Flashcards in The Elbow Joint & Pathology Deck (19):
What are the articulating surfaces?
H. Trochlea with the trochlear notch of u.
H. Olecranon fossa with the olecranon process of u.
H. Capitulum with the head of the radius
Nb the joint capsule also contains the proximal radio-ulnar joint
What type of joint is the elbow?
Which muscles produce the movements?
170 degree full extension of the ulna and humerus
Biceps brachii, triceps brachii and brachioradialis
What is the structure of the ulnar collateral ligament?
Composed of three separate bands
Anterior band is the strongest
Posterior band is a characteristic fan-shaped ligament
Oblique band runs in the trochlea notch. It deepens the socket to enhance the stability of the elbow joint
What is the structure of the radial collateral ligament?
Broad fan-shaped ligament
Blends with the anular ligament
Where is the anular ligament attached?
Both posteriorly and anteriorly to the radial notch of the ulnar
What are the two bursae of the elbow joint which may be problematic?
Subcutaneous olecranon bursa
Subtendinous olecranon bursa
What is the nerve supply to the elbow joint?
Anterior: radial, median, musculocutaneous
The radial nerve passes anterior to the lateral epicondyle
The ulnar nerve passes posterior to the medial epicondyle
What is Hilton's Law?
The nerves to the muscles acting on a joint give branches to that joint as well as the skin over the area of action of these muscles
What is the blood supply of the elbow joint?
Recurrent and collateral branches off the brachial and deep brachial arteries
What happens in pulled elbow?
More common in children especially when they are held by their hand and swung in the air
The anular ligament is soft and the head of the radius subluxates from the anular ligament
What happens in a supra-condylar fracture?
Occurs when falling on to a flexed elbow
The fracture fragments can rupture the brachial artery
The muscles of the anterior forearm become ischaemic and shorten to produce s flexion deformity known as Volkmann's contracture
What is meant by tennis elbow?
Aka Lateral epicondylitis
Pain over the common extensor tendon which attaches to the lateral epicondyle of the humerus (origin for FCRB, FCU and extensor digitorum)
What is the clinical presentation of tennis elbow?
Risk groups: women, fifth decade of life, jobs around the house like painting, tennis
Pain over the lateral elbow, worse with extension of the wrist, also pain when pressure is applied to the origin of the common extensor tendon
What are the management options in tennis elbow?
Advise modifying activity is possible
NSAIDs topical over oral
If persistent, consider corticosteroid injections
Referral to physiotherapy
Use of an orthosis (eg forearm brace is positive extensor grip test)
Consider specialist referral
What is meant by cubital tunnel syndrome?
Compression of the ulnar nerve at the elbow
Leading to hypothenar wasting, ulnar claw, paraesthesia
What is meant by Golfer's elbow?
Inflammation of the common flexor tendon which attaches to the medial epicondyle of the humerus (PFPF) aka medial epicondylitis
What is the clinical presentation of Golfer's elbow?
Pain over the medial aspect of the elbow joint
The pain is worse with griping movements, flexion of the wrist and pronation - rock climbing, turning and screwing
What happens in fractures of the olecranon?
Bimodal distribution - low energy in the elderly, high trauma in the young, direct blow/ fall on to limb
Presents with pain, palpable mass if fracture fragment displaced, loss of extension at the elbow due to disruption of the triceps mechanism
Imaging: AP, lateral, radicapitellar views