Elbow Fracture: AI-Powered Imaging Analysis

In adults, distal humerus fractures and radial head fractures predominate, often resulting from a fall on an outstretched hand or direct trauma. Olecranon fractures are also common in adults after a direct blow to the posterior elbow. In children, supracondylar humerus fractures are the most frequent pediatric elbow injury, accounting for up to 60 percent of elbow fractures in that age group, and carry a risk of anterior interosseous nerve injury and brachial artery compromise that must be assessed promptly.

Surgical fixation is indicated for fractures with articular displacement greater than 2 mm, comminution that renders the joint unstable, associated ligamentous instability creating a "terrible triad" injury (elbow dislocation with radial head and coronoid fractures), open fractures, or neurovascular compromise. Displaced distal humerus fractures in adults are almost universally treated with open reduction and internal fixation using parallel or perpendicular plating constructs to restore articular congruity and allow early mobilization to prevent stiffness.

The anterior interosseous nerve, a branch of the median nerve that runs in the antecubital fossa, is most commonly injured in supracondylar fractures and presents with inability to form the "OK" sign due to weakness of the flexor pollicis longus and flexor digitorum profundus to the index finger. The radial nerve or its posterior interosseous branch may be stretched in lateral condyle fractures. The ulnar nerve is vulnerable in medial epicondyle fractures and distal humerus fixation. The brachial artery is at risk in severely displaced supracondylar fractures and must be assessed by checking radial pulse and hand perfusion.