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Boards: Musculoskeletal > Elbow Conditions > Flashcards

Elbow Conditions Flashcards

1
Q

Elbow Contractures:

A
  • loss of motion in capsular pattern (loss flex>ext)
  • loss of motion in dif pattern = loose body in jt, lig sprain, and/or CRPS
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2
Q

Elbow Contractures: Dx

A

clinical exam

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3
Q

Elbow Contractures: PT

A

biomechanical faults

soft tissue techniques

splinting as adjunct

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4
Q

Lateral Epicondylosis/Epicondylopathy “Tennis Elbow”

A
  • most often chronic degen of ECRB at prox attachment to lat epicondyle
  • gradual onset, with occupation requires **repetitive wrist ext, or strong grip w/ wrist extended = overload **
  • MUST RULE OUT CERVICAL SPINE CONDITION
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5
Q

Lateral Epicondylosis/Epicondylopathy: Dx

A

lateral epicondylitis test

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6
Q

Lateral Epicondylosis/Epicondylopathy: PT

A
  • correct ms imbalance
  • endurance/strength w/ emphasis on **ECCENTRIC phase **
  • biomechanical faults
  • EDUCATION for prevention
  • cryotherapy, thermotherapy. hydrotherapy, sound agents, TENS for symptom relief
  • Counterforce bracing to reduce stress ECRB
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7
Q

Medial Epicondylosis/Epicondylopathy “Golfer’s Elbow”

A
  • degenerative condition of pronator teres and flexor carpi radialis at prox attachment
  • occurs w/ overuse in golf, baseball, swimming, or _strong hand grip & excessive pronation _
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8
Q

Medial Epicondylosis/Epicondylopathy: Dx

A

clinical exam

medial epicondylitis test

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9
Q

Medial Epicondylosis/Epicondylopathy: PT

A
  • correct ms imbalance
  • endurance/strength w/ emphasis on ECCENTRIC phase
  • biomechanical faults
  • EDUCATION for prevention
  • cryotherapy, thermotherapy. hydrotherapy, sound agents, TENS for symptom relief
  • Counterforce bracing to reduce stress ECRB
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10
Q

Distal Humeral Fractures:

A
  • complications:
    • loss of motion
    • myositis ossificans
    • malalignment
    • neurovascular compromise
    • lig injury
    • CRPS
  • Supracondylar fractures
    • must be examined quickly for neurovascular status (radial n) and vascular structures (may result in volkmann’s ischemia)
    • Assess growth plate in youth
  • Lat Epicondyle fractures: fairly common in young people and require ORIF
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11
Q

Distal Humeral Fractures: Dx

A

plain film imaging

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12
Q

Distal Humeral Fractures: PT

A

pain reduction and control of inflammatory response

improve flexibility of shortened structures, etc

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13
Q

Osteochondrosis of Humeral Capitellum

A
  • osteochondritis dissecans affects central and/or l**ateral aspect of capitellum or radial head . **
  • osteochondral bone fragment becomes detached from an articular surface forming a loose body in joint
  • caused by **rep compressive forces b/t radial head and humeral capitellum. **
  • *adolescents b/t 12-15*
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14
Q

Osteochondrosis of Humeral Capitellum: Panner’s Disease

A
  • localized avascular necrosis of capitellum leading to loss of subchondral bone, with f**issuring and softening of articular surfaces of radiocapitellar joint. **
  • etiology unknown, occurs in _children age <10 _
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15
Q

Osteochondrosis of Humeral Capitellum: Dx

A

plain film imaging

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16
Q

Osteochondrosis of Humeral Capitellum: PT

A
  • rest w/ avoiding throwing or UE activities
  • when pt is pain free, initiate flex and strength
  • late phase rehab: program to slowly increase load on joint
  • persistence of sx = surgery
    • after surg - min pain and increase flex
17
Q

Ulnar Collateral Ligament Injuries

A
  • occurs as result of repetitive valgus force to medial elbow w/ OH throwing.
  • clinical signs:
    • p! along medial elbow at distal insertion of lig
    • some cases paresthesias are reported w/ positive tinels
18
Q

Ulnar Collateral Ligament Injuries: Dx

A

MRI and clinical exam

medial lig instability test

19
Q

Ulnar Collateral Ligament Injuries: PT

A

rest and pain management

elbow flexor strength and taping

20
Q

Ulnar Nerve Entrapment

A
  • direct trauma to cubital tunnel
  • traction due to laxity at med elbow
  • compression due to a thickened retinaculum
  • hypertrophy of flex carpi radialis
  • recurrent sublux or disloc
  • DJD that effects cubital tunnel
  • Clinical Findings:
    • medial elbow pain
    • paresthesias in ulnar distribution
    • a positive tinels
21
Q

Median Nerve Entrapment

A
  • occurs w/in pronator teres ms and under superficial head of flexor digitorum superfiscialis w/ repetitive gripping activities
  • clinical signs
    • aching pain w/ weakness of FA ms
    • (+) tinels
    • paresthesias in median nerve distribution
22
Q

Radial Nerve Entrapment

A
  • entrapment of distal branches (PIN) occurs within radial tunnel (radial tunnel syndrome) as a result of OH activities/throwing
  • clinical signs
    • lateral elbow pain that can be confused with lateral epicondylitis
    • pain over supinator
    • parasthesias in radial nerve distribution
    • tinels may be positive
23
Q

Nerve Entrapment Dx

A

electodiagnostic tests and clinical exam

24
Q

Nerve Entrapment: PT

A
  • rest, avoidance of exacerbating activities, use of NSAIDs and modalities for soft tissue
  • if abn neurotension present - neuro mob
  • protective padding and night splints to maintain slackened position of involved nerve
  • w. reduct of p!/parasthesias, rehab focuses on strength, endurance, coordintation to achieve balance b/t agonist and antagonist
  • funx training and patient education
25
Q

Elbow Dislocations: Posterior Dislocations

A
  • defined by position of olecranon rel. to humerus
  • Postero-lateral are most common
    • elbow hyperextenson from FOOUE
  • frequently cause avulsion fractures of med epicondyle 2nd to traction pull of med coll lig
26
Q

Elbow Dislocations: Posterior - Clinical Signs

A
  • w/ complete dislocation:
    • ulnar lig will rupture
    • possible rupture anterior capsule, lat collateral lig, brachialis ms, and/or wrist flex/extensors
  • Clinical signs/symptoms
    • rapid swelling
    • sever pain at elbow
    • deformity with the olecranon pushed posterior
27
Q

Elbow Dislocations: PT

A
  • reduction of disloction
  • if stable: initial phase of immobilization followed by rehab focused on regaining flexibility w.in limits of stability and strength
  • not stable = surgery

Boards: Musculoskeletal (18 decks)

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