Upper Arm, Elbow, Forearm Conditions

Question 0

Rupture of the biceps brachii

Answer 0

Etiology: 97% of the biceps ruptures are proximal 3% are the distal attachments( purée siting conditions can cause degenerative changes in the distal tendon.
Signs and symptoms: tenderness, swelling and ecchymosis are visible in the ante initial fossa. Biceps tendon is not palpable because the belly retracts proximal.
Management: non operative approach or surgical repair. With none operative shows 40% loss in supination and 30% of flexion
Distal biceps seems to scar to the brachialis illuminating normal contour of the muscle
After surgical repair elbow is flexed 90 and immobilized with moderate supination for 8 weeks followed by gradual AROM

Question 1

Flexor extensor strains

Answer 1

Etiology: repetitive tensile stresses to elbow flexors. Excessive wrist motion during feathering action. ( tennis, baseball)
Signs and symptoms: palpable pain over the muscle and is increased with active and resistance
Management: RICE NSAIDS and programs for gradual ROM and strengthening. Proper fitting for equipment.

Question 2

Rupture of the Triceps

Answer 2

Etiology: a direct to the posterior elbow or an uncoordinated triceps contraction during a fall. 80% involve olecranon avulsion fracture. Spontaneous rupture could be cause by systemic diseases or steroid use

Signs and symptoms: pain and swelling over distal attachment of extensor on olecranon process, step off deformity, active extension is weak
Management: immediate referral, ice compression, immobilization
Surgery to attach tendon to olecranon process. Avulsion fracture needs open reduction and internal fixation of fragment. Elbow immobilized in 45 degrees of flexion for 4 weeks.