Elbow Trauma

Question 1

Sarmieneto brace absolute contraindications:

Answer 1

brachial plexus palsy

- no tone in the muscles, therefore no splinting force

Question 2

Jupiter Classification of Distal Humerus (2-columns)

Answer 2

• High T
• Low T (transverse just proximal to trochlea)
• Y (oblique portion through both columns)
• H - trochlea is a free fragment (AVN risk)
• medial Lambda
• lateral Lambda
• multi-plane

Question 3

Parallel vs perpendicular plating of distal humeral fractures

Answer 3

biomechanical studies support both

- medial plate medial, laterally based posterior plate

Question 4

Should you transpose ulnar nerve during ORIF of distal humerus fracture?

Answer 4

there is no evidence of benefit for routine transposition

Question 5

rates of ulnar nerve dysfunction following ORIF distal humerus?

Answer 5

10-15% (Egol 2010), transposition was not protective

Question 6

Tips for Olecranon Osteotomy

Answer 6

• drill for your plate or tension band before you make your osteotomy
• make chevron style
• use 2.0mm k-wire for perforating cortex

Question 7

what are the minimum bony requirements for the hinge articulation of the elbow?

Answer 7

the capitellum and the medial trochlea must be intact

Question 8

Should you transpose the ulnar nerve following ORIF of distal humerus fractures?

Answer 8

No
Increases the risk of ulnar neuritis
No benefit has been demonstrated for routine decompression and transposition