This paper is only available as a PDF. To read, Please Download here.
Abstract
Various mechanisms of injury have been hypothesized for each of the common elbow fractures,
but few have been proved. This paper describes cadaveric experiments demonstrating
some fracture mechanisms. Tests were performed at different angles of flexion, with
impacts around the elbow or along the forearm bones. A range of fractures occurred.
Radial head and coronoid fractures followed impact along the forearm up to 80° flexion.
Olecranon fractures occurred by direct impact around 90° flexion. Distal humeral fractures
mostly occurred above 110° flexion. A flexion-extension ‘arc of injury’ is shown,
which relates fracture types to elbow position at the moment of impact. The results
confirmed some of the mechanism hypotheses, and cast doubt on others. Knowledge of
these mechanisms can give greater understanding of the injury which has occurred,
such as the abnormal bone excursions which occur during impact and likely patterns
of soft tissue damage.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to InjuryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- ‘Latent’ dislocation of the elbow.Acta Othop Belg. 1975; 41: 375
- A contribution to the mechanism of fractures and dislocations in the elbow region.Ann Surg. 1929; 89: 108
- Cancellous bone: its strength and changes with aging and an evaluation of some methods for measuring its mineral content.J Bone Joint Surg [Am]. 1966; 48A: 289
- Stabilisation of, and load on, the elbow joint in some protective movements.Acta Anat. 1962; 48: 224
- Mechanism of elbow injuries.in: Dowson D Wright V Introduction to the Biomechanics of Joints and Joint Replacements. Mechanical Engineering Publications, London1981: 222
- Fractures about the elbow in adults.American Academy of Orthopaedic Surgeons: Instructional course lectures. 1981; 30: 200
- Fractures of the elbow joint and of the lower end of the humerus.Surg Gynaecol Obstet. 1923; 37: 452
- 5th Ed. Surgery of the Elbow. WB Saunders, Philadelphia1972
- Fractures of the distal humerus.in: Morrey BF The Elbow and its Disorders. WB Saunders, Philadelphia1985: 302
- Intercondylar fractures of the distal humerus.J R Coll Surg Edinb. 1982; 27: 276
- Adult trauma.in: Wadsworth TG The Elbow. Churchill Livingstone, Edinburgh1982: 190
- Intercondylar T-shaped fractures of the humerus.J Bone Joint Surg [Br]. 1971; 53B: 425
- Treatment of intracondylar fractures of the humerus by means of traction.J Bone Joint Surg. 1936; 18: 997
- Intercondylar T fractures of the humerus in the adult.J Bone Joint Surg [Am]. 1989; 71A: 310
- Fractures and fracture dislocations of the humeral condyles.J Trauma. 1964; 4: 592
- Fracture-dislocations of the elbow.Injury. 1976; 7: 143
- Isolated fracture of the humeral capitellum.Clin Orthop. 1981; 161: 262
- Fractures at the elbow.J Bone Joint Surg [Am]. 1966; 48A: 1623
- Unusual fracture of the capitulum humeri and capitulum radit.J Bone Joint Surg. 1931; 13: 882
- Fractures of the capitulum humeri.J Bone Joint Surg [Am]. 1975; 57A: 1093
- Fractures of the radial head and their treatment.Acta Orthop Scand. 1970; 41: 320
- Some observations on fractures of the head of the radius with a review of 100 cases.Br J Surg. 1954; 42: 123
- Recurrent dislocation of the elbow.J Bone Joint Surg [Br]. 1966; 48B: 340
- Elbow dislocations.in: Morrey BF The Elbow and its Disorders. WB Saunders, Philadelphia1985: 411
- Fractures of the head of the radius.in: 5th Ed. Proc R Soc Med. 25. 1932: 1011
- Fractures of the radial head. A review of 88 cases and analysis of the indications for excision of the radial head and non-operative treatment.J Bone Joint Surg. 1966; 48A: 1055
- Fractures and dislocations of the elbow.in: 5th Ed. Fractures in Adults. Vol 1. JB Lippincott, Philadelphia1984: 559
- Fractures of the coronoid process of the ulna.J Bone Joint Surg [Am]. 1989; 71: 1348
- 5th Ed. Watson Jones' Fractures and Joint Injuries. Vol 2. Churchill Livingstone, Edinburgh1976
- Fracture-dislocations of the elbow.Clin Orthop. 1967; 50: 95
- Fractures of the proximal ulna and olecranon.in: Morrey BF The Elbow and its Disorders. WB Saunders, Philadelphia1985: 382
- Anterior dislocation of the elbow with fracture of the olecranon.Am J Surg. 1948; 75: 700
- Fractures of the olecranon III. Fractures complicated by forward dislocation of the forearm.Ann Chirurg Gynaecol Fenniea. 1971; 60: 105
Article info
Publication history
Accepted:
October 18,
1994
Identification
Copyright
© 1995 Published by Elsevier Inc.
