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.

1. Dr.AkramJaffar
Imaging Anatomy of Fractures and Dislocations inImaging Anatomy of Fractures and Dislocations in
the Upper Limbthe Upper Limb
Dislocation of the elbowDislocation of the elbow
Akram Jaffar, Ph.D.
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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
Dislocation of the elbow
• Commonly dislocates posteriorly by an indirect force
such as a fall on the hand.
• Anatomical complications:
• Ulnar nerve injury.
• Injury of the brachial artery.
Ulnar n.
Radial
head
olecranon
humerus

5. Dr.AkramJaffar
Dislocation of the elbow
• Surface anatomy:
• The triangular relationship between the
olecranon and the two humeral condyles is
lost.
– With the arm bent, the three bony points
(medial epicondyle, olecranon, and
lateral epicondyle) should form a triangle
– A supracondylar fracture lies above the
three bony points, which therefore
remain in their triangular relationship to
each other
– In dislocation of the elbow, however, the
olecranon comes more or less in line
with the epicondyles
olecranon
Medial
epicondyle
lateral
epicondyle
norma Posterior dislocation Supracondylar fracture

6. 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

7. Dr.AkramJaffar
Anterior humeral and radiocapetellar lines
Supracondylar fracture
A radial head dislocation with an
olecranon fracture (Monteggia injury)
capitulum
capitulum