Elbow Conditions

Question 1

What is the most common mechanism of injury for a supra condylar fracture of the distal humerus?

Answer 1

FOOSH from a moderate height with elbow hyperextended

Question 2

What is the peak age of supracondylar fractures?

Answer 2

5-7 years. 90% of cases are seen in children under 10 years old

Question 3

What signs may a child present with if they have a supracondyar fracture of the distal humerus?

Answer 3

Pain, deformity and loss of function

Question 4

What are the three main complications of a supracondylar fracture of the distal humerus?

Answer 4

Malunion, damage to median nerve (or radial/ulnar but less common), ischaemic contracture

Question 5

What causes the complication of ischaemic contracture following a supracondylar fracture?

Answer 5

Damage to the brachial artery from fracture stops blood flow to anterior forearm so eventually replaced by scar tissue which contracts leaving arm with flexion contracture

Question 6

How do elbow dislocations usually occur?

Answer 6

Fall onto an outstretched hand with elbow partially flexed

Question 7

Are posterior or anterior elbow dislocations more common?

Answer 7

Posterior more common (90%)

Question 8

Fractures of which part of the elbow are commonly seen with anterior elbow dislocations?

Answer 8

Olecranon fractures

Question 9

What is a pulled elbow?

Answer 9

Subluxation of the radial head (basically an incomplete dislocation)

Question 10

What is the classic mechanism of injury for a pulled elbow?

Answer 10

Longitudinal traction of arm with forearm pronated (tugging uncooperative child)

Question 11

How may a patient present with radial head or neck fracture?

Answer 11

Pain in the lateral aspect of proximal forearm and loss of range of movement

Question 12

What are the X-ray features associated with rheumatoid arthritis?

Answer 12

Joint space narrowing
Periarticular osteopenia
Juxta-articular bony erosions
Subluxation and gross deformity