Skaggs D, Pershad J
Division of Orthopaedics, Children's Hospital of Los Angeles, University of Southern California 90027, USA.
Pediatr Emerg Care. 1997 Dec;13(6):425-34. doi: 10.1097/00006565-199712000-00021.
Acute pediatric elbow trauma is commonly seen in the emergency department (ED). Reports confirm that, compared to other fractures, children's elbow fractures are commonly misdiagnosed in the ED. In addition, missed orthopedic injuries are one of the leading causes of malpractice claims in emergency medicine. Radiologic diagnosis of these injuries is challenging, as a large portion of the pediatric elbow is composed of radiolucent cartilage. Knowledge of the normal anatomy and ossification centers around the elbow is essential for correct diagnosis. Acute neurovascular injury is frequently associated with these injuries, but is often difficult to assess in an apprehensive child. Immediate orthopedic consultation is indicated for any child with an elbow injury in whom neurologic or vascular compromise is suspected. Consultation should be strongly considered for children with displaced supracondylar fractures and/or significant echymosis and swelling about the cubital fossa.
小儿急性肘部创伤在急诊科很常见。报告证实,与其他骨折相比,儿童肘部骨折在急诊科常被误诊。此外,漏诊的骨科损伤是急诊医学中医疗事故索赔的主要原因之一。这些损伤的放射学诊断具有挑战性,因为小儿肘部的很大一部分由透光软骨组成。了解肘部周围的正常解剖结构和骨化中心对于正确诊断至关重要。急性神经血管损伤常与这些损伤相关,但在焦虑的儿童中往往难以评估。对于任何疑似有神经或血管损伤的肘部受伤儿童,应立即进行骨科会诊。对于有移位的髁上骨折和/或肘窝周围有明显瘀斑和肿胀的儿童,应强烈考虑会诊。