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Elbow Injuries

Elbow Injuries is a topic covered in the 5-Minute Emergency Consult.

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Bony Injuries
  • Supracondylar fracture:
    • Most common in children
    • Peak ages 5–10 yr, rarely occurs >15 yr
    • Extension type (98%): Fall on outstretched hand (FOOSH) with fully extended or hyperextended arm:
      • Type 1: Minimal or no displacement
      • Type 2: Slightly displaced fracture; posterior cortex intact
      • Type 3: Totally displaced fracture; posterior cortex broken
    • Flexion type: Blow directly to flexed elbow:
      • Type 1: Minimal or no displacement
      • Type 2: Slightly displaced fracture; anterior cortex intact
      • Type 3: Totally displaced fracture; anterior cortex broken
  • Radial head fracture:
    • Usually indirect mechanism (e.g., FOOSH)
    • Radial head driven into capitellum

Soft Tissue Injuries
  • Elbow dislocation:
    • 2nd only to shoulder as most dislocated joint
    • Most are posterior.
  • Medial/lateral epicondylitis:
    • Overuse injuries usually related to rotary motion at elbow
    • Involving attachment points of hand and wrist flexor/extensor groups to elbow
    • Plumbers, carpenters, tennis players, golfers
    • Pain made worse by resisted contraction of particular muscle groups

Pediatric Considerations
  • Subluxed radial head (nursemaid's elbow)
  • 20% of all upper extremity injuries in children
  • Peak age 1–4 yr; occurs more frequently in females than males
  • Sudden longitudinal pull on forearm with forearm pronated


  • Mechanism aids in determining expected injury.
  • Trauma predominates.
  • Most elbow injuries caused by indirect trauma are transmitted through bones of forearm (e.g., FOOSH)
  • Direct blows account for very few fractures or dislocations.

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Rosen, Peter, et al., editors. "Elbow Injuries." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307312/all/Elbow_Injuries.
Elbow Injuries. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307312/all/Elbow_Injuries. Accessed April 25, 2019.
Elbow Injuries. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307312/all/Elbow_Injuries
Elbow Injuries [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307312/all/Elbow_Injuries.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Elbow Injuries ID - 307312 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307312/all/Elbow_Injuries PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -