Semin Musculoskelet Radiol 2007; 11(1): 048-056
DOI: 10.1055/s-2007-984412
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001 USA.

Pediatric Elbow Trauma: An Orthopaedic Perspective on the Importance of Radiographic Interpretation

Sidney M. Jacoby1 , Martin J. Herman3 , William B. Morrison2 , A. Lee Osterman4
  • 1Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
  • 2Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania
  • 3Department of Orthopaedic Surgery, Drexel University College of Medicine, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania
  • 4Philadelphia Hand Center, Philadelphia, Pennsylvania
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Publikationsdatum:
31. Juli 2007 (online)

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ABSTRACT

Radiographic interpretation of pediatric elbow trauma presents a daunting task for both the radiologist and treating orthopaedic surgeon. Proper radiographic diagnosis and appropriate intervention requires a thorough understanding and appreciation of developmental anatomy. As the pediatric elbow matures, it transitions from multiple cartilaginous anlagen through a predictable pattern of ossification and fusion. When children sustain trauma to the elbow, they may have a limited capacity to communicate specific complaints and are sometimes difficult to examine reliably. Furthermore, the presence of multiple growth centers, and their variability, makes radiographic evaluation of pediatric elbow injuries particularly challenging. These variables, coupled with the known adverse long-term sequelae of pediatric elbow trauma (painful nonunion, malunion, elbow stiffness, growth disturbance, etc.) highlight the importance of accurate radiographic interpretation, which facilitates appropriate treatment. By using an orderly, systematic approach based on well-defined anatomical relationships and accepted radiographic markers, the radiologist may effectively interpret and communicate pertinent findings to the treating orthopaedic surgeon. Furthermore, using common classification systems may facilitate interdisciplinary communication. Finally, it is crucial that caregivers of children consider the possibility of child abuse in suspect cases.

REFERENCES

Sidney M JacobyM.D. 

Department of Orthopaedic Surgery, Thomas Jefferson University

1015 Walnut Street, Suite 801, Philadelphia, PA 19107