Arthrographic diagnosis of elbow injuries in children.

A prospective study was established to evaluate the value of arthrography in children with a variety of elbow injuries. Thirty-six arthrograms were performed on children with an average age of 3.8 years at an average of 20 h from the time of injury. The diagnosis made on the basis of standard radiographs was confirmed for 17 patients, and the initial diagnosis was altered for seven (19%). More important was that the treatment of these seven patients was altered by the arthrographic findings. Six of these seven were candidates for surgical management until arthrographic evaluation indicated a different diagnosis or that they could be treated nonoperatively. Elbow arthrography is recommended in skeletally immature patients whose diagnosis is in doubt. This technique is particularly helpful in humeral condylar fractures.