Unit 4: Outpatient Orthopedics/Elbow Flashcards
Humerus
-Lateral/medial epicondyles
-Olecranon fossa
-Trochlea/Capitulum
Elbow Joint-
Hinge Joint
-Humeral-Ulnar Joint: Trochlea/Ulna (olecranon)
-Humeral-Radial Joint: Capitulum/Radial Head
Elbow Ligaments
-Ulnar/Medial Collateral Ligament (resists lateral
(valgus) stress)
-Radial/Lateral Collateral Ligament (resists medial (varus) stress)
-Proximal Radio-Ulnar Joint/DistalRadio-Ulnar Joint
Elbow Evaluation
-Patient History
-Observation
-AROM/PROM/MMT
Patient History (Elbow Eval)
-Patient History: Pain (type and location), Pertinent medical history (Past surgeries, smoking, diabetes past neck/UE/back injuries
-What functional tasks have been limited due to symptoms?
-What functional tasks increase symptoms? May be helpful to have them demonstrate to see if proper arthrokinematic motion is occurring
Observation (Elbow Eval)
Observe functional task or motion and look for asymmetries, posture, muscle atrophy, etc.
AROM/PROM/MMT (Elbow Eval)
Look for weakness, crepitus, what’s their end feel?
Mid-Shaft Fractures
-Can be caused by falls, trauma (MVA)
-Can be associated with damage to the radial n. leading to radial nerve palsy*
Distal Humeral Fractures
-Supracondylar Fractures
-Intercondylar Fractures
Humeral guard or Elbow immobilization orthotic based on location while fracture heals
-ORIF may be completed if the fracture is unstable
-Controlled AA/AROM
Humeral guard or Elbow immobilization orthotic based on location while fracture heals
-ORIF may be completed if the fracture is unstable
-Controlled AA/AROM > PROM (typically 6 weeks) > Strengthening (typically 8 weeks)
-Do not want to put external force (PROM/Strengthening) until fracture is stable
Olecranon Fracture
-Commonly occurs from a fall on an outstretch hand
-Sling 1-2 weeks to rest (radial head) due to stability of ligaments around radial head
-If beyond grade I radial head fracture > Radial head replacement may be completed
Elbow Fractures Intervention (Olecranon/Radial Head)
Controlled AA/AROM > PROM (typically 6-weeks) > Strengthening (typically 8 weeks)
-Do not want to put external force (PROM/Strengthening) until fracture is stable
Step 1: Inflammation (Bone Healing)
-When a bone fractures, white blood cells move into the area to clean up debris created by the break
-This creates inflammation, which triggers the growth of new blood cells
-The first stage of healing
Step 2: Soft Callus Formation (Bone Healing)
As blood cells divide and multiply near the break, new blood vessels develop to fuel the repair process
-The body also begins to create cartilage around the bone fracture to bridge the gap in the bone
-Called the soft callus, this cartilage is simply fibrous tissue
