Effusions
into the elbow joint are commonly associated with undisplaced fractures of the
radial head due to trauma. These radial head fractures may be difficult to see
unless full projections are taken. The anterior and posterior fat pads are a
particularly useful guide in assessing an effusion, as both will be elevated
from their resting position against the distal end of the humerus. The two
views are again needed in trauma cases to show any dislocation with or without
associated fractures. A supracondylar fracture in children is particularly
important because of the risk of a Volkmann's contracture due to ischaemic
fibrosis.
When the forearm bones are x-rayed for trauma, it is essential to
have views of the joints at either end. This applies to any long bone
examination. Fractures of the forearm bones are often paired, and if single
fractures with displacement occur, then either wrist or elbow dislocation of
the other bone must be looked for. Examples of this are fracture of the ulna
with forward dislocation of the radial head (Monteggia) and fracture of the radial
shaft with distal radio-ulnar dislocation (Galeazzi).