MSK term 3 elbow surgeries

Question 1

loose body removal
tendon debridement

Answer 1

common orthopedic elbow debridements

Question 2

osseous and chondral common ortho elbow surgeries

Answer 2

ORIF
OCD lesion management
-microfracture
-OATS

Question 3

common repairs for ortho elbow surgeries

Answer 3

UCL repair
-direct repair
-internal brace
Tendon repairs
-distal biceps
-distal triceps

Question 4

common reconstruction of ortho elbow surgeries

Answer 4

UCL reconstruction “tommy john”
lateral collateral complex reconstructions

Question 5

arthroplasty of elbow

Answer 5

total elbow arthroplasty
radial head arthroplasty

Question 6

decompression of ortho elbow surgeries

Answer 6

ulnar nerve transposition

Question 7

ORIF
open reduction internal fixation

Answer 7

open reduction:
incision is made. fracture is reduced to anatomical position
internal fixation:
fixation device is used to stabilize fracture. fracture then stabilized below and above fracture line

Question 8

elbow ORIF - people who have had elbow fracture or elbow dislocations with concomitant fracture

precautions / restrictions ?

Answer 8

follow boney healing timelines
immobilized after surgery
when appropriate, PT starts with gentle PROM / AAROM
bone healing timelines are roughly 6-8 weeks , depending on patients demo

Question 9

bony healing timeline

Answer 9

6-8 weeks
if have OP or older person, may be 8-10 weeks

Question 10

elbow ORIF will probably have stabilization and immobilizations which =

Answer 10

stiffness

Question 11

complications of elbow ORIF

Answer 11

non union
infection
pain from fixation hardware
stiffness

Question 12

can repeat radiographs after surgery to see what stage of healing they are in

Answer 12

yeah

Question 13

supracondylar fracture

Answer 13

A supracondylar fracture is a break in the humerus bone, located in the upper arm, above the elbow joint
Children: Supracondylar fractures are most common in children under 8 years old.

Question 14

lateral condylar fracture

Answer 14

The fracture occurs on the lateral condyle of the humerus, a bony structure located on the outer side of the elbow joint.
Treatment: Treatment options vary depending on the severity of the fracture:
Conservative: Nondisplaced fractures (less than 2 mm of displacement) may be treated with immobilization, such as a cast or brace, for 4-6 weeks.
Surgical: Displaced fractures (more than 2 mm of displacement) may require surgery to realign the bone fragments and hold them in place with pins, screws, or plates. this part from google

Question 15

medial epicondyle avulsion fracture

Answer 15

A medial epicondyle avulsion fracture is a common elbow injury, particularly in young athletes, where the bone on the inner side of the elbow (medial epicondyle) is pulled away from its attachment site due to a forceful event, often a valgus stress or a fall

Question 16

radial head fracture 1 2 3

Answer 16

1 intraarticular fracture
2 displaced fracture
3 comminuted fracture

Question 17

monteggia fracture

Answer 17

anterior dislocation of radial head with
fracture of proximal 1/3 of the ulna

Question 18

OCD lesion of capitellum
stable or unstable

Answer 18

stable no loose body, small lesion probably
unstable means loose body, large lesion probably

Question 19

OCD lesion surgical management
precautions / restrictions

Answer 19

range of motion is encouraged early and often
restricted weight bearing for a period of time
NO heavy lifting for at least 12 weeks

Question 20

no heavy lifting for at least ___ weeks is a restriction following a OCD lesion post op

Answer 20

12 weeks no heavy lifting for OCD lesion surgical management

Question 21

complications with OCD surgery

Answer 21

infection
OAT graft failure
stiffness
graft donor site complications (pain/effusion)

Question 22

3 types of surgery can be done for OCD lesion

Answer 22

1. drilling
2. debridement/microfracture
3. fragment fixation by means of bone grafting or OAT
   (also loose body removal)

Question 23

OATS

Answer 23

osteochondral autologous transfer system
usually taken from non weight bearing portions of the lat femoral condyle transferred to elbow, your own bone to repair

Question 24

UCL repair with internal brace
why this one

Answer 24

the native ucl is repaired using an internal brace or a surgical tape dipped in collagen, proximal or distal avulsion tears only. cannot be performed with mid substance tears. faster recovery . can be converted to ucl reconstruction if it fails. used mainly on highschool athlets at this time

Question 25

UCL reconstruction (tommy john surgery)

Answer 25

a graft is used to reconstruct the ucl increased iatrogenic tissue damage due to bone tunnels, graft harvest slower recovery, but more long term data used for high level collegiate and pros

Question 26

UCL repair with internal brace, return to throwing around.....

Answer 26

16 weeks (3.5-4 months)

Question 27

UCL reconstruction , return to throwing around....

Answer 27

22 weeks (5 months) full return to pitching, 13 months average graft options ipsilateral palmaris longus contralateral gracilis

Question 28

ucl repair/reconstruction precautions restrictions

Answer 28

avoid valgus stress gradual opening of brace to improve ROM faster for ucl repair, slower for ucl reconstruction

Question 29

ucl repair/reconstruction possible complications

Answer 29

infection, pain stiffness, ulnar nerve injury heterotopic ossification

Question 30

ulnar nerve transposition is for who ?

Answer 30

used to treat ulnar neuritis at the level of the cubital tunnel overhead throwers manual laborists desk workers boxers

Question 31

ulnar nerve transposition precautions/restrictions

Answer 31

usually a period of immobiliations followed by slow reintroduction of ROM after 6 weeks, if no issues, can start progressing slowly back towards desired goals greater than 12 weeks for return to throwing if in combo with ucl repair/recon then follow that protocl and be aware of the UN symptoms

Question 32

ulnar nerve transposition possible complications

Answer 32

iatrogenic injury to the nerve failed fascial sling, leading to recurrent instability recurrent ulnar nerve symptoms

Question 33

distal bicep repair precautions/restrictions

Answer 33

gradual opening of brace over time to allow for more elbow extension avoid RESISTED SUPINATION and elbow FLEXION AROM at 6 weeks light isotonics at 10 weeks strength training principles at greater than 12 weeks if tolerable

Question 34

distal biceps tendon repair possible complications

Answer 34

tendon repair failure, lose length tension relationship loss of elbow rom due to stiffness proximal radioulnar synostosis infection posterior interosseous nerve palsu complex regional pain syndrome

Question 35

distal triceps tendon repair precautions/restrictions

Answer 35

full passive elbow extension allowed limit elbow flexion to 90 degrees 0-6 weeks avoid weight bearing on operative arm gradual progression back into elbow flexion ROM from 6-12 weeks AROM at week 6 light isotonics at week 10 greater than 12 weeks begin slow prog back into weight training NWB for at least 8 weeks

Question 36

total elbow arthroplasty

Answer 36

TEP