Elbow and Forearm Flashcards
What motion of the forearm brings the radius and ulna into their maximal possible separation?
Supination. This is why forearms are usually casted in this motion when there is a radius / ulna fracture - don’t want any bone fusing between the two.
In a normal radiograph, the A/P view is taken with the shoulder in ER and elbow extended. How is it take for the forearm?
In supination.
Rheumatoid arthritis can present as red hot and swollen and often leads to a joint replacement. What does it affect at the elbow, and with a replacement, what is the most difficult element to maintain?
- flexion contracture
- ligamentous laxity
- crepitation (caused by excess loose bodies in jt)
-difficult for artificial joint to maintain 15* valgus carrying angle
With OA and DJD, there is a lack in ext that’s greater than the lack in fxn, which can result in arthroscopy to release capsule (extra flexibility) or reduce excess loose bodies. What are some causes of these diseases?
- end result of trauma
- excess osteophyte activity
- narrowing of joint space
- fxn contractures
Which muscle attaching to the lateral epicondyle is most affected in Tennis Elbow? Who is most commonly effected and what are some signs and treatment options?
The extensor carpi radialis brevis muscle.
- > 35 yo, racket sport or carpentry/paintin
- common signs: pain with grip, swelling, redness, loss of ROM
- Conservative Rx: RICE, NSAID
- Rx: DFM, stretching and strengthening (eccentric)
What muscles are most commonly affected with medial epicondylitis?
Predominantly pronator teres with some FCR
Olecranon bursitis presents as a boggy, hot, swollen posterior elbow. What are its causes?
Trauma, gout and often prolonged pressure on olecranon.
-ice, rest, NSAID
What is heterotropic bone and what are its precautions?
Bleeding in the muscle that can lead to myocitis osiphicans.
No stretching, US or STM
Which elbow ligament is tested with a vargus stress?
MCL - radial collateral ligament
With a biceps tendon rupture at the musculotendinous junction, what is the treatment protocol?
Velpeau bandage, 3-6 weeks at 90* fxn
With adolescent sport injuries the usual cause is excessive valgus stress. What force is associated with a medial joint injury and a lateral joint injury?
Medial = pulls (traction or tensile force at forearm)
- “Little leaguer’s elbow”
- inflammation of wrist flexors at insertion
- 15* loss of ext ROM
- avulsion with >force (tenderness at med ep)
- 1cm sep = ORIF
Lateral = compression at lateral joint
What is a common cause of osteochondritis dessicans?
Trauma or avascularity (necrosis)
- from pressure, osteochondral piece of capitellum fractures off and becomes loose body on joint
- 12 to 16 wks
What are the healing times like for extra-articular fractures vs intra-articular fractures?
EXTRA ARTICULAR FRACTURE
- healing time wont be too long
- closed redution
INTRA ARTICULAR FRACTURE
- possibility for long term dysfunction grows
- lateral condyle fx most common
Supracondylar fractures occur when the distal humerus shaft is fx and moves either anteriorly or posteriorly, named extension or flexion fractures respectively. Describe each.
EXTENSION
- Extra articular
- distal part of humerus goes posterior
- jagged piece can move into brachialis, radial artery or median nerve
FLEXION
- distal part moves anterior
- jagged humerus posterior
An intercondylar fracture is a type IV fx and usually requires ___?
ORIF due to amount of fragments
TENSION BAND WIRING
-on olecranon because of amount of force that’s put on it due to triceps insertion
