Common injuries

Question 1

Golfers elbow

Answer 1

Medial epicondyle from repetitive flexion

Question 2

Tennis elbow

Answer 2

Lateral epicondyle from repetitive extension (think of backhand)

Question 3

Unhappy Triad

Answer 3

MCL, ACL, medial meniscus

From lateral force to a planted leg

Question 4

Baker Cyst

Answer 4

Popliteal fluid in gastrocnemius and semi membranous bursa behind knee

Question 5

Green stick fracture

Answer 5

Incomplete fracture of only part of width of bone following bending stress in pediatrics

See bent bone

Green twig

Question 6

Torus fracture

Answer 6

Axial force to immature bone

Simple and subtle buckle fracture of cortex

In pediatrics

Question 7

Fall on out stretch hand

Answer 7

Scaphoid most commonly fractured

May have avascular necrosis because retrograde blood supply

Question 8

Which meniscus is more commonly injured?

Answer 8

Lateral

Question 9

Humerus fractures by distance along bone

Answer 9

Surgical head - axillary nerve so flat deltoid and minimal abduction

Midshaft - radial so no elbow, wrist or finger extension and problem with sensation on posterior forearm

Supracondylar- median so no wrist flexion, lateral finger flexion, thumb opposition, sensation in median distribution

Question 10

Erb Palsy

Answer 10

Upper trunk injury from trauma or lateral traction on infant neck in delivery

Ancillary, musculocutaneous and suprascapular nerves

Deltoid, suprapsinatous, infraspinatous and bicep

Waiters tip - pronated, medially rotated and by side

Question 11

Klumpke Palsy

Answer 11

Lower trunk injury- grabbing a tree to break a fall

Ulnar damage - all intrinsic hand muscles and hypothenar

Complete claw because lumbricals cannot extend fingers

Question 12

Thoracic Outlet Syndrome

Answer 12

Compress lower trunk and subclavian vessels (as they pass thru scalene triangle - anterior scalene, middle scalene and first rib)

Can be caused by anomalous cervical rib, scalene muscle anomalies or injury form repetitive overhead arm movements)

Same total claw plus atrophy of hand muscles, ischemic pain and edema

Question 13

Winged Scapula

Answer 13

Long thoracic nerve lesion (stab in front of chest or axillary node dissection)

Cannot anchor scapula to thoracic cage because serratious anterior not innervated

Question 14

Distal v Proximal Ulnar Nerve Damage

Answer 14

Distal - at rest the pinky and ring finger cannot extend (ulnar claw) because flexor still intact but lumbricals not

Proximal- less pronounced, when make fist cannot bend pinky and ring into fist

Question 15

Distal v Proximal Median Nerve Lesions

Answer 15

Distal - at rest index and middle finger bent (median claw) because no lumbricals and unopposed flexors

Proximal - less pronounced, cannot bend middle, index and thumb into fist (popes blessing)

Question 16

Common Causes of Avascular Necrosis

Answer 16

CAST Bent LEGS

corticosteroids
Alcoholism
Sickle cell
Trauma

The bends

LEgg-Calve-Perthes disease
Gaucher Disease
Slipped capital femoral epiphysis

***insufficient medial circumflex femoral artery around femoral head

Question 17

Nursemaid’s Elbow

Answer 17

Sudden traction on outstretched, pronated arm in kids (ex - falling while holding someone’s hand)

Results in subluxation of radial head as the annular ligament is torn; ligament moves into the space between radial head and humerus at elbow joint

Present w/ arm pronated and extended

Pain when try to manipulate elbow

Question 18

Piriformis Syndrome

Answer 18

Hypertrophy or muscle injury to piriformis causes compression of sciatic nerve because both run in greater sciatic foramen

Symptoms = butt / posterior thigh pain + pain w/ adduction of flexed thigh and abduction of extended thigh

Piriformis responsible for adduction of flexed thigh and abduction of extended thigh

Question 19

Osgood Schlatter Disease

Answer 19

Repetitive quad contraction (esp in teen males)

Pain and swelling at tibial tuberosity

Quads attached to patellar ligament which inserts at tibia tuberosity (can separate from tuberosity w/ use)