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Musculoskeletal 1 > Upper Extremity Injuries - Elbow/Forearm > Flashcards

Upper Extremity Injuries - Elbow/Forearm Flashcards

1
Q

what commonly causes an olecranon fx?

A

a fall directly onto flexed or extended elbow

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2
Q

radiology needed in olecranon fx

A
  • 2-3 view of elbow

- need true lateral to see olecranon

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3
Q

initial tx of olecranon fx

A

-splint w/ long arm posterior

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4
Q

tx of olecranon fx w/ less than 1-2 mm of displacement

A

can be splinted and treated conservatively

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5
Q

tx of olecranon fx w/ > 2 mm displacement

A

need ORIF

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6
Q

common cause of radial head fx

A

FOOSH w/ elbow extended

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7
Q

PE of radial head fx

A
  • TTP of radial head

- swelling and decreased ROM

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8
Q

radiology for radial head fx

A
  • 3 view of elbow
  • look for “fat pad” sign and “sail” sign for subtle injuries
  • type I-IV
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9
Q

tx for type I radial head fx

A
  • no displacement

- can be tx conservatively w/ splinting and early ROM

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10
Q

tx for type II-IV radial head fx

A

need ORIF

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11
Q

ulnar head dislocation

  • MC kind
  • typical pt
  • cause
A
  • MC is posterior lateral dislocation
  • children more common
  • FOOSH
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12
Q

PE of ulnar head dislocation

A
  • obvious deformity w/ loss of ROM

- check neurovascular status

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13
Q

radiology for ulnar head dislocation

A
  • true lateral w/ 3 view of elbow

- look for other fx b/c of the “terrible triad”

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14
Q

“terrible triad” in elbow dislocations

A
  • elbow dislocation in combo with radial head fx and coronoid process fx
  • Prone to early recurrent instability and posttraumatic arthritis.
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15
Q

tx of ulnar head dislocation

A
  • closed reduction
  • splinting (long arm)
  • referral to ortho
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16
Q

radial head dislocation are also called?

A

nurse maid’s elbow

17
Q

radial head dislocation is commonly caused by?

A
  • axial traction on a pronated forearm in full extension (grabbing kid by arm)
  • common in young children
18
Q

PE of radial head dislocation

A

painful joint that the child does not want to move

19
Q

radiology for radial head dislocation

A
  • clinical diagnosis

- no films needed unless suspect fx

20
Q

tx of radial head dislocation

A
  • reduction by:

- supination/flexion and hyperpronation

21
Q

epicondylitits types

A
  • medial (golfer’s elbow)

- lateral (tennis elbow)

22
Q

medial epicondylitis aka golfer’s elbow

A
  • overuse injury from repetitive eccentric force
  • pronator teres and flexor carpi radialis
  • localized TTP of medial elbow
23
Q

lateral epidondylitis aka tennis elbow

A
  • overuse injury
  • extensor carpi radialis brevis
  • TTP lateral elbow
24
Q

tx of epicondylitis

A
  • conservative
  • bracing / spinting
  • PT/OT
  • they must stop activity or it won’t get better
25
Q

bicep tendonitis is more common in who?

A

-people who perform frequent pulling or lifting

26
Q

PE of bicep rupture

A

-tendon can be visible w/ a palpable mass or hematoma

tendonitis w/ no rupture produces pain at insertion site

27
Q

special tests for biceps tendonitis/rupture

A
  • speed test

- yergasons test

28
Q

speed’s test

A
  • pts elbow is extended, forearm supinated and the humerus elevated to 60 degrees
  • the examiner resists humeral forward flexion
  • pain located to bicipital groove = positive
29
Q

yergasons test

A
  • elbow flexed to 90 degrees
  • start in pronated position
  • active supination and flexion against resistance
  • palpate biceps tendon
  • pain or painful pop = positive
30
Q

tx for bicep tendonitis

A
  • basic ortho tx

- activity restriction

31
Q

tx for biceps rupture

A

-operative

32
Q

types of forearm fxs

A
  • nightstick
  • monteggia
  • galeazzi
  • both bone
33
Q

forearm fxs

A
  • commone
  • can be isolated or in combination
  • mechanism: high energy trauma or falls
34
Q

night stick fx

A

-midshaft ulnar fx (from blocking a nightstick)

35
Q

galeazzi fx

A

radial midshaft fx associated w/ radioulnar joint instability

36
Q

monteggia fx

A

fx of the proximal third of the ulnar shaft associated w/ dislocation of the radial head

37
Q

tx of isolated midshaft radius fx

A

-ORIF recommended w/i 1-2 days

38
Q

non-operative casting/splinting can be used as tx for nighstick fx if the following criteria are met:

A
  • > 50% apposition
  • <10 degrees angulation
  • no radial head dislocation
  • fx w/i distal 2/3 of ulna
39
Q

tx of galeazzi and monteggia fx

A

-splinted w/ well molded double sugar tong and ORIF

Musculoskeletal 1 (14 decks)

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