The Elbow and Forearm: Acquired Disorders

Abstract

This chapter fi rst discusses the timing of ossifi cation of the apophyses and epiphyses at the elbow, as an understanding of the appearance of the normal elbow is essential to correct interpretation of the pediatric elbow radiograph. It then discusses fractures that are common in younger children, such as supracondylar, lateral condylar, and medial condylar fractures. It presents radial neck and olecranon fractures, generally encountered in the adolescent period. The many injuries that result from valgus stress are then discussed, including osteochondritis dissecans of the capitellum and medial epicondylar apophysitis. The chapter concludes with a presentation of osteochondrosis of the capitellum (Panner disease).Fractures and overuse injuries are common in the pediatric elbow. Supracondylar, lateral condylar, and medial condylar fractures are especially common in younger children, often due to falls. After these centers fuse, physeal injuries no longer occur; radial neck fractures and olecranon fractures become more common in the adolescent period. Repetitive valgus stress-such as occurs in pitchers and other throwing athletesmay lead to osteochondritis dissecans of the capitellum, apophysitis of the medial epicondyle or olecranon, loose bodies, and growth disturbances.