Often, however, no fracture line can be identified.Lateral and AP radiographs are usually sufficient, and in many instances demonstrate an obvious fracture.Table 14.2 Radiographic classification of supracondylar humeral fracture The fracture results in an intra-articular fracture line, and when displaced there is posterior displacement of the distal humeral component. These injuries are almost always due to accidental trauma, such as falling from a moderate height with a hyper-extended elbow (e.g. These fractures are more commonly seen in boys. Simple supracondylar fractures are typically seen in younger children (90%, and are uncommon in adults. Supracondylar Humeral Fracture Discussion: There was a displaced fracture of the distal humerus, with ventral displacement of the anterior fat pad, consistent with a joint effusion. The anterior humeral line has been drawn on the image. Orthopedic consultation is generally warranted for treatment of Mason type II through IV fractures.įigure 14.8B Lateral x-ray of the elbow displaying a humeral fracture. Physical therapy may be added to encourage range of motion. Imaging of Mason type I fractures should be repeated after one to two weeks to ensure appropriate alignment. There is some evidence supporting the immediate initiation of elbow motion in patients with a Mason type I fracture. For these fractures, the elbow is placed in a posterior splint for five to seven days, followed by early mobilization and a sling for comfort. Mason type I fractures are generally treated conservatively and can be managed in the primary care setting. Table 14.1 Classification of radial head fractures based on the Mason System Presence of displacement, (>2mm) or angulation > 30 degrees Undisplaced fracture, no mechanical obstruction Radial head fractures are classified using the Mason system: Type There may be impaction and angulation of the radial head.A variety of fracture orientations may be seen consisting of a transverse neck fracture, linear or oblique fractures in any plane, triangular or quadrangular fragments.
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