[Elbow fractures in children; how do we minimize the risk of missing a fracture?]

Elbow fractures in children represent a frequent but diagnostically challenging presentation in both primary and secondary care. Due to multiple ossification centers and often subtle clinical signs, these injuries are at risk of being overlooked. Missed fractures may result in malunion, growth disturbances, chronic pain, or long-term functional impairment. This review highlights three commonly underdiagnosed fracture types: medial epicondyle fractures, lateral condyle fractures, and supracondylar humeral fractures. Using illustrative case material, we discuss key aspects of clinical evaluation, pitfalls in radiographic interpretation, and the importance of systematic assessment of neurovascular status. In cases of persisting pain with initially normal radiographs, additional imaging such as oblique X-rays, ultrasound, or CT should be considered. Structured follow-up and timely referral to pediatricorthopedic expertise are essential to prevent complications. With a pragmatic, knowledge-based approach, clinicians can significantly reduce the risk of missed diagnoses and optimize functional outcomes for pediatric patients.