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Essential points in traumatology of the child’s elb

Published in N°268 - Book 2 - November 2017
Article viewed 29 times

Essential points in traumatology of the child’s elb

By Ch. Glorion, S. Pannier, Z. Péjin, A. Alves, A. Desroches, D. Thomas, Y. Ouchrif in category
Service d’Orthopédie et Traumatologie pédiatrique Hôpital des Enfants Malades, Paris

Trauma to the child’s elbow is common, varied, sometimes difficult to diagnose and not always easy to treat. However, a large proportion of injuries fit into classic presentations and applying a few straightforward principles will lead to excellent results.
The elbow does not play a significant role in the longitudinal growth of the upper limb. The aim is essentially to restore the anatomical axes and joint surfaces.

 

 

Trauma to the child’s elbow is common, varied, sometimes difficult to diagnose and not always easy to treat. However, a large proportion of injuries fit into classic presentations and applying a few straightforward principles will lead to excellent results.

The elbow does not play a significant role in the longitudinal growth of the upper limb. The aim is essentially to restore the anatomical axes and joint surfaces.

Through a series of examples, we will attempt to provide some straightforward principles for treatment that can be applied by any orthopaedic surgeon who has undergone junior doctor training in a paediatric orthopaedics and trauma ward. For each fracture, we will advise which technique we believe to be suitable and we will try to illustrate the errors that may lead to complications.

 

Supracondylar fracture

Stages 3 and 4 are the most common forms (Fig. 1).

Figure 1 : Supracondylar elbow fracture, Lagrange and Rigault stage 4, with the proximal bone fragment often endangering the anterior skin.

 

Although there is sometimes significant displacement, this is not an obstacle to a non-surgical reduction restoring anatomic position, which is achieved in many cases. Stabilisation using the Blount technique (Fig. 2) is always possible, but it may not be...

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