Elbow

Question 1

type of movement resisted by medial collateral ligament?

Answer 1

valgus

Question 2

type of movement resisted by lateral collateral ligament?

Answer 2

varus

Question 3

type of deformity that may be produced with supracondylar humeral fractures?

Answer 3

cubitus varus= cosmetic problem only

Question 4

problem with cubitus valgus?

Answer 4

stretching of ulnar nerve

Question 5

most common direction of dislocation of elbow?

Answer 5

postero-lateral

Question 6

why is the empty can test (ECT) used to test for impingement?

Answer 6

arms abducted and thumbs pointing downwards= internal rotation of humerus- greater tubercle brought under acromion, compressing supraspinatus tendon.

tests supraspinatus function

Question 7

what is Hawkin’s test?

Answer 7

impingment test in which elbow is flexed repeatedly as arm is adducted, downward flexion elicits more pain as arm internally rotated, and adducting arm increases sensitivity.

Question 8

what is deformity of the elbow usually due to?

Answer 8

previous trauma:
cubitus varus due to malunited supracondylar fracture
or cubitus valgus due to old displaced and malunited fracture of lateral condyle

Question 9

symptoms to ask about in assessment of elbow?

Answer 9

pain
stiffness
deformity
swelling- soft lump on back of elbow suggests olecranon bursitis
instability-common in late stages of RA
ulnar nerve symptoms
LOF

Question 10

normal carrying angle?

Answer 10

5-10 degrees of valgus

Question 11

importance of looking for SC nodules around elbow?

Answer 11

rheumatoid nodules in RA= systemic manifestation
often over olecranon

often both elbows affected by arthritis in RA ptnts

Question 12

how is supination and pronation tested?

Answer 12

elbows tucked into sides and flexed to 90 degrees

Question 13

timescale for emergence of secondary ossification centres of elbow?

Answer 13

CRITOL
capitulum-2yrs
radial head- 4 yrs
internal epicondyle- 6 yrs
trochlea- 8 yrs
olecranon- 10 yrs
lateral epicondyle- 12 yrs

Question 14

how can a cubitus varus be corrected?

Answer 14

wedge osteotomy of lower humerus

Question 15

how can ulnar nerve symptoms caused at elbow be treated?

Answer 15

transposition of ulnar nerve to front of elbow

Question 16

common cause of sudden locking of the elbow?

Answer 16

loose body in elbow, for which most common cause= osteochondritis dissecans of capitulum

Question 17

clinical features of tennis elbow?

Answer 17

pain felt over lateral side of elbow
pain aggravated by movements such as pouring tea, turning a stiff door handle, shaking hands, or lifting with forearm pronated
elbow looks normal
F and E full and painless
tenderness localised to spot just in front of lateral epicondyle
pain reproduced if ptnt extends wrist against resistance, or passively flexing wrist so as to stretch common extensors

similar symptoms are medial epicondyle in golfer’s elbow, but pain reproduced by passive extension of wrist in supination

Question 18

tment of tennis and golfer’s elbow?

Answer 18

rest, avoid precip. activity
splint and physio
can inject area of max tenderness with mixture of corticosteroid and LA
persistent pain not responding to conservative tment can be treated by detaching common tendon from its origin surgically