Approach to pediatric patients with elbow injuries in the emergency department

Pediatric elbow injuries are a common complaint presenting to emergency departments. The unique anatomy and skeletal immaturity in children can make the elbow particularly difficult to evaluate and manage. Additionally, many healthcare institutions have limited or no access to pediatric orthopedic specialists, leaving management decisions to the clinician at the bedside. This review highlights the nuances of the pediatric elbow examination, addressing both acute and subacute (overuse) injuries. Common fracture types are reviewed, and key principles of x-ray interpretation are demonstrated, including recognition of normal variants and ossification centers. Management strategies are outlined, with an emphasis on identifying which patients can be safely managed without orthopedic consultation and which require more urgent care at a pediatric center with access to pediatric orthopedic specialists.