- Definition:
- displacement of less than 2 mm;
- no increase in minimal degree of separation of 90 deg flexion of elbow;
- usually frx gaps dorsally, and some separation of fragments occurs, which leads to joint incongruity;
- dorsal gapping w/ displacement of proximal fragment blocks extension;
- patients are able to extend the elbow actively against gravity;
- Treatment:
- treated by immobilization in long arm cast w/ elbow in 45 deg to 90 deg of flexion for a short time;
- do not place elbow in full extension (stiffness), & if frx is not stable in flexion, it will not be stable in extension;
- expect bony union in 6-8 weeks, but after 3 weeks, begin ROM, avoiding flexion past 90 deg until bone healing is complete radiographically;
- in elderly pts, period of immobilization should be even < 3 weeks;
- try a sling for a few days until the pt is comfortable for ROM;
- despite immobilization, be wary of displacement as triceps pull is frequently sufficient to cause displacement