elbow

Question 1

what would an anterior glide at the humeroradial joint improve?

Answer 1

flexion

Question 2

what would a posterior glide at the humeroradial joint improve?

Answer 2

extension

Question 3

what would an anterior glide at the proximal radioulnar joint improve?

Answer 3

supination

Question 4

what would a posterior glide at the proximal radioulnar joint improve?

Answer 4

pronation

Question 5

what are the tests for lateral epicondylagalgia?

Answer 5

-cozens
-mills
-third finger test
-palpatoin

Question 6

what are the tests for cubital tunnel syndrome/which nerve is affected?

Answer 6

ulnar n
-elbow flexion test
-shoulder IR test
-froments sign
-wartenburg sign
-tinnels sign

Question 7

what is the floor of the cubital tunnel

Answer 7

UCL

Question 8

As part of your differential diagnosis consideration, if a patient complains of elbow locking, which of the following diagnoses is most likely?

Answer 8

loose body in the joint/OCD

Question 9

what is the history of cubital tunnel syndrome

Answer 9

-repeptive activities
-trauma: hyperext, dislocation, UCL lax
-chronic compression

Question 10

what is non-surgical intervention for cubital tunnel syndrome

Answer 10

-control pain and edema
-night orthosis
-elbow pads

Question 11

what is the most frequently injured nerve in humerus fractures?

Answer 11

radial

Question 12

what is the history of a high radial nerve injury

Answer 12

-fracture of humerus
-strenous exercise
-extended crutch ambulation

Question 13

what are special tests for radial tunnel syndrome

Answer 13

-third finger sign
-reproduction of symptoms with direct pressure over nerve

Question 14

what is pronator syndrome

Answer 14

compression of the median nerve between humeral and ulnar heads of pronator teres

Question 15

where are the compression sites for anterior interosseous synrome

Answer 15

between muscle bellies of two heads of pronator teres

Question 16

what is lateral epicongylitis/algia

Answer 16

tennis elbow
-most common elbow issue
-inflammation of common extensor tendon
-extensor carpi radialis brevis

35-60 typical age
-younger high volume training athletes
-can be a result of cervical radiculopathyu at C5-6

Question 17

what is the lateral elbow pain differential dx

Answer 17

1. cervical radiculopathy
2. TOS
3. radial tunnel syndrome
4. radial head injury/OA

Question 18

are injections beneficial for lateral elbow pain?

Answer 18

worse in the long run
-surgery only if conservative tx has failed

Question 19

what is medial epicondyltis/algia

Answer 19

golfers/pitchers elbow
-forceful rep contractions of: prontator teres, FCR, FCU

-be sure to evaluate for laxity or ulnar n sypmtoms

Question 20

what should you assume if a 10-14 year old is having medial elbow pain?

Answer 20

assume apophysitis
NO HSR OR ECCENTRICS

Question 21

what is osteochondritis dessicans?

Answer 21

unknown etiology
-associated with gymnastics and throwing
-trauma and vascular insufficiency
-aged 15-20
-males>females

symptoms:
-joint effusion, limited ROM
-pain w activity, locking
-constant pain, ADL impairments

Question 22

what is snapping elbow

Answer 22

-lateral elbow pain with palpable/audible snapping that occurs during flex/ext over radial head
-subsequent to trauma/hyperext injury
-repetivie stress
-pain may limit function

Question 23

what is the differential dx of snapping elbow

Answer 23

-posteriolateral rotary instability
will have radial head translation/instability
sense of instaiblity with WB

-lateral epi

-OCD with loose body

Question 24

what is the mechanism of an elbow dislocation

Answer 24

FOOSH

Question 25

which direction elbow dislocation is most common

Answer 25

posterior ulna no longer articulates w humerus

Question 26

what are some associated fractures w an elbow dislocation

Answer 26

radial head coronoid epicondyles

Question 27

what is a posterior elbow dislocation due to

Answer 27

hyperext

Question 28

what is an anterior elbow dislocation due to

Answer 28

rare -fracture of olecranon and tearing of joint capsule and ligaments

Question 29

what is a lateral elbow dislocation due to

Answer 29

superior lateral displacement of radius

Question 30

what is a medial elbow dislocation due to

Answer 30

rare direct trauma

Question 31

what is the tx of an elbow dislocation with no fracture present

Answer 31

-gentle closed reduction (axial traction, unlock coronid in ext, reduce and flex) -check stability -check radiographs -splint/brace for 2 weeks

Question 32

explain the protection phase of an elbow dislocation

Answer 32

typically immob at 90 for 7-10 days -progresively begin to regain ROM at around 14 days post injury -younger immobilize for longer -early mobilize quicker to prevent stiffness

Question 33

which kind of fracture is seen in 10% of elbow dislocations?

Answer 33

coronoid -contributes to ant stability and brachialis insertion

Question 34

talk about biceps tendon rupture

Answer 34

almost exclusively in males -domniant elbow -happens w sudden contractino of biceps against significant load with the elbow in 90 degrees of flexion -need to see orthopedist ASAP as outcomes are better if they get surgery in first 24-48 hours

Question 35

talk about late cocking

Answer 35

acceleration -primary valgus force at elbow occurs during late cocking through acceleration

Question 36

what is valgus extension overload syndrome

Answer 36

-secondary to medial instability -impingement of medial olecranon on trochlea and olcecranon fossa -may lead to osteophyte formation, loose bodies, chondromalacia

Question 37

what are valgus extension overload syndrome S&S?

Answer 37

-pain in full ext, accentuated by valgus stress -possible flexion contracture

Question 38

what is a lateral compression injury

Answer 38

radiocapitellar overload syndrome -secondary to medial instability -abutment of radial head against capitulum -may lead to osteophyte formation, loose bodies, chondromalacia, OCD

Question 39

which kind of elbow instability is rare

Answer 39

varus

Question 40

describe screening for elbow fx

Answer 40

elbow trauma plus 1 of the following 1. unable to fully extend the elbow 2. specific bony tenderness over: -radial head -medial epicondyle -lateral epicondyle -olecranon process 3. bruising/prescent of ecchymosis around elbow

Question 41

what are the FOOSH possible fracture sites at the elbow

Answer 41

forces through radius: -radial head on capitulum -radial head fracture forces through ulna: -ulna on humerus -fracture of either coronoid or olecranon