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Injuries Around Elbow

  1. Elbow Anatomy
    1. Capitellum is the first ossification centre about the elbow to appear. It appears around 2 years of age.
    2. The mnemonic “CRITOE” is helpful in memorizing the progression of the radiographic appearance of ossification centre about the elbow in children:
Ossification centre around the elbow
C - Capitellum - 2 years
R - Radius head - 4 years
I - Internal (medial) epicondyle - 6 years
T - Trochlea- 8 years
O - Olecranon- 10 years
E - External (Lateral) epicondyle - 12 years
  1. Three Point Bony Landmarks In Elbow
    1. The tips of medial and lateral epicondyles and the olecranon process have a definite relationship & these Form Isosceles triangle- With the elbow flexed (in ~900)
    2. Lie transversely in straight line-With the elbow extended
    3. Three point bony relationship is not disturbed in fracture supracondylar humerus as the fracture occurs above the level of these bony landmarks
  2. Three Point Bony Relationship
  1. Maintained - Fracture supracondylar humerus
  2. Disturbed
  3. With disturbed (increased) intercondylar distance
    1. Fracture medial epicondyle & condyle
    2. Fracture lateral epicondyle & condyle
    3. Fracture intercondylar humerus’
  4. With maintained intercondylar distance
    1. Fracture olecranon (i.e. upper end ulna)
    2. Dislocation of elbow
  5. Weak posterior capsule may disrupt three point bony relation by promoting subluxation or dislocations of elbow.
    Radial head, lateral epicondyle and tip of olecranon form a triangle over the posterolateral aspect of elbow joint. This space is occupied by anconeus muscle and so known as anconeus triangle.
  1. Various injuries around elbow

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