Incidence- 3% of all fractures

Diagnosis

·                 History-Accidental/Fall on hand sustaining injurylo elbow.

·                 Pain around elbow joint which increases on movement

·                 Examination-Swelling, deformity, bruising, tenderness, crepitus, instability

·                 Check for any signs of increased compartment pressure

·                 Check for distal pulses & neurological deficit of ulnar, radial & median nerves

Investigations

·                 Xray-elbowAP/Lateral view

·                 CT scan— to delineate geometry of fracture & plan surgery especially in intraarticular fractures. compartment pressure monitoring in suspicious cases

·                 Ultrasound Doppler Study-to rule out vascular injury

·                 Angiogram- if vascular injury suspected

·                 MRI -rarely needed

Treatment

·                 Initial management - Splint the limb, elevation of the limb& ice packs application for anti-oedema measures.

·                 Conservative - in medically unfit patients and very comminuted fractures treated with casts (BAG OF BONES TREATMENT)

Patients with associated neurovascular injury or in unstable fractures where facilities are not available for ideal internal fixation should be referred to higher centres.