The Elbow and Forearm Flashcards
Describe the Elbow joint
Synovial join with hyaline cartilage lining the articular surfaces. Fat pad are present in the coronoid fossa, olecranon fossa and radial fossa and attachments of the brachialis and triceps pull these away when necessary. There are three main ligaments: the radial and ulna collateral ligaments and the annular ligament which surrounds the attachment of the radius to the ulna. The sacciform recess allows rotation of the radius in pronation/supination.
What vascular innervation of the elbow joint
Innervation of the elbow comes from collateral and recurrent branches of the brachial and Profunda brachii.
Describe a supracondylar fracture to the humerus
Supracondylar Fracture of the humerus commonly in children. This is a transverse fracture of the distal humerus above the epicondyles. This results in the distal fragment being pulled posteriorly by the triceps and as a result pulls the brachial artery across the fracture site. This is relatively severe as it results all the muscles in the anterior compartment of the forearm becoming ischaemic.
What is pulled elbow
Pulled Elbow again in young children due to the radius not being yet fully developed and as a result when the child is say pulled up a curve or when being swung by the parents can result in the partial dislocation of the radius out of the anular ligament. This will be extremely painful for the child but can be easily fixed by simple supination and compression of the elbow.
What kind of fracture may you get from falling on a hyper abducted extended arm?
Avulsion of the medial epicondyle due to falling on a hyper abducted extended arm. Ulnar collateral ligament rips off medial epicondyle.
Describe dislocation of the elbow
Posterior dislocation of the elbow due to fall – again puts the vessels and nerves at risk.
What kind of fracture at the elbow are you likely to get from falling on outstretched hands?
Fractured head of radius (at elbow) after falling on outstretched hands. Requires surgical reconstruction and physiotherapy. Not always obvious on X-ray but you may see that synovial cavity is full of fluid raising the fat pads – called the fat pad sign.
Describe tennis/golfer elbow
Tennis/Golfers elbow – overuse strain injury. For tennis pain originates in lateral epicondyle and for gold on the medial epicondyle.
Describe the structure of the cubital fossa
Formed from medial side of the Brachioradialis and the lateral side of the pronator teres. Major contents include the biceps tendon, brachial artery bifurcating into the radial and ulnar artery, medial and radial (on the lateral side) nerves. Superficially the cephalic and Basilic veins connect via the medial cubital vein.
Which bones articulate at the wrist?
The radius articulates with two of the carpal bones (lunate, scaphoid and triquetrum) whilst the ulna only articulates with the radius at the ulna notch and isn’t part of the wrist joint (it is separated by an articulating disc).
What is the purpose of the interosseous membrane between the radius and ulna in the forearm
Interosseous membrane joins the radius to the ulna and allows for smooth supination and pronation.
What is Geleazzi’s fracture
Galeazzi’s fracture – fracture of the distal 1/3 of the radius and partial disolcation of the ulna at the wrist joint.
What is Colle’s fracture
Colles’ fracture – fracture and posterior diplasmcement of the distal end of the radius. Comonly also avulsion fracture of the ulnar styloid porcess. This ffracture usually occurs when falling on outsretched hands.
What is smith’s fracture
Smith’s Fracture – opposite of Colles’ fracture where the patient falls on dorsum of hand or full flexed wrists or due to a direct blow to the posterior forearm – fractures the distal radius, distal fracture fragment will displace ventrally.
What is Monteggia’s fracture?
Monteggia’s fracture – fracture in proximal 1/3 of ulna and anterior dislocation of radius at the elbow.
