Elbow is a complex joint which is frequently involved in injuries usually secondary to indirect trauma.
It has been estimated that up to 15% of upper extremity's injuries which visit the emergency department annually involve the elbow.
Distal humerus fractures can appear in both condyles often in continuation with the joint space and represent the 2% of adult fractures.
Location determines the classification of distal humerus fractures.
There are fractures of radial head,
olecranon and coronoid process and combined fractures and dislocations.
AO Classification of fractures is introduced by Müller ME et al and published by AO Foundation at 1987.This method categorizes injuries taking into account their treatment and prognosis .It was validated by Audigé L et al at 2004 and it is remain in use still today.
It is also provides a framework for the recognition ,
identification and description of the long bones fractures.
In this classification system first it is described the fracture localization ( bone and segments).
Different colors are used to denote the progressive levels of severity.
The long bones are divided in three segments from proximal to distal numbered 1,2 and 3 respectively.
The proximal and distal segment are defined by length of the widest part of the epiphysis.
The center of fracture has to be determinate.
It has to determined the type of the fracture ( simple,wedge,complex) and numbered with A,B and C respectively.
The metaphyseal/epiphyseal fracture types are distinguished in extrarticular (A) ,partial intraarticular (B) and complete intraarticular (C).In partial intraarticular fractures a part of joint remains in continuity with diaphysis and in complete ones no part of joint remains in continuity with diaphysis .There are four types of partial articular fractures: a) pure split,
resulting from a shearing force,
in longitudinal direction of the split b) pure depression,
central or peripheral ,without c) split-depression ,a combination of a split and a depression,
with separation of joint fragments and d) multifragmentary depression,in which part of the joint is depressed and the fragments are completely separated.
Although radiography is the initial imaging of choice,
the availability of computed tomography (CT) for the assessment of comminuted and radiographically occult fractures at the emergency departments has increased.The multislice CT scanners with multiplanar reformation make accurate imaging of elbow fractures possible.
It can show precise details of the fractures since more bone fragment can be identified.
A better understanding of the normal anatomy and the various injury mechanisms from the radiologists improves the meaningful interpretation of different CT imaging elbow fracture patterns whereas the use of a standard classification such as the AO/OTA Trauma Classification leads to a better communication with orthopaedic surgeons and consequently the assistance of the appropriate surgical planning.
The aim of this retrospective study was to review multidetector computed tomography (MDCT) examinations of a large group of elbow trauma patient in order to describe different elbow fracture patterns using AO/OTA trauma classification system