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How to Never Miss an Elbow Fracture Again: A Radiographic Roadmap

How to Never Miss an Elbow Fracture Again: A Radiographic Roadmap

Update: 2025-04-23
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We explore the essential techniques for accurately interpreting elbow X-rays, focusing on key lines, fat pad signs, and common fracture patterns that help reveal hidden injuries.

• Standard elbow series includes AP, lateral, and oblique views, with the lateral being the most critical "money shot"
• Two essential lines to draw: anterior humeral line (should pass through middle third of capitellum) and radiocapitellar line (should bisect the capitellum)
• Fat pad signs are crucial indicators – posterior fat pads are NEVER normal and always indicate pathology
• Pediatric injuries typically involve supracondylar fractures (60% of all pediatric elbow fractures)
• Adult injuries commonly involve radial head fractures, with 20-40% showing only fat pad signs initially
• Always check and document neurovascular status before and after any intervention
• Displaced or comminuted fractures require urgent orthopedic consultation
• Simple non-displaced fractures can be splinted with outpatient orthopedic follow-up

Check out the complete lecture and more educational content coming soon to the Invictus Board Review site.


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How to Never Miss an Elbow Fracture Again: A Radiographic Roadmap

How to Never Miss an Elbow Fracture Again: A Radiographic Roadmap

Mel Herbert