Inability to Extend the Elbow After Acute Injury Predicts Fracture

The elbow extension test compares a patient’s ability to extend elbows on both sides while the arms are supinated and the shoulders are flexed to 90 degrees. Investigators prospectively examined the utility of the test for predicting fracture in 960 adults (age range, 16–94) and 780 children (age range, 3–15 years) who presented to five emergency departments in England with acute, isolated elbow injuries.

Adult patients with full extension did not undergo radiography; children underwent radiography at the discretion of the treating physician regardless of test results. Patients who did not undergo radiography were followed up by telephone assessment at 7 to 10 days, and those who met predefined criteria were recalled for radiography. Among 3…