Severe pain in the elbow, pressure swelling may be accompanied by subcutaneous bruising, mostly caused by fracture, fracture displacement may be serious with the lower humerus transverse diameter widening, overlapping displacement may be heavy with the upper arm shortening deformity. The elbow joint is semi-extended, the forearm is rotated forward, the bony structure of the posterior triangle is disturbed, the fracture block can be palpated, and the bone rubbing sensation is obvious. Sometimes nerve and blood vessel injury may be combined, which should be noted during the examination. Three major diagnostic criteria for severe pain, pressure and swelling in the elbow: 1. Inquiries about the injury include the cause of injury, time, place, body position at the time of injury and what part of the body hit the ground first. 2.Comprehensive physical examination Pay attention to the presence of shock, soft tissue injuries, bleeding, check the size, shape, depth and contamination of the wound. With or without bone end exposure, with or without nerve, vascular, cranial, visceral injury and other parts of the fracture. For serious injuries must be carried out quickly. 3.X-ray examination In addition to frontal and lateral x-ray, special body positions should be taken according to the injury, such as open position (upper cervical spine injury), dynamic lateral position (cervical spine), axial position (navicular bone, heel bone, etc.) and tangential position (patella). For complex pelvic fractures or suspected intravertebral fractures, body films or CT examinations should also be performed as appropriate.