Elbow dislocation Flashcards

1
Q

Two types elbow dislocation

A
  • Simple
  • Complex - concomitant fracture
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2
Q

Most common direction of elbow dislocation

A
  • 90% posterior
  • 50% get associated bony injury
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3
Q

Elbow joint stability - how?

A
  • Primary static stabilisers - humeroulnar joint, medial and collateral ligaments
  • Secondary static - radiocapitulum joint, capsule, common flexor and extensor origin tendons
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4
Q

What happens to elbow stabilising elements during dislocation?

A
  • Damaged if traumatic dislocation
  • Loss of all static stabilisation
  • = ongoing instability
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5
Q

Clinical features elbow dislocation

A
  • High energy fall
  • Painful and deformed elbiw
  • Swelling and decreased function
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6
Q

NV exam for elbow dislocation - what are the findings often

A
  • Deficit often found in ulnar nerve territory - common nerve injury
  • Good capillary refill can be found even if arterial injury - elbow has rich collateral circulation
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7
Q

X-ray findings of elbow dislocation

A
  • Loss of radiocapitellar and ulnotrochlea congruence
  • Anterior humeral line and radiocapitellar line help to identify
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8
Q

Management elbow dislocation

A
  • Closed reduction
  • Sufficient analgesia +/- sedation
  • Then above elbow backslab at 90 degrees
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9
Q

Methods for closed reduction of elbow dislocation

A
  • In line traction OR
  • Manipulation of olecranon
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10
Q

Management post reduction elbow dislocation - simple elbow

A
  • Position of arm dependent on soft tissue damage - if medial collateral ligament damaged, more secure supinated and vice versa
  • If simple: Immobilise and review 5-14 days as outpatient
  • Early rehab

THINK pronator teres comes from medial epicondyle, if damaged, weak

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11
Q

Management post reduction of complicated elbow dislocation

A
  • If #, open injury or NV compromise - operative fixation
  • ORIF with soft tissue repair
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12
Q

Complications elbwo dislocation

A
  • Stiffness - loss of terminal extension - early rehab and treatment reduce risk
  • Stretching of ulnar nerve
  • Recurrent instability
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13
Q

What is terrible triad?

A

Elbow dislocation +:
* Lateral collateral ligament injury
* Radial head #
* Coronoid fracture

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14
Q

Why is terrible triad bad? How do we fix it?

A
  • very unstable elbow
  • Associated with poor outcomes
  • Recurrent instability problems
  • Radial head and coronoid process ORIF with LCL reconstruction
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15
Q
A
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