April 2021: ​Name that Fracture

Growing up in the ’70s, I loved the game show, “Name That Tune.” I was enthralled by the challenge of guessing the correct answer with the barest of clues. I marveled at the knowledge of those contestants who said they could name a tune in one note and who were proved right when the entire song was played. I wanted to have the expertise to say the answer with conviction before all was revealed.I never got that good with music, but I found a corollary in the emergency department in which I wished to excel. How many radiographs did I need to know where the fracture was? Could I know from subtle signs on just one view that was then confirmed by the series?I again had the chance to play the game when this lateral elbow popped up on the screen. The historical clue given: slipped on the ice, elbow hurts. The anterior and posterior fat pad jumped out at me. Posterior is always pathologic. Not pediatric because no growth plates were present. If the patient were a child, I would look toward the humerus for a supracondylar fracture, but the culprit almost always hid in the proximal radius in adults. I didn't see the defect on the lateral, but I was sure it must be there. Tags: Fracture, elbow, anterior and posterior fat pad, proximal radius Published: 4/1/2021 9:34:00 AM
Source: Lions and Tigers and Bears - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs