyle injury. J Am Med Assoc 142:396–402

    Article  CAS  Google Scholar 

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

    Article  Google Scholar 

  • Song KS, Kang CH, Min BW, Bae KC, Cho CH, Lee JH (2008) Closed reduction and internal fixation of displaced unstable lateral condylar fractures of the humerus in children. J Bone Joint Surg Am 90:2673–2681

    Article  Google Scholar 

  • Spencer HT, Wong M, Fong YJ, Penman A, Silva M (2010) Prospective longitudinal evaluation of elbow motion following pediatric supracondylar humeral fractures. J Bone Joint Surg Am 92(4):904–910

    Article  Google Scholar 

  • Steele JJA, Graham HK (1992) Angulated radial neck fractures in children. A prospective study of percutaneous reduction. J Bone Joint Surg (Br) 74:760–764

    Article  CAS  Google Scholar 

  • Steinberg EL, Golomb D, Salama R et al (1988) Radial head and neck fractures in children. J Pediatr Orthop 8:35–40

    Article  CAS  Google Scholar 

  • Vahvanen V (1978) Fracture if the radial neck in children. Acta Orthop Scand 49:32–38

    Article  CAS  Google Scholar 

  • Vincelet Y, Journeau P, Popkov D, Humont T, Lascombe P (2013) The anatomic basis for anterior interosseous nerve palsy secondary to supracondylar humerus fracture in children. Orthop Traumatol Surg Res 99(5):543–547

    Article  CAS  Google Scholar 

  • Vocke AK, Von Laer L (1998) Displaced fractures of the radial neck in children: long-term results and prognosis of conservative treatment. J Pediatr Orthop 7B:217–222

    Article  Google Scholar 

  • Vocke-Hell AK, Schmid A (2001) Sonographic differentiation of stable and unstable lateral condyle fractures of the humerus in children. J Pediatr Orthop 10(2):138–141

    CAS  Google Scholar 

  • Weller A, Garg S, Larson AN, Fletcher ND, Schiller JR, Kwon M, Copley LAB, Browne R, Ho CA (2013) Management of the pediatric pulseless supracondylar humeral fracture: is vascular exploration necessary? J Bone Joint Surg Am 95:1906–1912

    Article  Google Scholar 

  • Wilkins KE (1990) Residuals of elbow trauma in children. Orthop Clin North Am 21(2):291–314

    Google Scholar 

  • White L, Mehlman CT, Crawford AH (2010) Perfused, Pulseless, and puzzling: a systematic review of vascular injuries in pediatric Supracondylar Humerus fractures and results of a POSNA questionnaire. J Pediatr Orthop 30(4):328–335

    Article  Google Scholar 

  • Zhang JD, Chen H (2008) Ultrasonography for nondisplaced and mini-displaced humeral lateral condyle fractures in children. Chin J Traumatol 11:297–300

    Article  Google Scholar 

  • Zionts LE, McKellop HA, Hathaway R (1994) Torsional strength of pin configurations used to fix supracondylar fractures of the humerus in children. J Bone Joint Surg Am 76:253–256

    Article  CAS  Google Scholar 

  • Zionts LE, Woodson CJ, Manjra N, Zalavras C (2009) Time of return of elbow motion after percutaneous pinning of pediatric supracondylar humerus fractures. Clin Orthop Relat Res 467(8):2007–2010

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. S.C. Ortopedia e Traumatologia Pediatrica, Istituto Ortopedico Rizzoli, Bologna, Italy

    Diego Antonioli, Manuele Lampasi & Stefano Stilli

  2. S.C. Medicina Fisica e Riabilitativa, Istituto Ortopedico Rizzoli, Bologna, Italy

    Isabella Fusaro & Stefania Orsini

Authors
  1. Diego Antonioli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Manuele Lampasi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stefano Stilli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Isabella Fusaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stefania Orsini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Diego Antonioli .

Editor information

Editors and Affiliations

  1. Policlinico di Modena, Shoulder and Elbow Unit, D. Cervesi Hospital, Cattolica, Italy

    Giuseppe Porcellini

  2. Rizzoli Institute, Bologna, Italy

    Roberto Rotini

  3. Terme di San Petronio - Antalgik, Bologna, Physiomedica, Faenza, Italy

    Susanna Stignani Kantar

  4. Shoulder Team, ForlìCio - Collegio Italiano Osteopatia, Parma, Italy

    Silvia Di Giacomo

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Cite this chapter

Antonioli, D., Lampasi, M., Stilli, S., Fusaro, I., Orsini, S. (2018). Paediatric Elbow Fractures and Rehabilitation. In: Porcellini, G., Rotini, R., Stignani Kantar, S., Di Giacomo, S. (eds) The Elbow. Springer, Cham. https://doi.org/10.1007/978-3-319-27805-6_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27805-6_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27803-2

  • Online ISBN: 978-3-319-27805-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation