Chapter 84 - Elbow Injuries in the Athlete

Question 1

what is the blood supply to the capitellum?

Answer 1

radial recurrent a
interosseous recurrent a

Question 2

what is the mechanism of injury in OCD of the wlbow

Answer 2

repetitive massive compressive loads (gymnasts)
repetitive large valgus loads (throwers)

Question 3

indicators of good prognosis for an elbow OCD lesion?

Answer 3

• open physis
• localized flattening of the subchondral plate
• no fluid behind the lesion

Question 4

indicators of poor prognosis on an elbow OCD lesion?

Answer 4

• closed physis
• fluid behind the lesion (unstable)
• restriction of elbow motion > 20 degrees on presentation

Question 5

best predictor of good non-operative outcome in a stable OCD lesion?

Answer 5

younger age, skeletally immature

Question 6

MCL complex of the elbow has how many bands?

Answer 6

3:
anterior oblique (primary restraint to valgus stress) - inserts on the sublime tubercle
posterior oblique (gets contracted in elbow flexion contracture)
transverse

Question 7

with regard to the anterior limb of the mcl, how many arms is it made of?

Answer 7

anterior band -
- tight in extension

posterior band
- tight in flexion

Question 8

what phase of throwing puts greatest force on medial elbow

Answer 8

late cocking, early accelerations

Question 9

when reconstructing the MCL (anterior oblique ligament specifically) what should you do with the ulnar nerve?

Answer 9

leave it in place unless they had pre-op ulnar nerve sx

Question 10

clinical presentation of valgus extension overload

Answer 10

posteromedial elbow pain during the DECELERATION phase of throwing

loss of terminal extension, possible flexion contracture

pain when elbow is forced into extension

Question 11

XR findings in valgus extension overload

Answer 11

posteromedial olecranon fossa osteophytes

Question 12

complications of elbow arthroscopy for valgus extension overload

Answer 12

overagressive olecranon resection can result in valgus instability of the elbow