Elbow

Question 1

What type of joint is the elbow

Answer 1

a synovial hinge joint between the distal humerus and proximal radius and ulna

Question 2

What bone possesses the olecranon process

Answer 2

The ulna

Question 3

What other joints should be examined that can cause elbow pain

Answer 3

The shoulder and the cervical spine

Question 4

What is cubitus valgus

Answer 4

When the carrying angle of the elbow is greater than normal (5-15degrees)

Question 5

What is cubitus varus

Answer 5

When the carrying angle of the elbow is decreased

Question 6

What is the most common cause of cubitus valgus

Answer 6

Acquired deformity most comply after a melanin of the lateral condylar fracture

Question 7

What is the most common cause of cubitus varus

Answer 7

Following a melanin of a supracondylar fracture

Question 8

What is another name for Cubitus varus

Answer 8

Gunstock deformity

Question 9

What is the treatment for both cubitus varus and valgus

Answer 9

Osteotomy

Question 10

What is Tennis elbow

Answer 10

Gradual onset of tenderness over the lateral epicondyle of the elbow

Question 11

Why does pain occur in tennis elbow

Answer 11

due to a small tear, fibrosis, calcification or a vascular reaction in the tendon fibres of the common extensor origin

Question 12

What sort of activities can result in tennis elbow

Answer 12

gardening
lifting
decorating
tennis playing

Question 13

How is a diagnosis of tennis elbow made

Answer 13

on the clinical history and examination
plain X-ray may show sclerosis or calcification of the insertion
US sometimes helpful

Question 14

What is the management of tennis elbow

Answer 14

identification and adjustment of the causative activity, along with rest followed by physio
NSAIDs, corticosteroid and local anaesthetic joint injections help with symptoms
Surgery to release the extensor tendon origin from the lateral epicondyle

Question 15

What is golfer’s elbow

Answer 15

Similar to Tennis but less common/ am os over the medial epicondyle of the elbow

Question 16

What is an olecranon bursitis

Answer 16

swelling of the olecranon bursa which is found lying over the ulna at the tip of the elbow

Question 17

What are the clinical features of Olecranon bursitis

Answer 17

Large swelling over the posterior aspect of the elbow

Elbow is likely to be warm but not always painful

Question 18

What are some of the causes of bursitis

Answer 18

Repeated minor trauma, such as continual pressure or friction
gout
RA
Infection

Question 19

What are some investigations for olecranon bursitis

Answer 19

Routine blood tests for underlying cause/ infection

Signs of RA or OA may be visible on Xray

Question 20

What is the management for olecranon bursitis

Answer 20

Depends on the underlying cause
NSAIDs are first line
Aspiration or surgical excision for persistently inflamed bursa
Antibiotics if infection is the cause

Question 21

What will the patient complain of if they have loose bodies

Answer 21

locking of the elbow joint limiting the range of various movements
Intermittent locking as the loose body floats around the joint

Question 22

What investigations are useful in detecting a loose body

Answer 22

Plain Xray

CT if more are needed

Question 23

How are patients with loose bodies managed

Answer 23

Reassurance and left alone if not bothered

If they want them removed, this can be done arthroscopically or as an open procedure

Question 24

Describe RA in the elbow

Answer 24

commonly bilateral and may affect both the elbow and the superior radioulnar joint

Question 25

What are the management options for RA in the elbow

Answer 25

Excision of the radial head with a synovectomy

Total elbow joint replacement

Question 26

Where does the ulnar nerve lie

Answer 26

in the cubital tunnel

Question 27

What are the most common forms of elbow dislocation

Answer 27

Posterior and posterolateral dislocation of the radius and ulna

Question 28

What are the clinical features of an elbow dislocation

Answer 28

Patient supports their own arm in slight flexion
Olecranon and epicondyles are not in their usual anatomical position
Nerve damage may be found on hand examination

Question 29

What is the treatment for an elbow dislocation

Answer 29

Reduction with traction

Arm should be placed in a collar and cuff flexed at over 90 degrees for 2 weeks

Question 30

What are some complications that can arise due to an elbow dislocation

Answer 30

neurovascular damage
compartment syndrome
recurrent dislocation
myositis ossificans

Question 31

Who may sustain a supracondylar fracture and how does this occur

Answer 31

Children following a fall on an outstretched hand

Question 32

How do intra-articular fractures occur

Answer 32

usually as a result of high energy trauma to the elbow though they may occur in osteoporotic individuals with a simple fall

Question 33

What are the clinical featrures of an intra-articular fracture

Answer 33

swelling and deformity of the elbow
tenderness
reduced movement at the elbow joint

Question 34

What is the treatment for an intra-articular fracture

Answer 34

Neurovascular assessment
Backslap if undisplaced with elbow flexed to 90degrees
surgery for displaced fractures

Question 35

What are 4 complications of an intra-articular fracture

Answer 35

OA
Compartment syndrome
Non-union
Ulnar nerve palsy

Question 36

How might a medial epicondylar fracture occur

Answer 36

direct trauma
result of a valgus force being applied which results in an avulsion fracture
during dislocation of the elbow

Question 37

What nerve is most at risk with a medial epicondylar fracture

Answer 37

Ulnar nerve - it runs close to the medial epicondyle

Question 38

How might an olecranon become fractured

Answer 38

Direct fall onto the flexed elbow

Direct blow to the elbow resulting in a comminuted fracture

Question 39

What is the treatment for an olecranon fracture

Answer 39

Undisplaced - closed with immobilisation with a cast

Displaced - surgery using tension band wiring or a plate