Elbow injuries are very common in adults and children. The treatment of injuries depend on the pattern of injury and age of the patient along with many other factors.
Following are various xrays of elbow injuries in adults and children
Image 1 – Xray of Operated Fracture Lateral Condyle in a Child
The image today is an xray of operated fracture lateral condyle, done immediately after surgery. As viewed, the xray shows a fracture of lateral condyle which is held in position by a Kirschner wire and a screw.
The Kwire is longer than it should be. A longer protruding implant beyond the bone is dangerous for nerves and vessels.
Image 2 – Xray of Fracture Lateral Condyle of Humerus
The Xray in picture shows fracture lateral condyle of humerus.
This xray belongs to fourteen years old male who hit his elbow when he fell from cycle.
Image 3 – Xray of Posterior Dislocation of Elbow
The image shows a posterior dislocation of elbow. This is xray of a 60 years old woman who suffered household trauma but did not take any treatment for 4 weeks. There are some bone fragments visible too.
All dislocations are emergency. This elbow was neglected for 4 weeks and could not be reduced with closed methods. It was operated and functional outcome is acceptable.
To avoid all kind of complications, all dislocations should be reduced immediately. But the first step in that is to seek medical help.
Image 4 – Fracture Of Lateral Condyle of Humerus In A Child – Anteroposterior and Lateral Views
Fracture of lateral condyle is a very common fracture in the children. Following xray is of an eleven year old boy who fell down while playing.
The boy was treated with open reduction and internal fixation using three kwires.
Image 5 – Dislocation of Elbow With Fracture of Radial Neck – AP and Lateral Views
45 years old lady came to out patient department with a history of fall from two wheeler 3 days back and complained of swelling in left elbow and inability to use the limb.
On examination there was tenderness around the elbow and any movement elicited the pain. An xray of elbow that she had carried along revealed following picture.
Though the xray is not of good quality, it is able to show the dislocation and radial neck fracture.
The patient was offered treatment by closed reduction of elbow and if required open reduction and fixation of radial neck.
Patient due to some personal reasons refused the treatment. She did not visit in follow up also.
Image 6 -Xray Of Fracture 0f Medial Epicondyle Of Humerus In 14 Years Old Girl
The following xray depicts an anteroposterior view of the elbow of 14 years old girl who fell from mango tree. She presented with pain and swelling of the elbow.
The xray looked like this, showing fracture of medial epicondyle of the humerus.
She did not have any ulnar nerve deficit. The elbow was not grossly unstable.
She was managed in above elbow plaster cast.
Image 7 – Xray of United Fracture of Lateral Condyle Of Humerus
Following is the 8 weeks postoperative xray showing union of fracture in lateral condyle of humerus.
Preoperative photograph is here.
Image 8 – Anteroposterior Xray Of Elbow of a Child Showing Fracture Of Neck Of Radius
Fracture of neck of radius are common in children as compared to radial head fracture which are commoner in adults.
Following xray is of 11 years old child with fracture of radial neck. AS the xray quality is not good, I have encircled the area of interest.
The fracture was managed by closed manipulation and above elbow cast.
Image 9 – Monteggia Fracture Dislocation Xrays
Monteggia fracture involves fracture of shaft of ulna and dislocation of radius. Following xray is of 39 years old male who suffered a motor vehicle injury to his upper limb and found to have a Monteggia fracture.
AS per Monteggia fracture classification, the fracture is Bado type I.
The fracture was treated by open reduction and internal fixation using low contact dynamic plate and transfixing the radial head to ulna.
Image 10 – Postoperative Film of Supracondylar Fracture of Humerus In 16 Years Old
Following is the postopeartive xrays of supracondylar fracture of humerus shown here.
The fracture was approached by posterior approach and fixed with two reconstruction plates.
Image 11 – Xray Of Supracondylar Fracture In A 16 Year old Child
The anteroposterior xray of the elbow is of quite poor quality. You would need to strain to see the fracture line. Unfortunately, there was only this preoperative image available.
The supracondylar fracture was treated by open reduction and internal fixation with reconstruction plates and distal epiphyseal injury to radius was treated with closed reduction and Kwire fixation.
Image 12 – Xray of Elbow Showing Fracture Of Capitellum
Fracture of capitellum in 43 yars old lady.
She refused for any treatment though.
Image 13 – Neglected Dislocation Of Elbow In A Child
Xray of negelcted elbow dislocation in 10 years old child.
There is a periosteal reaction present on the posterior side.
Image 14 – Xray Of Intercondylar Fracture of Humerus With Diaphyseal Extension
The patient was treated with open reduction and internal fixation using long recon plates and cancellous screws.
Image 15 – An Unusual Fracture Of Proximal End Ulna Along With Dislocation of Radial Head
An unusual of fracture of upper end of ulna
The fracture involves vertical split upper part of shaft of ulna along with coronoid process of ulna.
There is also dislocation of radial head.
Image 16 – Lateral View Radiograph of Fracture Capitellum
Lateral Xray of Elbow showing Capitellum fracture
A smaller comminuted fragment is visible as well
Image 17 – Xray Elbow Showing Old Ununited Fracture Lateral Condyle With Cubitus Valgus
Following is an xray of adult who had suffered fracture of lateral condyle in childhood and was not treated for the same
The xray shows an united fracture of lateral condyle and elbow in high degree of valgus.
Image 18 -AP and Lateral Xrays of Elbow Showing Comminuted Supracondylar Fracture of Humerus
33 years old lady with history of motor vehicle accident suffered injury to her right elbow and xray of the elbow revealed a supracondylar fracture.
The fracture was grade I open fracture.
Image 19 -Fracture Of Radial Head and Medial Epicondyle Of Humerus
Xray of elbow of 13 years old boy after injury.
The injury resulted due to fall from bicycle.
Image 20 -Xray Elbow Showing Nonunion of Fracture Lateral Condyle Humerus With Cubitus Valgus
Cubitus Vlagus is the deformity of the elbow resulting in forearm pointing outwards in relation to arm. One of the late complication of non union of humerus lateral condyle fracture is cubitus valgus.
Following is an xray of adult who presented with deformity of cubitus valgus and xray revealed non union of lateral condyle.
He gave a history of childhood injury for which no treatment was taken.
Image 21 – Xrays of Radial Neck Fracture In A Child
AP and lateral views of elbow showing nadial neck fracture in a child
Fracture has been marked with arrows in both the views.
AP and Lateral Views Of Undisplaced Fracture of Neck of Radius
Image 22 – Fracture of radial neck in adult.
The fracture is undisplaced and has been marked with an arrow.
Image 23 -Xray of Elbow Showing Fracture of Head of Radius
Xray of elbow showing fracture of head of radius in 39 year old male
The fracture has been marked with an arrow.
Image 24 – Supracondylar Fracture of Humerus With Fracture of Medial Epicondyle
Four years old child with history of fall on elbow showing fracture in supracondylar part of the elbow and medial apicondyle
Both fractures have been marked with arrow.
Image 25 – Fracture Dislocation of Elbow
Anteroposterior and lateral view of xray of 35 years old male showing fracture of olecranon extending till upper fourth of ulnar shaft, fracture of cornoid, dislocation of ulno humeral joint and radial head.
A very severe trauma is required to produce this kind of injury in an adult. This patient suffered injury in motor vehicle injury.
Image 26 – Xray Showing New Bone Formation In Excised Radial Head Leading To Ankylosis
After achieving a good initial movements for 2 months, this 40 years old female, a follow up case of radial head excision started having stiffness in supination and pronation movements of the affected elbow.
The following xray was done after 3 months of recurrence of symptoms.
It shows new bone formation in the excision area which resulted in ankylosis.
Image 27 – Xray of Fracture of Medial Epicondyle of Humerus and Ipsilateral Radial Head
Xray of elbow showing fracture of medial epicondyle and radial head.
The other view of the elbow is not available.
Image 28 – Postoperative Xray of Elbow After Radial Head Excision
Postoperative xray of elbow after radial head excision done for radial head fracture.
Staples used in suturing the incision can also be seen.
Image 29 – Fracture Through Elbow With Previously Bony Ankylosis and Flexion Deformity
43 years old male patient fell from bike and injured his elbow. The xray revealed a fracture in ankylosed elbow. The ankylosis was bony type in nature.
The patient could not provide reliable history or documents related to ankylosis.
The patient was treated in fiber cast after positioning the limb in same amount of deformity.
The xray above was taken after 4 weeks of application of cast and shows a uniting fracture.
The fracture united quite well eventually.
Image 30 -Xray Elbow Showing Intercondylar Fracture of Humerus
Xray of fracture of intercondylar region of humerus.
The fracture occurred following a motor vehicle injury and was open fracture.
Image 31 – Xray of Dislocation of Elbow Joint
Xray of dislocation of elbow in 19 years old male.
The dislocation was treated by closed reduction and above elbow plaster slab.
Image 32 – Xray Elbow Showing Ulna United In Malposition and Ununited Radial Head Fracture
Forty eight years old lady came to OPD after two months of injury with complaint of stiffness of elbow. She had been treated conservatively at some other hospital.
Previous xrays revealed a fracture of radial head and fracture of upper end of ulna.
Her extremity was wasted as compared to opposite limb and had an angular deformity.
A frash xray was done and revealed malunited ulna and ununited radial head fracture.
She was advised surgical correction of the deformity and excision of radial head. She refused.
Image 33 – Clinical Photograph of Elbow Dislocation
Note the prominent olecranon which appears more posterior than its usual position and a taut prominent triceps. The elbow is kept in attitude of flexion.
The xray revealed a posterior dislocation of elbow.
The dislocation was reduced and an above elbow plaster was applied in flexion.
Image 34 – Xray of Elbow With Ununited Olecranon and Broken Implant
Following xray is of an elbow which must have been operated for fracture of olecranon and radial head dislocation [asumption- original history not available]
The xray shows a broken plate that fixed olecranon and a broken kwire that passes from humerus to radius.
Image 35 – Xray of Reduced Monteggia Fracture Dislocation In A Child With Ulna In Malposition
Nine years old child fell from height and had Monteggia Fracture Dislocation [ Monteggia fracture dislocation involves fracture of upper ulna bone and dislocation of radial head from elbow.]
The fracture was reduced and above elbow plaster was applied.
The xray above is taken after application of plaster and shows a reduced radial head but ulna is in malposition. The patient was advised surgery for correction of the position but patient guardians refused.
Image 36 – Xrays of Supracondylar Fracture of Humerus Before And After Surgery
53 years old male fell from scooter and injured his elbow. An xray of the elbow revealed a supracondylar fracture of the humerus.
The xray is shown below
The fracture was treated by open reduction and internal fixation using reconstruction plates. Following image was taken just after the surgery using C arm image intensifier.
Patient is still under follow up and showing good improvement.
Image 37 – Xray of Elbow Showing Fracture of Head of Radius
Xray of elbow showing fracture of head of radius in 39 year old male
The fracture has been marked with an arrow.
Image 38 – Xray of Monteggia Fracture Dislocation in Adult Patient
Xray of Monteggia fracture dislocation in an adult patient who was injured in motor vehicle accident.
Monteggia fracture dislocation involves dislocation of radial head along with fracture of ulnar shaft.
Image 39 -Xrays Intercondylar Fracture of Humerus Treated By Open Reduction and Internal Fixation
Following xrays are of 15 years old male who had intercondylar fracture of humerus. Here is AP view of the elbow showing intercondylar fracture of humerus.
Same fracture on lateral view xray.
The fractures were fixed using screws and plates. Here is the AP view after fixation
The boy regained almost full range of motion of the elbow.
Image 40 – Photograph Excised Radial Head Reconstructed on Trolley
Radial head excision procedure is done for those injuries of radial head where open reduction and internal fixation is not an option. This may be either due to the severity of the injury itself, low patient demands or patient’s decision to remove the radial head instead of preserving it.
After removal of radial head, it is important to ensure completeness of the removal by reconstructing the radial head peroperatively.
This photograph is of a removed and reconstructed radial head.
You can visualize the complete radial head.
Image 41 – Fracture Upper End Ulna Fixed with Reconstruction Plate and Interfragmentary Fragment
Following xrays are of fracture of upper end of ulna and belong to a labourer who fell from height.
Here is AP view
Fracture was treated by open reduction and internal fixation using interfragmentary screws and reconstruction plate.
Here is peroperative photograph taken during surgery.
The fracture united within 6 weeks and patient achieved almost full range of motion of elbow.
Image 41 – Minimally Displaced Fracture of Olecranon
Fracture of olecranon in 45 years old male who fell from height. The fracture had minimum displaced.
The fracture was treated by plaster cast.
Image 42 – Xray of Fracture of Supracondylar Region of Humerus
Fracture of supracondylar region of humerus in 39 years old female who suffered this injury in a motor vehicle accident.
There was no neurovascular deficit. The patient was treated with open reduction and internal fixation using reconstruction plates.
Image 43 – Xrays of Fracture of Radial Neck In Adult
Fractures of radial neck are relatively uncommon injury around the elbow in the adults. This injury is more common in children. In contrast, radial head fractures are more common in adults.
The xray in the image are of 48 years old lady who fell from scooter. This fracture generally results from a hard fall on an extended & supinated outstretched hand. The force is transmitted through shaft of radius and momentum of body drives capitellum (A projection of lower humerus that articulates with head of radius) against lateral half of radial head, tilting & displacing it laterally.
- If the forearm is fully supinated, the displacement is lateral
- If the forearm is in neutral mid position, displacement is posterior
In the present xray a lateral displacement is noted.
Image 44 – Fracture Of Radial Head – Anteroposterior View of Elbow
Radial head fractures occur in isolation or in association with fracture dislocations around elbow. The following xray is of 37 years old male who suffered trauma to his right elbow following a fall in a pit.
The patient presented to us about 3 weeks after the injury and was treated by radial head excision.
It is worthy of noting that had this patient presented earlier, there were strong chances of radial head preservation.
The treatment depends upon the displacement of the fracture. A mildly displaced fracture like in the picture may be amenable to closed reduction but a severe displacement may warrant open reduction and internal fixation.
The lady refused any treatment for this and was sent home in a splint.
Image 45 -Comminuted Fracture Of Olecranon Process Of Ulna
This xray was brought to the OPD for opinion. The patient was 85 year old lady who was struck by a motorbike and fell down.
The xray showed a comminuted fracture of olecranon that consisted of two large fragments, sparated from ulna and from each other.
The person was advised to bring the patient so that she could be assessed but never showed up.
Image 46 – Anteroposterior and Lateral Xrays of Elbow Showing Fracture of Radial Head
Fracture of radial head in a 38 year old female.
Anteroposterior view above shows fracture of radial head.
The lateral view shows comminution as well.
Iamge 47 – Xray of Fracture Lateral Condyle In Two Years Old Child
Fracture of lateral condyle are very common fracture in children. lateral condyle is part of the humerus bone that projects on outer astect of lower part of arm just above the level of flexor crease of the elbow (cubital fossa).
Most of the undisplaced fractures can be managed conservatively. The surgery is required in cases which have displacement of the fragment more than 2mm or the fragment is rotated.
As this is a type of epiphyseal injury, anatomical reduction is absolutely necessary. Otherwise growth disturbances of elbow and deformity of the elbow may result, most common being cubitus valgus or valgus deformity of the elbow.
The xray above is of two years old child who sustained an injury due to fall from bed. The fracture is not displaced and was managed conservatively.
Image 48 – Xray of Flexion Type Supracondylar Fracture In A Child
Flexion type suprcondylar injuries are rarer as compared to extension type
Image 49 – Dislocation of Elbow in a Child
Dislocation of elbow in children is less common than adult. Here is an xray of elbow lateral view in 12 years old child.
The patient was treated with closed reduction of the dislocation and plaster splint.
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