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The boy-to-girl ratio for the incidence of physical fractures when examined for specific ages varied from 1 to 1 in children 11 years old or younger and 7 to 1 in children older than 11 years. In girls, most physical fractures occur at the ages of 9mto 12 and 12 to 15 years in boys. The epidemiology of elbow trauma in children is interesting due to a trend toward earlier physical fusion in girls compared to boys.
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Overarm-throwing sports usually associated with elbow collateral ligament insufficiency. Sports that commonly associated with elbow trauma are those with high impact (skateboarding, inline-skating, skiing) and those involved in overarm-throwing sports such as cricket, baseball, and tennis. Weight lifters often sustain sprains and strains injury to the elbow, accounting for 2.6% of all bodily sprains and strains. Commonly encountered pediatric elbow fractures include (but are not limited to) :Įlbow trauma in the young adult usually occur in the setting of sports and following either an acute avulsion injury, ligamentous injury, or insidiously and progressively with chronic repetitive trauma. Moreover, careful attention during the assessment is necessary, given the characteristic sequence of ossification center appearance and fusion, which can make the radiographic assessment rather challenging. Įlbow trauma in children most commonly occurs via sport or following falls. These can include but are not limited to, lateral epicondylitis (tennis elbow), and chronic partial UCL injuries or strains. Īnother form of elbow injuries consists of the subacute-to-chronic variety that occurs secondary to repetitive motions, eventually leading to various tendinosis conditions. These patients present commonly present with painful clicking and weakness. While simple elbow dislocations most often resolve following nonoperative management alone, some patients develop recurrent dislocations or subluxation episodes. Additionally, isolated soft tissue injuries can range from mild contusions, sprains, and strains to more significant soft tissue-based injuries requiring clinical attention, such as deep penetrating lacerations or gunshot wounds (GSWs) resulting in traumatic arthrotomies. Direct trauma to the elbow, which often occurs from a fall directly onto the olecranon can yield various types of fracture- and fracture-dislocation patterns as well. The latter is often seen following a fall on an outstretched hand while the forearm is supinated and the elbow is either partially flexed or fully extended. Traumatic injuries range from simple contusions to more complex osseoligamentous fracture-dislocation patterns.
#ACUTE TRAUMA MANUAL#
Manual laborers with analogous occupational repetitive demands The transition between the upper arm and the forearm is the region of the antecubital fossa, which contains the radial nerve, brachial artery, and median nerve. Moreover, these ligamentous structures contribute to the physiologic rotational stability of the elbow joint. The ulnar collateral ligament (UCL) and lateral collateral ligament (LCL) complex play an important role in stabilizing the joint to valgus and varus stress throughout the arc of motion, respectively. The radial neck and the proximal radial metaphyseal region includes the radial tuberosity, the site of attachment of the distal biceps tendon. The capitellum, a distinct ossification center located at the lateral distal humerus, articulates with the radial head. The anterior aspect of the proximal ulna (i.e., the trochlear notch or semilunar notch) articulates with the trochlea of the distal humerus on the medial side of the elbow joint. The elbow joint is one of the most complex joints in the human body, comprised of three distinct articulations: ulnohumeral, radiohumeral, and proximal radioulnar joints. The latter occurs secondary to a multitude of factors, including deconditioning, decreased agility and balance, poor vision, decreased muscle mass, and osteopenia or osteoporosis.
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Elderly patients, however, are at risk for elbow injuries and traumatic fractures following even low-energy falls. In the adult patient, most of these acute injuries occur secondary to high energy mechanisms such as falls from height or motor vehicle accidents (MVAs). In general, these injuries encompass a vast array of injury patterns from mild soft tissue injuries and contusions to complex osseoligamentous injury patterns and terrible triad injuries. Elbow trauma is a common entity in the acute care setting.