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MSK 2 (F22) > Elbow Pathologies > Flashcards

Elbow Pathologies Flashcards

1
Q

Lateral Epicondalgia: MOI

A

Overuse/degeneration of ECRB tendon (wrist & elbow extension)

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2
Q

Lateral Epicondalgia: population/risks

A

35-55yr, highly repetitive UE routines (e.g., construction workers).

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3
Q

Lateral Epicondalgia: presentation

A

TTP: distal to lateral epicondyle.
Pain: sharp, stabbing.
Aggs: gripping, wrist ext, RD, finger ext.
AROM limited d/t pain, PROM usually WNL.
Impaired grip strength.
Weak shoulder ER = compensation with ECRB.

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4
Q

Lateral Epicondalgia: risk factors for degenerative

A

35-55yo
Symptoms >3mo
>1 episode

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5
Q

Lateral Epicondalgia: diagnostic test

A

ultrasound

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6
Q

Lateral Epicondalgia: surgery indications

A

If pain/disability remains after 6-12mo

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7
Q

Medial Epicondalgia: MOI

A

Repetitive microtrauma.
Involves:
Pronator Teres
FCR
Palmaris Longus

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8
Q

Medial Epicondalgia: presentation

A

TTP: medial epicondyle.
Aggs: stretching pronator mass (elbow & wrist ext, forearm supination).
Strength: may be compensating for weak shoulder IR.

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9
Q

Medial Epicondalgia: interventions

A

same as Lateral, but now focusing on forearm flexors instead of ext.

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10
Q

Distal Biceps Rupture: MOI

A

Overuse or traumatic (e.g., catching very heavy load).
GH elevation, elbow ext, forearm sup.
Violent pull of forearm into ext while biceps is contracting.

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11
Q

Distal Biceps Rupture: population

A

middle-age M > F

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12
Q

Distal Biceps Rupture: presentation

A

Popping, visual defect.
TTP antecubital fossa.
ROM/Strength: weak flexion/supination; may be WNL bc brachialis takes over elbow flexion.

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13
Q

Distal Biceps Rupture: surgical approaches & risks associated

A

Single-Incision Anterior Approach - lower risk of HO.
Double-Incision Posterior Approach - lower risk of neuropraxia.

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14
Q

Humerus Fx: population

A

12-19yo (M)
>80yo (F)

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15
Q

Humerus Fx: MOI

A

High-energy injuries (FOOSH from a ladder or MVC).

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16
Q

Humerus Fx: surgery indications

A

comminuted and/or fx within the joint.

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17
Q

Humerus Fx: surgical approaches

A

ORIF: best outcomes.
Total Elbow Arthroplasty: only if really bad, cant be stabilized with ORIF, elderly. No lifting >10lb restriction for LIFE.

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18
Q

Humerus Fx: non-operative treatment

A

Cast: no more than 2wks.
Hinged Brace: after cast comes off, allows F/E but protects lateral stability until healed.

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19
Q

Olecranon Fx: MOI

A

fall on elbow

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20
Q

Olecranon Fx: treatment

A

ORIF if displaced (most olecranon fx are displaced)

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21
Q

Radial Head Fx: MOI

A

FOOSH

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22
Q

Radial Head Fx: treatment for non-displaced

A

no surgery. AROM & 1wk in sling. If still fucked after 3 wks, refer to therapy.

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23
Q

Radial Head Fx: treatment for displaced

A

ORIF

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24
Q

Radial Head Fx: treatment for comminuted

A

radial head surgically removed

25
Q

Capitellum/Trochlea Fx: MOI

A

FOOSH

26
Q

Important considerations with elbow fractures

A

Avoid prolonged immobilization: elbow gets stiff FAST.
Avoid aggressive ROM too early: risk of HO.

27
Q

Dislocations: population

A

5-20yo athletes

28
Q

Dislocations: MOI

A

FOOSH

29
Q

What is the most common type of dislocation (direction)?

A

Posterior

30
Q

Dislocation: tx

A

Closed reduction
Sling & AAROM (1wk)
Compression sleeve for swelling
Return to sport 3mo

31
Q

Cubital Tunnel Syndrome: what nerve?

A

Ulnar

32
Q

Cubital Tunnel Syndrome: presentation

A

Sharp, ache at medial elbow.
Aggs: flexion.
Paresthesia: pinky & ring finger.
Strength: ↓ grip & lateral pinch.
If prolonged: thenar wasting, clawing, ABD of the pinky finger.

33
Q

Cubital Tunnel Syndrome: indications for non-op

A

No atrophy
Mild EMG findings

34
Q

Cubital Tunnel Syndrome: most common surgical procedure

A

Anterior Transposition

35
Q

Cubital Tunnel Syndrome: rehab

A

Avoid terminal flex.
Stretch pronator mass.

36
Q

Pronator Syndrome: compression sites

A

Ligament of Struthers
Bicipital Aponeurosis
Pronator Teres

37
Q

Pronator Syndrome: populations

A

F 4x > M
Age 50+

38
Q

Pronator Syndrome: subjective

A

Pain: prox forearm.
Aggs: forearm rotation, elbow motion.
Paresthesia: thenar eminence, thumb, index, middle, radial half of ring finger.

39
Q

Pronator Syndrome: rehab

A

STM to biceps, pronator teres, FDS.
Nerve glides/flossing.
Limit gripping & repetitive turning.
If highly irritable - Posterior Elbow Gutter Orthosis for 2wks.

40
Q

Radial Tunnel Syndrome: compression site

A

PIN

41
Q

Radial Tunnel Syndrome: subjective

A

Pain: burning, achy at extensor mass & distal forearm.
Weak: supination, wrist/digit ext.

42
Q

Radial Tunnel Syndrome: rehab

A

Stretch supinator & ECRB (pain-free range).
STM, nerve glides.
Off-shelf braces can make it WORSE - go with a custom orthosis.

43
Q

Olecranon Bursitis: MOI

A

trauma, infection, excessive rubbing/friction

44
Q

Olecranon Bursitis: presentation

A

Inflamed bulge where bursa is
Agg - flexion (pushes on bursa)

45
Q

Olecranon Bursitis: rehab

A

ice, US, regain ROM/strength.

46
Q

UCL Injury: MOI

A

Valgus stress on medial elbow (lateral blow to elbow).
May be combined with dislocation.
Most tears on humeral side of UCL.

47
Q

UCL Injury: risk factors

A

Pitching velocity & volume.
Throwing mechanics
Breaking Ball toss
Humeral Retrotorsion

48
Q

UCL Injury: presentation

A

Change in pitch stamina/strength.
Pain during cocking phase.
Ulnar N paresthesia.

49
Q

UCL Injury: indications for surgery

A

Complete tear = surgery required.
Incomplete tear = surgery if conservative fails after 3mo.

50
Q

UCL Injury: surgical options

A

Tommy John Surgery: splinted for 1 wk post-op, very specific protocol to follow.
Other: ASMI (modified Tommy John), Docking, and DANE-TJ.

51
Q

UCL Injury: conservative treatments

A

Throwers 10 Program, strength, ROM, address biomechanics.
Platelet-rich plasma.
Return to pitch 12-14wks.

52
Q

How does pitching cause humeral retrotorsion?

A

Throwing arm: excess shoulder ER & restricted IR = increased retrotorsion.
ER concentric during cocking phase, then ER eccentric during throw.

53
Q

Throwing stress on the elbow = ___x BW

A

5

54
Q

Proper pitch mechanics

A

Lead with hips
Hand on top position
Closed-shoulder position
Stride foot toward home plate
Elbow flex on ball release
Plant foot before trunk rotation.

55
Q

What type of pitch is a higher risk for UCL injury?

A

Sidearm pitch = more valgus stress than overhand pitch.

56
Q

Medial Epicondyle Apophysis: definition

A

UCL injury in age 12-13 - “Little League Elbow.”
Epiphyseal plate separates from medial epicondyle.
Same MOI/risks as UCL.

57
Q

Capsular Tightness causes

A

Prolonged immobilization post-injury

58
Q

Myositis Ossificans

A

Same as HO, but in muscle.
Causes: aggressive stretching post-injury.

59
Q

Myositis Ossificans treatment

A

Self-resolving process.
Immob 3-7 days, RICE.
Surgery if lesion matures despite conservative tx.

MSK 2 (F22) (17 decks)

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