Elbow Clinical Conditions

Question 1

Give 3 complications of supracondular fractures of the distal humerus.

Answer 1

Malunion - cubital varus - gunstock deformity
+/- damage - median, ulnar and radial nerves
Ischaemia contracture

Question 2

What is Ischaemia contracture and how does it cause the arm to present?

Answer 2

BA damage and reflex spasm of the collateral circulation around the elbow
Oedema and infarction results

Flexed elbow, wrist, pronated, hyperextended MCPJs, flexed IPJs

Question 3

Name 1 common and 2 less common complications of an posteriorly dislocated elbow.

Answer 3

MCL tear

+_/- ulnar nerve / fracture

Question 4

What is the mechanism for pulled elbow?

Answer 4

Longitudinal traction on arm when pronated.

Pronated due to annular ligament being more relaxed.

Question 5

What clinical sign is associated with pulled elbow?

What causes this sign?

Answer 5

Fat pad sign

Displacement of anterior fat pad due to haemarthrosis

Question 6

What is used to treat tophi gouty?

Answer 6

Xanthine oxidase inhibitors