72.1 Introduction

Injuries of the elbow fall into two groups—those of children and those of adults. A child seldom suffers from any of the adult fractures and vice versa. But dislocations can occur at any age. The penalty for mismanaging any of these injuries is likely to be a stiff painful elbow always.

The ligamentous injuries of the elbow include: (1) epicondylitis (tennis elbow) in adults, in which the attachment of the extensor muscles to the lateral condyle is strained, and (2) pulled elbow in children in which the head of the radius jams inside the annular ligament. In pulled elbow there is usually a history of a specific injury, but not in epicondylitis.

The signs in the list which follows should enable you to diagnose most injured elbows, even if you do not have X–rays. They are especially useful in children whose X–rays are difficult to interpret. You cannot remember all these signs, so consult the following section with the patient in front of you.