Imaging anatomy subluxation of the head of the radius
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After completion of this session, students should be able to discuss, identify, and describe: The anatomical factors predisposing to the etiology of a fracture or dislocation. The anatomy of displacement or deformity. Imaging anatomy features and how to differentiate from epiphyseal lines. Anatomy related to correct relocation and alignment. Anatomical complications of a fracture or dislocation.
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Imaging anatomy subluxation of the head of the radius
- 1. Dr.AkramJaffar Imaging Anatomy of Fractures and Dislocations inImaging Anatomy of Fractures and Dislocations in the Upper Limbthe Upper Limb Subluxation of the head of the radius:Subluxation of the head of the radius: pulled elbowpulled elbow Akram Jaffar, Ph.D. Subscribe to Human Anatomy Education Channel https://www.youtube.com/user/akramjfr Human Anatomy Education platforms by Akram Jaffar Follow @AkramJaffar Like Human Anatomy Education Page https://www.facebook.com/AnatomyEducation
- 2. Dr.AkramJaffar References and suggested reading • Ellis H (2006): Clinical anatomy, A revision and applied anatomy for clinical students. 11th Ed. Blackwell Publishing. Massachusetts. • Moore KL et al. (2013): Clinically Orientated Anatomy. 7th Ed. Lippincott, Williams & Wilkins. Philadelphia. • Hamblen DL & Simpson HRW (2007): Adam’s outline of fractures including joint injuries. 12th ed. Churchill Livingstone Elsevier. Edinburgh. • Solomon L, Warwick DJ & Nayagam S (2001): Apley's System of Orthopedics and Fractures. 8th ed. Arnold Publishing.
- 3. Dr.AkramJaffar Objectives After completion of this session, students should be able to discuss, identify, and describe: • The anatomical factors predisposing to the etiology of a fracture or dislocation. • The anatomy of displacement or deformity. • Imaging anatomy features and how to differentiate from epiphyseal lines. • Anatomy related to correct relocation and alignment. • Anatomical complications of a fracture or dislocation.
- 4. Dr.AkramJaffar Anterior humeral and radiocapetellar lines • Radiographic anatomy: • The anterior humeral line should intersect the middle third of the capitulum on the lateral view. Failure indicates supracondylar fracture. • Radio capetellar line drawn through the middle of the radius should bisect the capitulum. Failure to align properly indicates a radial head dislocation. olecranon capitulum
- 5. Dr.AkramJaffar Anterior humeral and radiocapetellar lines Supracondylar fracture A radial head dislocation with an olecranon fracture (Monteggia injury) capitulum capitulum
- 6. Dr.AkramJaffar Humerus lower end ossification centres • Four centres appear – Capitulum at the 2nd year – Medial epicondyle – Trochlea by the 12th year – Lateral epicondyle by the 13th year 3 years 5 years capitulum capitulum Medial epicondyle radius ulna radius ulna humerus humerus lateral epicondyle trochlea
- 7. Dr.AkramJaffar Humerus lower end ossification centres • The ossification centers blend with each other at puberty • Blend with the shaft at 14-16 years • The medial epicondyle unites with the shaft at 20 years The four centers are present Medial epicondyle Medial epicondyle radius ulna lateral epicondyle radius ulna capitulum trochlea humerus humerus
- 8. Dr.AkramJaffar Ulna and radius ossification • Ulna: – Head (6th year), fuses at 20 years – Olecranon (8th year), fuses at 18 • Radius: – Lower end (2nd year), fuses at 20 – Head (4th year), fuses at 18 11years 11years radius ulna Radial head ulnar head
- 9. Dr.AkramJaffar • The annular ligament is funnel-shaped in adults, but its sides are vertical in children. • Sudden pull on the pronated forearm of a child results in incomplete dislocation of the head of the radius • Part of the annular ligament becomes trapped between the radial head and the capitulum. • Reduction is affected by firm supination of the elbow to return the radial head back into place. Subuxation of the head of the radius “Pulled elbow” Annular lig. capitulum Radial head supination
- 10. Dr.AkramJaffar • The annular ligament is funnel-shaped in adults, but its sides are vertical in children. • Sudden pull on the pronated forearm of a child results in incomplete dislocation of the head of the radius • Part of the annular ligament becomes trapped between the radial head and the capitulum. • Reduction is affected by firm supination of the elbow to return the radial head back into place. Subuxation of the head of the radius “Pulled elbow” Annular lig. capitulum Radial head supination