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Upper Limb > Elbow conditions > Flashcards

Elbow conditions Flashcards

1
Q

What type of fracture is a fracture of the medial epicondyle of the humerus?

A

An avulsion fracture

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2
Q

What is an avulsion fracture?

A

Fracture where fragment of bone is pulled away from main bone mass

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3
Q

What is the mechanism of a medial epicondylar fracture of the humerus?

A

Arm is extended
Extremely abducted at elbow
Pulls ulnar collateral ligament
Pulls off medial epicondyle from rest of humerus

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4
Q

Which nerve is most likely injured by a medial epicondylar fracture of the humerus? Why?

A

Ulnar nerve

because it runs behind the medial epicondyle

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5
Q

What type of injury does the ulnar nerve suffer in a medial epicondylar fracture of the humerus?

A

Nerve traction - stretching

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6
Q

An elbow dislocation is usually what type of dislocation?

A

Posterior dislocation

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7
Q

What are the causes of elbow dislocation?

A

Falling onto outstretched hand, elbow joint flexes

Hyperextension of elbow joint

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8
Q

What happens in an elbow dislocation?

A

Distal humerus driven through anterior part of joint capsule, the weakest part

Radius and ulna move posteriorly

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9
Q

What are the complications of an elbow dislocation?

A

Tearing of ulnar collateral ligament

Fracture of coronoid process or olecranon

Fracture of head of radius

Ulnar nerve injury

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10
Q

What is a pulled elbow?

A

Subluxation of the elbow joint - incomplete dislocation

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11
Q

What is partially dislocated in a pulled elbow?

A

The head of the radius in the elbow joint and proximal radioulnar joint

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12
Q

What is a pulled elbow caused by?

A

Pulling on extended and pronated forearm

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13
Q

What happens in a pulled elbow?

A

Tearing of annular ligament
Radial head moves distally out of socket formed by annular ligament
Annular ligament becomes trapped between radial head and capitulum of humerus

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14
Q

How does a pulled elbow present?

A

Elbow is flexed

Forearm is pronated

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15
Q

What is olecranon bursitis?

A

Inflammation of the bursa in the elbow joint

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16
Q

Which bursae may become inflamed in olecranon bursitis?

A

Subcutaneous bursa

Subtendinous bursa

17
Q

What causes inflammation of the subcutaneous bursa?

A

Repeated pressure and friction by falls on elbow

Infection by abrasions over elbow

18
Q

What causes inflammation of the subtendinous bursa?

A

Excessive friction between triceps brachii tendon and olecranon
due to repeated flexion and extension of elbow

19
Q

Which is more commonly inflamed - subcutaneous bursa or subtendinous bursa?

A

Subcutaneous bursa

20
Q

When is olecranon bursitis more painful - flexed elbow or extended elbow? Why?

A

Flexed elbow

More pressure exerted on inflamed bursa

21
Q

How is olecranon bursitis treated?

A

Compression bandaging
Aspiration
If infected - surgical drainage, washout, antibiotics
If chronic - hydrocortisone injections

22
Q

What is a Colles’ fracture?

A

Type of fracture of the distal radius and ulna

23
Q

What type of fracture does the distal radius show in a Colles’ fracture?

A

Transverse fracture

24
Q

What type of fracture does the distal ulnae show in a Colles’ fracture?

A

Avulsion fracture of ulnar styloid process

25
Q

What causes a Colles’ fracture? Give an example

A

Forced extension of wrist

e.g. falling on outstretched hand

26
Q

How do the bone fragments displace in a Colles’ fracture?

A

Distal bony fragment of radius displaces dorsally

27
Q

Why is there shortening of the forearm with a Colles’ fracture?

A

Distal fragment of radius overrides proximal fragment

28
Q

How does a Colles’ fracture present?

A

Dinner fork deformity - abnormal curvature in distal posterior forearm

29
Q

Do Colles’ fractures heal well or not? Why?

A

Yes they do

rich blood supply to distal radius

30
Q

What is a complication of a Colles’ fracture in children?

A

Fracture may pass through epiphyseal plate of radius
may malalign during healing
disturbs growth of radius

31
Q

What is a Smith’s fracture?

A

Type of fracture of distal radius and ulna

32
Q

What causes a Smith’s fracture? Give an example

A

Forced flexion of wrist

e.g. falling onto a flexed wrist

33
Q

How do the bone fragments displace in a Smith’s fracture?

A

Distal radius fragment displaces anteriorly

34
Q

What causes a scaphoid fracture? Give an example

A

Hyperextension of wrist

e.g. falling onto an outstretched hand

35
Q

How does a scaphoid fracture present?

A

Tenderness in anatomical snuffbox

36
Q

When are scaphoid fractures visible on an X-ray?

A

Don’t show up immediately on X-ray

Take 10-14 days to show up

37
Q

What is a complication of a scaphoid fracture?

A

Avascular necrosis of proximal bony fragment

Predisposes to wrist arthritis in later life

38
Q

Why can avascular necrosis occur with a scaphoid fracture?

A

Because blood supply is distal to proximal

blood supply to proximal fragment is cut off

Upper Limb (23 decks)

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