Radiology Teaching Files > Case 34440217

Contributed by: Patrick Davis, Resident, Brooke Army Medical Center, Texas, USA.
Patient: 6 year 1 month old male
History: 6 year 1 month old male: with elbow pain after fall on outstreched hand.

Fig. 1

Fig. 2

Anterior sail sign. Visualization of posterior fat pad. Nondisplaced fracture through the lateral condyle involving the metaphasis and epiphysis (capitellar ossiphication center).

Other findings include delayed appearance of the elbow ossification centers.  6 year old patients should have radial head and medial epicondyle ossification centers--not seen in this 6 year old patient.

Diagnosis: Lateral humeral condyle fracture involving the capitellum, Salter-Harris type IV fracture.

Usually a result of fall on outstreched hand with the load being transmitted through the radial head.  Second most common elbow fracture and accounts for 18% of distal humerus fractures with a peak age of 6 years.

Posterior fat pad sign, lucent fracture line with variable size fragment and displacement. Look for associated fractures of the radial neck.

Two staging classifications, Milch and Jakob.  The fracture may have an intact trochlear ridge, a Salter Harris type II fracture. If the fracture extends through the epiphysis  then it is unstable, a Salter Harris type IV fracture.




Stoller, David MD. Diagnositic Imaging, Lateral condylar fracture, pg 2-70 and 2-71. 2004.


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Additional Details:

Case Number: 34440217Last Updated: 2011-09-24
Anatomy: Skeletal System   Pathology: Trauma
Modality: Conventional RadiographAccess Level: Readable by all users
Keywords: elbow fracture

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