Common Elbow and Wrist Conditions Flashcards Preview

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Flashcards in Common Elbow and Wrist Conditions Deck (33)
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1
Q

How does a medial epicondyle fracture result in ulnar claw?

A
  • Damages the ulnar nerve
  • There will be a loss of sensation over the medial 1 and 1/2 fingers of the hand, on both the dorsal and palmar surfaces.
2
Q

Dislocated elbow

A

Cause: FOOSH
Common in: Children and young adults
Symptoms: Pain, deformity and loss of function
Mostly posterior

3
Q

Pulled elbow

A

Subluxation of radial head/ ‘Nursemaid’s elbow’
Subluxation from annular ligament
Cause: Longitudinal traction along extended arm
Common in: 2-5 yrs
Symptoms: Reduced movements/ later pain

4
Q

Olecranon bursitis

A

Inflammation of bursa due to trauma or friction = ‘student’s elbow’
Presentation: Soft, cystic and transilluminates (shows its cystic not cellular)
Cosmetic concerns
Can become infected

5
Q

Colles fracture

A

Fracture of distal radius +/- ulna

Dorsal displacement and angulation, shortening

6
Q

Smiths fracture

A

Fracture of distal radius +/- ulna

Palmar displacement and angulation, shortening

7
Q

Scaphoid fracture

A

Cause: FOOSH
Common in: Teens and 20s’
Symptoms: Tenderness in anatomical snuffbox
Hard to see on X-rays
Delayed presentation
Limited blood supply - poor healing and avascular necrosis

8
Q

Where do the flexor muscles originate from?

A

The flexor muscles originate from the medial epicondyle.

9
Q

What is the cause of Volkmann’s ischaemic contracture?

A

Distal fracture of humerus - Direct damage, or swelling can cause interference to the blood supply of the forearm from the brachial artery. The resulting ischaemia can cause Volkmann’s ischaemic contracture – uncontrolled flexion of the hand, as flexor muscles become fibrotic and short. There also can be damage to the median, ulnar or radial nerves.

10
Q

What is the difference between tennis elbow and golfers elbow?

A

Typically, tennis players experience pain in the lateral epicondyle from the common extensor origin. Golfers experience pain in the medial epicondyle from the common flexor origin.

11
Q

How does a supracondylar fracture occur?

A

A supracondylar fracture occurs by falling on a flexed elbow. It is a transverse fracture, spanning between the two epicondyles.

12
Q

What are golfers/tennis elbow?

A

Sportspersons can develop an overuse strain of the common tendon – which results in pain and inflammation around the area of the affected epicondyle.

13
Q

What is the initial management of an elbow dislocation?

A
  • Sling or spintage
  • Analgeisa
  • NVT assessment (nerve, vessel, tendon distal to fracture)
  • X-Ray
14
Q

What is the definitive management of an elbow dislocation?

A
  • Closed reduction under sedation to relocate joint
  • Reassess NVT stability
  • Immobilisation
  • Re-X-ray
15
Q

What is the prognosis of someone with an elbow dislocation?

A

Good outcome if simple
Stiffness
Recurrent instability

16
Q

Supracondylar fracture of distal humerus

A

FOOSH
Normally age 5-7
Pain, marked swelling, bruising, no function
Neuromuscular compromise

17
Q

What are the complications that may arise from a supracondylar fractures of the distal humerus?

A

Neurovascular injury
Late deformity (cubitus valgus/varus)
Late neuropathy

18
Q

Radial head/neck fracture

A

FOOSH
Commonest elbow fracture
Lateral pain/ modest swelling/ loss of range
Occult fracture (not visible on imaging)
Fat pad sign

19
Q

What is the treatment for a radial head/neck fracture?

A
  • Sling and early range of motion if minimally displaced
  • Open reduction and internal fixation (ORIF)
  • Replacement of head
20
Q

What is the treatment for subluxation of the radial head?

A
  • Closed reduction = procedure to set a broken bone without surgery = manipulation of bone
  • Sling (spontaneous resolution)
21
Q

Elbow osteoarthritis

A
  • Degenerative disease of articular cartilage
  • Primary or secondary (post traumatic)
  • More common in males
  • Stiffness tolerated well esp. loss of extension
22
Q

Supracondylar fracture of distal humerus

A

Cause: FOOSH
Common in: Age 5-7
Symptoms: Pain, marked swelling, bruising, no function
Complications: Neuromuscular compromise

23
Q

Elbow rheumatoid arthritis

A

Systemic autoimmune disease
Commonest inflammatory arthropathy
Lining of the synovial membrane develops into a large mass of tissue (pannus) which leads to joint destruction.
Symptoms: Symmetrical polyarthropathy with morning stiffness

24
Q

What is lateral elbow tendinopathy?

A

Lateral epicondylitis/ tennis elbow
- Degenerative tendinopathy - common extensor origin
Cause: repetitive activity
5th-6th decades

25
Q

Radial head/neck fracture

A

Cause: FOOSH
Symptoms: Lateral pain/ modest swelling/ loss of range
Occult fracture (not visible on imaging)
Fat pad sign

26
Q

What are rheumatoid nodules?

A
  • Extra-articular manifestation of rheumatoid arthritis
  • Cosmetic concerns
  • Treatment: treat the underlying disease
27
Q

What is the treatment for olecranon bursitis?

A

Aspiration +/- injection

Surgery

28
Q

What is gouty tophi?

A

Disorder of nucleic acid metabolism leading to hyperuricaemia (build up of sodium urate crystals)

29
Q

Fracture of distal radius +/- ulna

A

FOOSH

Pain/swelling/ ‘dinner fork’ deformity

30
Q

What is the treatment for a scaphoid fracture?

A

POP cast - forearm or scaphoid

Surgery if displaced

31
Q

What is ulnar nerve neuropathy?

A
  • ‘Cubital tunnel sundrome’
  • Compressive neuropathy of ulnar nerve at elbow (beware of compression at wrist or neck)
  • Paraesthesiae, numbness and weakness
  • Hypersensitive ‘funny bone’
32
Q

How do you treat ulnar nerve neuropathy?

A
  • Splintage

- Decompression +/- anterior transposition of nerve

33
Q

When should you consider surgery for elbow conditions?

A

If the outcome is better than nature

Failure of non-operative treatment