Snapshot A 35-year-old man presents to the emergency room for severe right elbow and forearm pain after sustaining a blunt injury to his right arm. On examination, the affected arm is swollen and tender around his elbow. Radiographs demonstrate a displaced fracture of the proximal ulnar diaphysis and radial head dislocation. Introduction Clinical definition traumatic injury to the elbow and forearm characterized by the presence of two bony injuries login to view 2 more bullets Prognosis Unfavorable delayed diagnosis login to view 1 more bullet Epidemiology Incidence less common than other types of serious elbow injuries in children (e.g., supracondylar fracture, radial head subluxation, and lateral condylar fracture) Demographics more common in children than adults login to view 1 more bullet Etiology Traumatic injury Fall On an OutStretched Hand (FOOSH) direct blow to the ulna Pathoanatomy normal anatomy of the elbow and forearm login to view 7 more bullets fracture mechanics login to view 2 more bullets Associated conditions may occur with other traumatic injuries to the elbow and forearm login to view 4 more bullets Presentation Symptoms elbow pain and swelling Physical exam tenderness to palpation along the elbow decreased elbow range of motion due to pain radial head may be palpable if significantly dislocated Imaging Radiographs indication login to view 1 more bullet finding login to view 3 more bullets Differential Galeazzi fracture distinguishing factors login to view 2 more bullets Supracondylar fracture distinguishing factors login to view 1 more bullet Treatment Conservative closed reduction +/- intramedullary fixation and casting login to view 2 more bullets Operative open reduction and internal fixation (ORIF) login to view 2 more bullets Complications Posterior interosseous nerve (PIN) palsy generally, a neuropraxia caused by anterior displacement of the radial head spontaneous recovery is expected