//fpnotebook.com/
Elbow Posterolateral Fracture Dislocation
Aka: Elbow Posterolateral Fracture Dislocation, Terrible Triad of the Elbow, Fracture Dislocation of the Elbow
- See Also
- Elbow Dislocation
- Radial Head Fracture
- Coronoid Process Fracture
- Pathophysiology
- Terrible Triad of the Elbow (Posterolateral Fracture Dislocation)
- Posterior Elbow Dislocation AND
- Radial Head Fracture AND
- Coronoid Process Fracture
- Associated injuries (responsible for instability)
- Elbow Ulnar Collateral Ligament Injury (Medial collateral ligament tear)
- Joint capsule injury
- Lateral collateral ligament tear
- Mechanism:
- Fall on Outstretched Hand
- Other contibuting factors
- Axial load
- Valgus stress
- Posterolateral rotation
- Symptoms
- Elbow Pain
- Clicking
- Swelling
- Decreased elbow range of motion
- Signs
- Unstable elbow on reduction (varus and valgus)
- Other associated injuries
- Ulnar Nerve injury (unable to abduct fingers)
- Distal radioulnar joint dislocation
- Exam
- See Elbow Exam
- See Hand Neurovascular Exam
- Imaging
- Elbow XRay
- First-line study which is typically sufficient for diagnosis
- Wrist or Forearm XRay
- Consider if associated distal injury is suspected
- CT Elbow
- May be indicated for surgical planning
- Management
- Elbow closed reduction
- Performed under Procedural Sedation
- Apply posterior Long Arm Splint
- Obtain post-reduction xrays
- Operative management
- Most patients will undergo surgical repair (e.g. radial head arthroplasty, coronoid repair, ligament repair)
- Complications
- Chronic elbow instability
- Post-Traumatic Arthritis
- References
- Kiel (2021) Crit Dec Emerg Med 35(9): 16-7