S8L2 - Disorders Of The Elbow

Question 1

What is the most common elbow injury?

Answer 1

Supracondular fracture of the distal humerus

Question 2

What’s a common mechanism of supracondylar fracture of the distal humerus?

Answer 2

Fall onto outstretched hand with the elbow hyperextended.

Question 3

What are the presenting symptoms of a supracondular fracture of the distal humerus?

Answer 3

Pain, deformity and loss of functions

Question 4

Describe a supracondular fracture?

Answer 4

Fracture line is extra-articular and the distal fragment (condyles) are displaced posteriorly

Question 5

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

Answer 5

Malunion resulting in cubitus varus

Damage to the median nerve, radial nerve or ulnar nerve

Ischaemic contracture

Question 6

What is Volkmanns ischaemic contracture?

Answer 6

When the brachial artery is damaged or occluded during fracture of the distal humerus. If reflex spasm of the collateral circulation around the elbow, there will be ischaemia of the anterior compartment of the forearm. This causes oedema and a rise in compartment pressure (compartment syndrome). Further exacerbation of ischaemia, impeding arterial flow, resulting in infarction. Fibrosis occurs of dead muscle tissue. Fibrotic tissue contracts resulting in flexion contracture.

Wrist becomes flexed, fingers are extended at the metacarpophalangeal joints and flexed at the interphalangeal joint, forearm is pronates and the elbow is flexed.

Question 7

How can you test for median nerve injury?

Answer 7

Supplies the anterior aspect of the forearm
Palmar abduction of the thumb by the abductor pollicis brevis
OK sign

Question 8

What is done to assess the risk of ischaemic contracture?

Answer 8

Palpate radial pulse

Assess capillary return

Question 9

What is the treatment for a supracondylar fracture of the distal humerus?

Answer 9

Undisplaced: