Skip to main content
SpringerLink
Log in

Physical Examination of the Pediatric Elbow

  • Chapter
  • First Online:
Book cover Pediatric Elbow Fractures

  • 1158 Accesses

Abstract

Pediatric elbow injuries often present a diagnostic dilemma for the treating physician. The unique anatomy of the elbow in the growing child along with the narrow therapeutic window and relatively high complication rates associated with certain types of fracture patterns creates a challenging diagnostic environment for the clinician. Moreover, injury patterns change with the growth and development of the elbow into adolescence and young adulthood. Understanding the context and chronicity of the injury helps guide the clinician through a comprehensive physical examination and establishes the appropriate diagnostic framework to successfully treat pediatric and adolescent patients presenting with a wide variety of elbow pathology.

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

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Malanga GA, Ramirez JA. Common injuries of the foot and ankle in the child and adolescent athlete. Phys Med Rehabil Clin N Am. 2008;19:347–71.

    Article  PubMed  Google Scholar 

  2. Miller MD, Thompson SR, DeLee J, Drez D. DeLee & Drez’s orthopaedic sports medicine. 4th ed. Elsevier/Saunders; 2015.

    Google Scholar 

  3. Freed GL, Gafforini S, Carson N. Age distribution of emergency department presentations in Victoria. Emerg Med Australas. 2015;27(2):102–7.

    Article  PubMed  Google Scholar 

  4. Arora R, Fichadia U, Hartwig E, Kannikeswaran N. Pediatric upper-extremity fractures. Pediatr Ann. 2014;43(5):196–204.

    Article  PubMed  Google Scholar 

  5. McLeod TCV, Decoster LC, Loud KJ, Micheli LJ, Parker JT, Sandrey MA, White C. National Athletic Trainers’ Association position statement: prevention of pediatric overuse injuries. J Athl Train. 2011;46(2):206–20.

    Article  Google Scholar 

  6. Dizdarevic I, Low S, Curie DW, Comstock RD, Hammoud S, Atanda A Jr. Epidemiology of elbow dislocations in high school athletes. Am J Sports Med. 2016;44(1):202–8.

    Article  PubMed  Google Scholar 

  7. Ireland ML, Hutchinson MR. Upper extremity injuries in young athletes. Clin Sports Med. 1995;14(3):533–69.

    CAS  PubMed  Google Scholar 

  8. Wingfield JJ, Ho CA, Abzug JM, et al. Open reduction techniques for supracondylar fractures in children. J Am Acad Orthop Surg. 2015;23(12):e72–80.

    Article  PubMed  Google Scholar 

  9. Simanovsky N, Lamdan R, Mosheiff R, Simanovsky N. Underreduced supracondylar fracture of the humerus in children: clinical significance at skeletal maturity. J Pediatr Orthop. 2007;27(7):733–8.

    Article  PubMed  Google Scholar 

  10. Lanson AN, Garg S, Weller A, et al. Operative treatment of type II supracondylar humerus fractures: does time to surgery affect complications? J Pediatr Orthop. 2014;34(4):382–7.

    Article  Google Scholar 

  11. Badkoobehi H, Choi PD, Bae DS, Skaggs DL. Management of the pulseless pediatric supracondylar humeral fracture. J Bone Joint Surg Am. 2015 Jun 3;97(11):937–43.

    Article  PubMed  Google Scholar 

  12. Cheng JC, Lam TP, Maffuli N. Epidemiological features of supracondylar fractures of the humerus in Chinese children. J Pediatr Orthop B. 2001;10(1):63–7.

    CAS  PubMed  Google Scholar 

  13. Scanell BP, Jackson JB 3rd, Bray C, et al. The perfused, pulseless supracondylar humeral fracture: intermediate-term follow-up of vascular status and function. J Bone Joint Surg Am. 2013;95(21):1913–9.

    Article  Google Scholar 

  14. Landin LA, Danielesson LG. Elbow fractures in children: an epidemiological analysis of 589 cases. Acta Orthop Scand. 1986;57:309–12.

    Article  CAS  PubMed  Google Scholar 

  15. Crowther M. Elbow pain in pediatrics. Curr Rev Musculoskelet Med. 2009;2(2):83–7.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Goldberg C. Musculoskeletal examination general principles and detailed evaluation of the knee & shoulder. The Regents of the University of California; 2011.

    Google Scholar 

  17. Omid R, Choi PD, Skaggs DL. Supracondylar humeral fractures in children. J Bone Joint Surg Am. 2008;90(5):1121–32.

    Article  PubMed  Google Scholar 

  18. Lee SS, Mahar AT, Miesen D, Newton PO. Displaced pediatric supracondylar humerus fractures: biomechanical analysis of percutaneous pinning techniques. J Pediatr Orthop. 2002;22(4):440–3.

    PubMed  Google Scholar 

  19. Farnsworth CL, Silva PD, Mubarak SJ. Etiology of supracondylar humerus fractures. J Pediatr Orthop. 1998;18(1):38–42.

    CAS  PubMed  Google Scholar 

  20. Kazakos CJ, Galanis VG, Verettas DJ, Dimitrakopoulou A, Polychronidis A, Simopoloulos C. Unusual patterns of Monteggia fracture-dislocation. J Orthop Surg. 2006;1:12.

    Article  PubMed Central  Google Scholar 

  21. Swoboda SL, Feldman KW. Skeletal trauma in child abuse. Pediatr Ann. 2013;42(11):236–43.

    Article  PubMed  Google Scholar 

  22. Flaherty EM, Perez-Rossello JM, Levine MA, Hennrikus WL. Evaluating children with fractures for child physical abuse. Am Acad Pediatr. 2014;133:2.

    Google Scholar 

  23. Difiori P, Benjamin HJ, Brenner J, Gregory A, Jayanthi N, Landry GL, Luke A. Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. Clin J Sport Med. 2014;24:3–20.

    Article  PubMed  Google Scholar 

  24. Kramer DE. Elbow pain and injury in young athletes. J Pediatr Orthop. 2010;30:S7–S12.

    Article  Google Scholar 

  25. Dwek JR. A structural and mechanism-based perspective toward understanding pediatric and adult sports injuries. AJR Am J Roentgenol. 2016;206(5):980–6.

    Article  PubMed  Google Scholar 

  26. Golden DW, Jhee JT, Gilpin SP, Sawyer JR. Elbow range of motion and clinical carrying angle in a healthy pediatric population. J Pediatr Orthop B. 2007;16(2):144–9.

    Article  PubMed  Google Scholar 

  27. Hsu SH, Moen TC, Levine WN, Ahmad CS. Physical examination of the Athlete’s elbow. Am J Sports Med. 2012;40:699.

    Article  PubMed  Google Scholar 

  28. O’Holleran JD, Altchek DW. The Thrower’s elbow: arthroscopic treatment of valgus extension overload syndrome. HSS J. 2006;2(1):83–93.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Kramer DE, Yen YM, Simoni MK, Miller PE, Micheli LJ, Kocher MS, Heyworth BE. Surgical management of osteochondritis dissecans lesions of the patella and trochlea in the pediatric and adolescent population. Am J Sports Med. 2015;43(3):654–62.

    Article  PubMed  Google Scholar 

  30. Chen NC. Osteochondritis dissecans of the elbow. J Hand Surg Am. 2010;35(7):1188–9.

    Article  PubMed  Google Scholar 

  31. Barad JH, Kim RS, Ebramzadeh E, Silva M. Range of motion of the healthy pediatric elbow: cross-sectional study of a large population. J Pediatr Orthop B. 2013;22(2):117–22.

    Article  PubMed  Google Scholar 

  32. Da Paz SN, Stalder A, Berger S, Ziebarth K. Range of motion of the upper extremity in a healthy pediatric population: introduction to normative data. Eur J Pediatr Surg. 2016;26(5):454–61.

    PubMed  Google Scholar 

  33. Berme N, Engin AE, Correia da Silva KM Biomechanics of normal and pathological human articulating joints. NATO ASI Series. 1985;3:123.

    Google Scholar 

  34. Fedorka CJ, Oh LS. Posterolateral rotatory instability of the elbow. Curr Rev Musculoskelet Med. 2016;9(2):240–6.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Shrader MW. Pediatric supracondylar fractures and pediatric physeal elbow fractures. Orthop Clin North Am. 2008;39(2):163–71.

    Article  PubMed  Google Scholar 

  36. Robertson JS, Marsh AG, Huntley JS. Neurological status in paediatric upper limb injuries in the emergency department current practice. BMC Res Notes. 2012;5:324.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Davidson AW. Rock-paper-scissors. Injury. 2003;​34(1):61–3.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Drexel University College of Medicine, Philadelphia, PA, USA

    Matthew Varacallo M.D.

  2. Drexel University College of Medicine, Philadelphia, PA, USA

    Kush S. Mody B.S. & Darshan Parikh B.S.

  3. Drexel University College of Medicine, St. Christopher’s Hospital for Children, 3601 A Street, Philadelphia, PA, 19134, USA

    Martin J. Herman M.D.

Authors
  1. Matthew Varacallo M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kush S. Mody B.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Darshan Parikh B.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Martin J. Herman M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin J. Herman M.D. .

Editor information

Editors and Affiliations

  1. Departments of Orthopedics and Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA

    Joshua M. Abzug

  2. St. Christopher’s Hospital for Children, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA

    Martin J. Herman

  3. Shriners Hospitals for Children, Philadelphia, Pennsylvania, USA

    Scott Kozin

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Varacallo, M., Mody, K.S., Parikh, D., Herman, M.J. (2018). Physical Examination of the Pediatric Elbow. In: Abzug, J., Herman, M., Kozin, S. (eds) Pediatric Elbow Fractures. Springer, Cham. https://doi.org/10.1007/978-3-319-68004-0_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-68004-0_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-68002-6

  • Online ISBN: 978-3-319-68004-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation