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MSK- Surgery and Trauma (CORTEXT 5 and 6) > Elbow and Distal Radius > Flashcards

Elbow and Distal Radius Flashcards

1
Q

Most elbow dislocations occur in what direction?

What is usually the mechanism of injury?

A

Posterior

FOOSH

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2
Q

What is the management for a pure elbow dislocation with no associated fractures?

A

Reduce (assessing neurovascular status before and after)

Sling for a week

Physio

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3
Q

If an elbow dislocation is causing instability problems, how can this be treated?

A

Lateral elbow ligament reconstruction

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4
Q

What structures may fracture as a result of an elbow dislocation?

A

Radial head

Ulna

Corcoid

Humeral epicondyles

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5
Q

What is the treatment for elbow dislocation with a radial head fracture?

What is the treatment for elbow dislocation with a humeral epicondyle fracture?

What is the treatment for elbow dislocation with a large coranoid fracture?

A

ORIF / Excision and replacement

Large screw

ORIF with small screw

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6
Q

Are distal humeral fractures usually intra or extra articular?

How are these treated?

When may elbow replacement be considered?

A

Intra-articular (elbow)

ORIF

Highly comminuted fractures in the elderly

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7
Q

What is the mechanism of injury behind an olecranon fracture?

A

Fall onto the elbow with triceps contraction

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8
Q

What is usually the treatment for an olecranon fracture?

What is used if it is only a simple transverse avulsion fracture?

A

ORIF with plates and screws (to restore triceps function and articular surface)

Tension band wiring

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9
Q

What is usually the mechanism of inury for distal radial head/neck fractures?

What movements is the radial head important for?

A

FOOSH

Pronation and supination

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10
Q

Fractures of the radial head often occur alongside what other injury?

A

Elbow dislocation

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11
Q

What is seen in this image?

What type of x-ray is needed to see this?

When will there be pain with this injury?

A

Fat pad sign- radial head fracture

Lateral elbow x-ray

Supination/pronation

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12
Q

How are minimally displaced, marginal radial head fractures treated?

What function is often lost in patients with radial head fractures?

A

Conservative: sling followed by early elbow exercises to minimise stiffness

10-15 degrees of terminal extension

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13
Q

How should radial head fractures with displaced fractures and large fragments blocking movements be treated?

How should comminuted radial head fractures be treated?

A

Internal fixation and removal of fragments blocking movement

Exision +/- replacement

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14
Q

In patients with radial head fractures, what can be done to assess whether a patient actually has an obstrucution to movement or if it is only caused by pain?

A

Aspiration of haemarthrosis

Injection of local anaesthetic

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15
Q

What should you always suspect when there is a fracture of one of the bones of the forearm?

A

That there will be a fracture or dislocation in the other bone of the forearm

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16
Q

What is a Galeazzi fracture?

A

Fractured radius

Dislocated ulna at DRUJ

17
Q

If a patient has an isolated radius fracture, what imaging should you request?

A

Lateral wrist x-ray

18
Q

What is a Monteggia fracture?

A

Fractured ulna

Dislocated radial head at the radiocapitellar joint

19
Q

If a patient has an isolated ulna fracture, what other imaging should you request?

A

Elbow x-ray

20
Q

What is a Nightstick fracture?

A

An isolated fracture of the ulna from a direct blow

21
Q

If both bones of the forearm are fractured, how is this managed?

A

ORIF

22
Q

How are Monteggia and Galeazzi fractures treated?

A

ORIF of the fractured bone, this should reduce the fracture

23
Q

How are Nightstick fractures managed?

A

Mainly conservatively- ORIF can bring around quicker restoration of function and decrease the risk of non-union however

24
Q

Colles fractures are often associated with what other fracture?

A

Ulnar styloid

25
Q

What is the mechanism of injury of a Colles fracture?

Are these intra or extra articular?

What direction will these angulate/displace?

A

FOOSH with the wrist extended

Exra-articular (within 1 inch)

Dorsally

26
Q

What are some complications of Colles fractures?

A

Median nerve compression / bleed in the carpal tunnel

EPL rupture

Complex regional pain syndrome

Loss of grip strength

27
Q

How is an EPL tendon rupture as a result of a Colles fracture treated?

A

Tendon transfer

28
Q

How do you treat a minimally displaced, angulated Colles fracture?

What is the normal angulation of the radius articular surface?

How do you treat a Colles fracture which is beyond this normal degree of angulation?

A

Splintage

10 degrees volarly

Manipulation

29
Q

How is a Colles fracture usually held in place after manipulation?

If it has dorsal comminution or is felt to be particularly unstable after reduction, what is done?

A

Cast

Percutaneous wires OR ORIF with plates and screws

30
Q

Some distal radius fractures are so comminuted that stable fixation of the joint fragment is not possible.

What can be used to hold the wrist in reasonable alignment?

A

External fixation

Supplementary wires

31
Q

What is the mechanism of injury of a Smith’s fracture?

Are these intra or extra articular?

What direction are they displaced/angulated?

A

Fall onto the back of the hand

Extra

Volarly

32
Q

Smith’s fractures are very unstable. How are they treated?

What are some complications?

A

ORIF

Grip strength and wrist extension are greatly reduced

Excessive volar angulation can cause malunion

33
Q

What type of fractures are Barton’s fractures?

How are they treated?

A

Intra articular fractures of the volar or dorsal rim, associated with subluxation of the carpal bones

ORIF

34
Q

A volar Barton’s fracture is the same as what?

A dorsal Barton’s fracture is the same as what?

A

Intra-articular Smith’s fracture

Intra-articular Colles’ fracture

MSK- Surgery and Trauma (CORTEXT 5 and 6) (13 decks)

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