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Sự nhổ lên của các tài khoản epicondyle trung gian cho khoảng 10% của tất cả các chấn thương khuỷu tay trẻ em và thường thấy giữa các độ tuổi 7 và 15 năm. Cơ chế chấn thương này thường rơi vào một bàn tay dang ra kết quả là căng thẳng nghiêm trọng khuỷu tay valgus. Avulsed epicondyle trung gian thường sẽ di chuyển | Skeletal trauma 143 Epicondyles Avulsion of the medial epicondyle accounts for approximately 10 of all paediatric elbow injuries and is typically seen between the ages of 7 and 15 years. The mechanism of injury is commonly a fall on an outstretched hand resulting in severe valgus elbow strain. The avulsed medial epicondyle will generally move inferiorly and may become trapped within the elbow joint space where it can be confused with the trochlear ossification centre. As the epicondyle may lie outside the joint capsule this injury will not necessarily have an associated effusion and elevated fat pads. The most useful evaluation tool to ensure that this injury is not missed is therefore the CRITOL mnemonic Fig. 7.23 . Proximal radius Although common in adults radial head injuries are rare in children as ossification of the radial head is not complete until approximately 10 years of age. Instead Salter-Harris type II fractures of the radial neck tend to occur and these injuries are best demonstrated on the lateral elbow projection Fig. 7.24 . Proximal ulna Fractures of the proximal ulna tend to involve the olecranon process Fig. 7.25 but care should be taken as the olecranon ossification centre can often appear fragmented and should not be confused with a fracture. Olecranon fractures occur following a fall on an outstretched hand or as a result of a direct blow to the elbow and are frequently associated with proximal radius fractures Fig. 7.26 . Separation of the fracture fragments can occur on contraction of the triceps muscle if the fracture is distal to the site of the triceps muscle insertion Fig. 7.27 . Elbow dislocations Although true joint dislocations are rare in children a dislocation at the elbow may occur and typically results in posterior movement of the radius and ulna relative to the humerus7 Fig. 7.28 . The mechanism of injury is usually a fall on an outstretched hand and an associated fracture of the coronoid process as a result of impaction against
