Elbow Disease

Question 1

Peak age for supra condylar fracture

Most common mechanism of action

Answer 1

5-7 years old
FOOSH with elbow extended

Question 2

Presentation of a supracondylar fracture

Answer 2

Sudden severe pain
Gross deformity
Swelling
Low ROm
Echymossis of the antecubital fossa

Question 3

Investigations for supracondylar fracture

Answer 3

Plain film radiograph

Anterior and lateral views

On lateral view in fracture:

Posterior fat pad can be seen
Displacement of the anterior numeral line (should be in middle third of the capitellum)

Question 4

Neurovascular status following SC fracture

Answer 4

Check radial and ulnar pulse
Hand pink or pale
CRT

Median nerve and ant interosseous nerve injury most common - median (finger flexion) and and AIN pincer

Question 5

Classification of supracondylar fracture

Answer 5

Gartland classification-

Type 1 - undisplaced
Type2- displaced with an intact posterior cortex
Type 3- displaced in two or three planes

Question 6

Immediate managment of supracondylar fracture and mx dependent on type

Answer 6

Immediate closed reduction- most will need K wire fixation also

Type 1 can have conservative mx with above elbow cast at 90 degrees

Type 2 and above need closed reduction of fracture with percutaeneous k wire

Question 7

Pulseless arm in supracondylar fracture

Answer 7

Elbow splint
Discuss with vascular and plastics

Question 8

Unable to reduce supracondylar fracture

Answer 8

Open reductiom