Elbow Injuries

Question 1

Who usually gets supracondylar fractures?

Answer 1

-Children

Question 2

Common way of obtaining a supracondylar fracture?

Answer 2

-Extension type fractures

eg Heavy fall on outstretched hand

Question 3

Less common way of obtaining a supracondylar fracture?

Answer 3

Fall onto point of flexed elbow

eg Called a flexion type fracture

Question 4

Signs and symptoms of supracondylar fracture?

Answer 4

• Off-ended extension type fracture:

- Unable to make OK sign (Loss of FPL & FDP)

Question 5

Treatment of supracondylar fractures?

Answer 5

• Undisplaced: stable an treated with splint
• Angulated/rotated/displaced: closed reduction and pinning with wires
• Severely displaced/off-ended: open reduction (brachialis muscle)
• If radial pulse absent/reduced: emergency surgery
• Nerve injury: emergency surgery

Question 6

Treatment of undisplaced supracondylar fracture?

Answer 6

Stable and treated with splint

Question 7

Treatment of angulated/rotated/displaced supracondylar fracture?

Answer 7

Closed reduction and pinning with wires

Question 8

Treatment of severely displaced/off-ended SC fracture?

Answer 8

Open reduction

Brachialis muscle

Question 9

Treatment for intra-articular distal humerus fractures?

Answer 9

Elbow replacement

Question 10

Cause of olecranon fracture?

Answer 10

Fall onto point of elbow + contraction of triceps

Question 11

Treatment of olecranon fracture?

Answer 11

Comminuted fractures: ORIF: restores triceps function & articular surface
-Simple transverse avulsion fracture: tension band wiring

Question 12

What is ORIF?

Answer 12

Open reduction internal fixation

Question 13

Cause of elbow dislocation/fracture?

Answer 13

Posterior direction

• Fall onto outstrecthed hand
• Fractures of radial head, humeral epicondyles, coronoid process of ulna may occur

Question 14

What may elbow dislocation/fracture be associated with?

Answer 14

Neurovascular injury

Question 15

Treatment of an uncomplicated elbow dislocation?

Answer 15

Closed reduction under sedation

• Asses NV status pre and post reduction
• 1-3 weeks sling
• Elbow exercises

Question 16

Treatment of an elbow fracture/dislocation with entrapped bony fragments preventing reduction/blocking motion?

Answer 16

SURGERY

-Radial neck/head fractures: ORIF/ Excision & replacement with prosthetic radial head to maintain stability

Question 17

Treatment of epicondyle fractures with bony fragments?

Answer 17

Screw

Question 18

Treatment of large coronoid fractures?

Answer 18

ORIF with small screws

-Elbow ligament reconstruction may be needed