Elbow and Distal Radius Flashcards
Most elbow dislocations occur in what direction?
What is usually the mechanism of injury?
Posterior
FOOSH
What is the management for a pure elbow dislocation with no associated fractures?
Reduce (assessing neurovascular status before and after)
Sling for a week
Physio
If an elbow dislocation is causing instability problems, how can this be treated?
Lateral elbow ligament reconstruction
What structures may fracture as a result of an elbow dislocation?
Radial head
Ulna
Corcoid
Humeral epicondyles
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?
ORIF / Excision and replacement
Large screw
ORIF with small screw
Are distal humeral fractures usually intra or extra articular?
How are these treated?
When may elbow replacement be considered?
Intra-articular (elbow)
ORIF
Highly comminuted fractures in the elderly
What is the mechanism of injury behind an olecranon fracture?
Fall onto the elbow with triceps contraction
What is usually the treatment for an olecranon fracture?
What is used if it is only a simple transverse avulsion fracture?
ORIF with plates and screws (to restore triceps function and articular surface)
Tension band wiring
What is usually the mechanism of inury for distal radial head/neck fractures?
What movements is the radial head important for?
FOOSH
Pronation and supination
Fractures of the radial head often occur alongside what other injury?
Elbow dislocation
What is seen in this image?
What type of x-ray is needed to see this?
When will there be pain with this injury?
Fat pad sign- radial head fracture
Lateral elbow x-ray
Supination/pronation
How are minimally displaced, marginal radial head fractures treated?
What function is often lost in patients with radial head fractures?
Conservative: sling followed by early elbow exercises to minimise stiffness
10-15 degrees of terminal extension
How should radial head fractures with displaced fractures and large fragments blocking movements be treated?
How should comminuted radial head fractures be treated?
Internal fixation and removal of fragments blocking movement
Exision +/- replacement
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?
Aspiration of haemarthrosis
Injection of local anaesthetic
What should you always suspect when there is a fracture of one of the bones of the forearm?
That there will be a fracture or dislocation in the other bone of the forearm
What is a Galeazzi fracture?
Fractured radius
Dislocated ulna at DRUJ
If a patient has an isolated radius fracture, what imaging should you request?
Lateral wrist x-ray
What is a Monteggia fracture?
Fractured ulna
Dislocated radial head at the radiocapitellar joint
If a patient has an isolated ulna fracture, what other imaging should you request?
Elbow x-ray
What is a Nightstick fracture?
An isolated fracture of the ulna from a direct blow
If both bones of the forearm are fractured, how is this managed?
ORIF
How are Monteggia and Galeazzi fractures treated?
ORIF of the fractured bone, this should reduce the fracture
How are Nightstick fractures managed?
Mainly conservatively- ORIF can bring around quicker restoration of function and decrease the risk of non-union however
Colles fractures are often associated with what other fracture?
Ulnar styloid
