Elbow Common Presentations: Fractures & other Flashcards
olecranon bursitis, MOI & presentation
- easily injured due to superficial location, can become infected
- MOI: direct trauma, repeated grazing or weight bearing on area
- presentation: swelling, tender to palpation, ROM painful
interventions for olecranon bursitis
draining and corticosteroid injection
elbow contracture
history: trauma and/or immobilization
hypomobile joint
ROM of elbow contracture
ROM loss typically in capsular pattern
flexion > extension
treatments for elbow contracture
joint mob
stretching
may need to strengthen in new available ranges as improvements are made
radial head fracture dislocation
history: traumatic, FOOSH
systems review symptoms for radial head fracture dislocation
integumentary: swelling
neurovascular: nerve or vascular injury highly possible
UQS symptoms for radial head fracture
- decreased ROM at elbow
- pain with ROM at elbow
palpation symptoms for radial head fracture
tenderness at radial head
ROM/MMT symptoms for radial head fracture
ROM: loss both active and passive, inability to extend, flex, supinate or pronate with a traumatic cause = fracture
MMT: contraindicated
joint mob symptoms for radial head fracture
contraindicated
type 1 radial head fracture treatment
non-operatively with slint of sling
type 2 radial head fracture treatment
treated non-operatively
type 3 radial head fracture treatment
surgery, ORIF
following immobilization of radial head fracture, PT should:
- early mobilization to tolerance
- strengthen once allowed starting with isometrics –> isotonic
- heavy resistance not allowed until 8 weeks at earliest
- surgery precautions
monteggia fracture
involves dislocation of the proximal radius and fracture of ulna
instead of dislocation of proximal radial head or neck could also lead to fracture of radial head or neck
history of monteggia fracture
traumatic
MOI: FOOSH, hyperextension or hyperpronation
when is a monteggia fracture typically seen
seen in PT after surgery
systems review symptoms of monteggia fracture
integ: swelling
neurovascular: nerve or vascular injury
UQS symptoms of monteggia fracture
decreased ROM
pain with ROM
ROM/MMT/joint mobility symptoms of monteggia fracture
ROM: loss both active and passive, painful
MMT: weak
joint mobility: hypomobile
olecranon fracture
MOI: low or high energy injury, fall backwards on to elbow common, FOOSH - avulsion fracture
treatment for olecranon fracture
- prevent ROM loss, atrophy of muscle
- nutrient exchange
- SAID principle
- controlled stress to properly lay down bone
- if surgery, follow precautions
osteochondritis dissecans capitellum
- bone underneath the cartilage of a joint dies due to lack of blood flow, bone and cartilage break loose causing pain and limiting motion
- children and adolescents
history of osteochondritis dissecans capitellum
- insidious onset of diffuse lateral elbow pain common, can be repetitive trauma
- hx of locking in elbow
pain symptoms from osteochondritis dissecans capitellum
- humeroradial joint
- increased activities especially involving supination/pronation
ROM/MMT symptoms for osteochondritis dissecans capitellum
ROM: supination/pronation, loss full active and passive
MMT: may be painful, crepitus
interventions for osteochondritis dissecans capitellum
- avoid strain, minimize strength loss
- 3-4 months of nonabusive activity
- focus on bicep and tricep strength and muscular balance to control elbow extension forces
- motion limiting brace
