ABSTRACT
The elbow is second only to the distal forearm for frequency of fractures in children. Most of these injuries are supracondylar fractures, the remainder being divided between condylar, epicondylar and proximal radial and ulnar fractures. A good knowledge of the normal anatomy is essential if fracture displacements are to be recognized. If there is even a suspicion of a fracture, the elbow is gently splinted in 30 degrees of flexion to prevent movement and possible neurovascular injury during the X-ray examination. Swelling is usually not severe and the risk of vascular injury is low. If the posterior cortices are in continuity, the fracture can be reduced under general anaesthesia by gentle traction and then flexion of the elbow with pressure on the olecranon to correct the posterior angulation. The fracture is reduced by pulling on the forearm with the elbow semi-flexed, applying thumb pressure over the front of the distal fragment and then extending the elbow fully.
