Conditions of the elbow Flashcards
What type of fracture will falling on outstretched arms cause
Supracondylar fracture of distal humerus
Complications of supracondylar fracture
Malunion resulting in cubitus virus
Damage to the median nerve, radial or ulnar
Ischaemic contracture
What are most elbow dislocations
Posterior
What happens during an elbow dislocation
Distal end of humerus is driven through joint capsule anteriorly
Ulnar collateral ligament is usually torn and there is associated fracture
Ulnar nerve damage
How are elbow dislocations named
Displacement of the distal fragment (ulna and radius) not proximal (humerus)
What is a pulled elbow
Sublaxation of the radial head
Mechanism of injury- when longitudinal traction is applied to the arm with forearm pronated
Why is sublaxtion more common in pronation
The annular ligament is taut in supination and more relaxed in pronation so sublaxation is easier
What happens in subluxation of radial head
Longitudinal traction on the radial head tears the distal attachment of the annular ligament from where it is loosely attached to the neck of the radius
Radial head is displaced dismally through the torn ligament
What is seen in radial head and neck fractures
Fat pad sign which indicates than an effusion is present which is due to a haemarthrosis
Symptoms/signs of OA
Grating sensation- crepitus
Locking
Swelling
X ray features of RA
LESS
Loss of joint space
Erosions of bone
Soft tissue swelling
See through bone- osteopenia
In severe cases subluxation of joints
What joints in the hand are affected by rheumatoid arthritis particularly
Metacarpopharangeal joints and proximal interpharangeal joints of hands feet and cervical spine
What is RA
an autoimmune disease in which autoantibodies,
known as rheumatoid factor, attack the synovial membrane. The inflamed synovial cells proliferate to form a pannus, which penetrates through the cartilage and adjacent bone, leading to joint erosion and deformity.
What is tennis elbow
Lateral elbow tendinopathy
Pain at the sit of the common extensor origin at the lateral epicondyle
This is easily remembered as golfers aim for the ‘middle’ of the fairway, while tennis players aim for the ‘lateral’ line of the court!
What is golfers elbow
Medial elbow tendinopathy
Affects the common flexor origin at the medial epicondyle
Valgus stress
This is easily remembered as golfers aim for the ‘middle’ of the fairway, while tennis players aim for the ‘lateral’ line of the court!
What three common things cause swellings around the elbow
Olecranon bursitis
Rheumatoid bursitis
Gouty tophi
What is Olecranon bursitis
Inflammation of the Olecranon bursa
What is gouty
An inflammatory condition resulting from defective purine metabolism leading to an
increased production of uric acid.
Uric acid concentration increases in the blood, forming crystals of monosodium urate in the
synovial cavity of joints
In tendons and in the surrounding tissues. These urate crystals trigger an innate immune response leading to acute inflammation
What are tophi
Nodular masses of monosodium irate crystals deposited in the soft tissues
What is carpal tunnel syndrome
Ulnar nerve compression caused by minor trauma to ulnar nerve - funny bone
Leads to parasthesia in the cuteneous territory of the ulnar nerve and may lead to weakness in the muscles supplied by the ulnar nerve
Contents of the Cubital fossa
Really need beer to be at my nicest
RN= RADIAL
BT=BICEPS TENDON
MN=MEDIAN NERVE
Muscles of posterior arm
3x3 (+3) -
3x muscles to the wrist - extensor carpi radialis longus, extensor carpi
radialis brevis, extensor carpi ulnaris
3x muscles to fingers - extensor digitorum, extensor digiti minimi, extensor indicis
3x muscles to the thumb - abductor pollicis longus, extensor pollicis longus, extensor pollicis brevis
+3 - anconeus, supinator and brachioradialis
What innervates muscles of the posterior forearm
Radial nerve
Action of extensor digitorum
Muscle in superficial posterior compartment of the forearm that extends the fingers
What does the extensor digitorum Longus do
extends the toes
