acute injuries around elbow Flashcards
(20 cards)
What are the three joints that form the elbow?
Radiocapitellar joint
Ulnohumeral joint
Proximal radioulnar joint
What movements does the elbow joint allow?
Flexion
Extension
Forearm rotation (supination/pronation)
What is the usual mechanism of elbow injuries?
High-energy impact
What is the ATLS priority in elbow injuries?
Life before limb
Neurovascular and soft tissue assessment
Proper documentation
What stabilizes the elbow joint?
Joint capsule
Ligaments
Crossing muscles
What is the most common direction of elbow dislocation?
osterolateral
(Both radius and ulna move posterolaterally)
What defines a simple elbow dislocation?
No associated fractures
What defines a complex elbow dislocation?
Associated fractures (e.g., radial head, coronoid, olecranon, capitellum)
What is the terrible triad of the elbow?
Elbow dislocation
Radial head fracture
Coronoid fracture
How is a posterolateral elbow dislocation reduced?
Traction on forearm
Counter traction on arm
Downward pressure on olecranon
Gentle elbow flexion
What is the next step after reduction of elbow dislocation?
Reassess neurovascular status
Control radiographs
Assess stability from 90° to 30° elbow extension
How are unstable elbow dislocations managed?
If re-dislocation at 60°: Reduce, flex to 90°, pronate, and immobilize in pronation
If unstable between 90° and 60°: Immobilize and refer to ortho for surgery
How are complex dislocations managed?
Attempt reduction
Immobilize in back slab
Urgent orthopaedic referral
Meticulous neurovascular assessment
How are undisplaced radial head fractures managed?
Arm sling for 3 weeks
Encourage early range of motion
How are angulated radial head fractures (>30°) managed?
Reduce
Immobilize in above-elbow back slab for 3 weeks
What is the role of a haematoma block in radial head fractures?
Relieves pain
Allows assessment for mechanical block to pronation/supination
When is surgery indicated for radial head fractures?
Mechanical block present
Displaced and non-reducible
Associated with elbow dislocation (manage as complex dislocation)
How are undisplaced olecranon fractures treated?
Conservatively
Immobilize in an above-elbow back slab for 4–6 weeks
Why do displaced olecranon fractures require surgery?
Triceps tendon pulls on olecranon
Disrupts the elbow extension mechanism
What are other surgical indications for olecranon fractures?
Open fractures
Trans-olecranon dislocations
Multiple ipsilateral/contralateral injuries
