Upper Limb Conditions- ELBOW + FOREARM Flashcards
Causes of lateral epicondylitis
Repetitive strain injury with regular resisted extension at the wrist or degenerative enthesopathy at the common EXTENSOR origin
Symptoms + Diagnosis of lateral epicondylitis
Pain + tenderness at lateral epicondyle
MILS test positive
US for tendinopathy
Treatment of lateral epicondylitis
Self-limiting, rest, physiotherapy, NSAIDS, steroid injection, brace
Cause of Medial epicondylitis
Repetitive strain/degeneration causing inflammation of common FLEXOR origin
Diagnosis of medial epicondylitis
Test flexor muscles, resisted wrist/middle finger flexion + pain at medial epicondyle
Treatment of medial epicondylitis
Self-limiting, physio, rest, NSAIDS, steroid injections (risk of ulnar nerve damage)
Cause of cubital tunnel
Compression of the ulnar nerve at the elbow behind the medial epicondyle due to: Tightness at the intermuscular septum or two heads at origin of the flexor carpi ulnaris
What is the name of the fascia that forms the roof of the cubital tunnel
Osborne’s Fascia
Symptoms of cubital tunnel
Numbness of pinkie and half of ring finger
Diagnosis of cubital tunnel
Positive Tinel’s test
Positive Froment’s test
Treatment of cubital tunnel
Surgical release of tight structures
Causes of supracondylar fracture
FOOSH- Kids
Treatment of supracondylar fracture
Undisplaced: Splint
Displaced/angulated: Closed reduction + wires
Severe: Median nerve compression (can’t make OK sign)
Olecranon fracture causes and treatment
Due to blow/direct fall on point of elbow when tricep is contracted
Causes and symptoms of radial head/neck fracture
FOOSH causing lateral elbow pain on supination/pronation
Treatment of radial head/neck fracture
Undisplaced: Fat pad sign on XR treated with sling + exercises to reduce stiffness
Displaced: surgery if fragment blocks extension, aspiration of haemarthrosis for restrictive ROM, ORIF if large fragment
What is a nightstick fracture
Isolate fracture of the ulna due to direct blow
Causes, diagnosis and treatment of Monteggia fracture
Fracture of the ulna and dislocation of the radius at radial head, diagnosed by forearm and elbow XR treated with ORIF
Causes, diagnosis and treatment of Galeazzi fracture
Fracture of the radius with dislocation of the ulna and the distal radioulnar joint, diagnosed by forearm + lateral XR, treated with ORIF
What is a Barton’s fracture and how is it treated
Intra-articular distal radius fracture involving dorsal/volar rim causing subluxation of carpal bones due to displaced rim fragments, treated with ORIF
What is a Colles Fracture
Extra-articular distal radius fracture with DORSAL displacement/angulation due to FOOSH with extended wrist
Complications of Colles Fracture
EARLY: Ulnar styloid fracture, median nerve compression
LATE: Rupture of EPL, dinner fork deformity
Treatment of Colles Fracture
Minimal displacement: Splintage
Angular past neutral: MUA + plaster cast
Dorsal communication + instability: K wires + ORIF
What is a Smiths fracture
Extra-articular distal radius fracture with VOLAR displacement/angulation due to FOOSH with flexed wrist
