Distal Biceps Ruptures

Question 1

Structures in the AC Fossa from medial to lateral

Answer 1

• median nerve
• brachial artery
• biceps tendon
• radial nerve

Question 2

Most commonly injured nerve during repair is:

Answer 2

lateral antebrachial cutaneous nerve

next most common is superficial radial nerve

Question 3

Benefit of distal biceps repair?

Answer 3

40% improvement of supination strength

30% improvement of flexion strength

Question 4

management of partial biceps tear with chronic pain?

Answer 4

exploration, debridement, and reattachment

Question 5

where does the distal biceps usually tear?

Answer 5

radial aspect of tendon

Question 6

cortisone fro lateral epicondylitis?

Answer 6

don’t do it

can worsen your overall outcomes, increase rate of recurrence

Question 7

where does ECRB insert

Answer 7

base of the 3rd MC

Question 8

pathoanatomy of lateral epicondylitis

Answer 8

ECRB rubs against the capitellum

angiofibroblastic dysplasia

Question 9

where does the LUCL insert

Answer 9

supinator crest of ulna

Question 10

best grafts for LUCL reconstruction?

Answer 10

palmaris longus autograft

gracilis allograft

Question 11

muscles that originate on the lateral epicondyle

Answer 11

• anconeus
• ecrb
• ecrl
• edc
• ecu

Question 12

Facts about elbow OA

Answer 12

• preferential for radiocapitellar joint

- spares the ulnohumeral joint

Question 13

Primary stabilizers of the elbow:

Answer 13

• anterior band of the MCL (anterior oblique fibers)
• LCL
• Coronoid

Question 14

Secondary stabilizers of the elbow:

Answer 14

• radial head
• medial capsule
• anconeus

Question 15

symptoms of elbow OA:

Answer 15

pain at end range of motion

• usually painless mid-flexion arc
• loss of terminal extension
• ulnar neuropathy in 50%

Question 16

Who gets a total elbow arthroplasty

Answer 16

old patients

low demand

Question 17

soft tissue interpositional elbow arthoplasty reserved for:

Answer 17

young patients
high demand
would otherwise be TEA candidates

Contraindicated in:

• rheumatoid
• osteonecrosis

Question 18

what do you do for young guy with elbow OA who is a laborer

Answer 18

scope, osteophyte removal, capsular release

there is generally no role for PT with advanced OA and joint contracture

Question 19

can you convert an elbow interpositional arthroplasty to a TEA?

Answer 19

yes
results are good
10/12 patients in one series had good results

Question 20

waht degree of constraint should be used in a TEA?

Answer 20

semiconstrained

fully constrained prosthesis have high rates of loosening

Question 21

who is at risk for elbow OCD lesions?

Answer 21

people who have repeitive upper extremity activties like throwers and gymnasts

Question 22

waht is Panner’s diseae?

Answer 22

osteochondrosis of the capitellum

• children < 10 years
• benign course, self-limiting
• no surgery
• involves the entire capitellar ossific nucleus

Question 23

earliest sign of elbow OCD?

Answer 23

lack of elbow extension

Question 24

Management of stable type 1 capitellum OCD

Answer 24

• treat with cessation of activity +/-
  immobilization
• gradual return to activity over 12 weeks

Question 25

Management of unstable type 1 or type 2 OCD capitellum?

Answer 25

driling/microfracture

Question 26

Management of a large type 2 OCD incompletely displaced?

Answer 26

scope and fix it

Question 27

Should you MRI a partial biceps tear?

Answer 27

yes

Question 28

Where does the pec major insert relative to the LHBT

Answer 28

just lateral to it.