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Year 5 Acute Care & Trauma > Y5 - Elbow: fracture (coronoid, olecranon, radial head) > Flashcards

Y5 - Elbow: fracture (coronoid, olecranon, radial head) Flashcards

1
Q

what are coronoid fractures indicative of

A

an episode of elbow instabiltiy

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2
Q

what can coronoid fractures be associated with

A

elbow dislocation

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3
Q

what is the mechanism for how a coronoid fracture occurs

A

a traumatic shear injury

- the distal humerus is driven against the coronoid with an episode varus stress or posterior subluxation

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4
Q

is a coronoid fracture an avulsion fracture

A

no

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5
Q

why can a coronoid fracture amplify elbow instability

A

the anterior bundle of the medial collateral ligament attaches to the sublime tubercle distal to the tip
and the anterior capsule attaches distal to the tip of the coronoid

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6
Q

what is the terrible triad of elbow fracture dislocation

A

an elbow dislocation associated with radial head fracture and coronoid fracture

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7
Q

epi

A

10% of elbow injuries

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8
Q

what is posteromedial rotatory instability

A

coronoid anteromedial facet fracture, LCL injury

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9
Q

what is posterolateral rotatory instability

A

coronoid tip fracture, radial head fracture, LCL injury

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10
Q

what is olecranon fracture-dislocation associated withq

A

a large coronoid fracture

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11
Q

what is the medial facet of the coronoid important for

A

varus stability

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12
Q

what does the medial facet of the coronoid do

A

provides insertion for the medial ulnar collateral ligament

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13
Q

what is the coronoid important for

A

preventing posterior subluxation

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14
Q

what classification is used for coronoid fractures

A

regan and morrey classification

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15
Q

what are the three types of regan and morrey classification

A

type 1 coronoid process tip fracture
type 2 fracture of 50% or less
type 3 fracture of 50% or more

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16
Q

presentation of coronoid fracture

A

elbow deformity, pain, swelling

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17
Q

physical exam of a coronoid fracture

A

varus or valgus deformity
ecchymosis & swelling
tenderness
crepitus

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18
Q

investigations

A

Xray

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19
Q

what view on a xray would be useful for elbow fractures

A

AP and lateral elbow

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20
Q

management for non-operative fractures

A

period of immobilisation

followed by reintroduction into range of motion

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21
Q

what are the indications for non-operative fractures

A

all types of the regan and morrey classification with a minimally displaced stable elbow

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22
Q

what are the different types of olecranon fracture

A

1 isolated undisplaced/stable fracture

2 displaced/unstable fracture

23
Q

management for an isolated undisplaced or stable olecranon fracture

A

immobilisation at above-elbow at 90 degrees elbow flexion

24
Q

management for a displaced or unstable olecranon fracture

A

place arm in above-elbow backslab at 90 degrees elbow flexion and refer to ortho

25
Q

what do most displaced or unstable olecranon fractures require

A

reduction/fixation

26
Q

how are olecranon fractures classified

A

anatomical location
fracture pattern
displacement

27
Q

what different anatomical locations are common in olecranon fractures

A

metaphyseal
physeal
epiphyseal

28
Q

what are the different fracture patterns for olecranon fractures

A

transverse
oblique
longitudinal

29
Q

when is deformity associated with olecranon fracture

A

with radial head dislocation

30
Q

what investigations are ordered for potential olecranon fracture

A

AP and lateral view of the elbow

31
Q

what must the AP view of the elbow in a potential olecranon fracture show

A

the relationship of the proximal radius and the ulna to the humerus

32
Q

what % of olecranon fractures require reduction

A

20%

33
Q

what is the olecranon part of

A

the ulna

34
Q

when may an olecranon fracture occur

A

a fall onto the outstretched arm

intense contraction of the triceps tendon

35
Q

what is the mayo classification of olecranon fractures based upon

A

the stability, the displacement, and the comminution of the fracture

36
Q

what are the different types of olecranon fracture for the mayo classification

A

T1 non-displaced fracture
T2 displaced stable fracture
T3 displaced unstable fracture

37
Q

what is a T2 displaced stable fracture

A

fracture fragment is displaced more than 3mm but ligaments are intact

38
Q

what is a T3 displaced unstable fracture

A

displaced fracture fragment with damaged ligaments

39
Q

what are the different subtypes of mayo olecranon fractures

A

non-comminuted

comminuted (lots of fragements)

40
Q

who are olecranon fractures common in

A

adults due to its exposed position

rare in children

41
Q

what nerve may be damaged with an olecranon fracture

A

olecranon forms part of the ulna, therefore may cause ulnar injury
(numbness and tingling in the 4th and 5th fingers)

42
Q

management for nondisplaced olecranon fracture

A

immobilisation with a posterior splint with limited flexion

43
Q

management for a displaced olecranon fracture

A

surgically

e.g. tension band fixation

44
Q

what is the most common cause of a radial head fracture

A

an outstretched arm

45
Q

management of a radial head fracture

A

nondisplaced/stable is supportive casting

displaced/unstable is possible surgery

46
Q

epidemiology of radial head fractures

A

women>men

30-40yrs

47
Q

what are the most common elbow fractures

A

radial head fractures

48
Q

what is the mechanism of injury of a radial head fracture

A

fall onto an outstretched arm

elbow extension and forearm pronation

49
Q

what injuries are associated with a radial head fracture

A 
ligament injury (lateral collateral ligament)
Essex-Lopresti injury
50
Q

what is a essex-lopresti injury

A

a distal radioulnar joint injury

51
Q

what classification system is used for radial head fractures

A

mason classification

52
Q

what are the 4 different types of mason classification for radial head fractures

A

type I - nondisplaced or minimally displaced
type 2 displaced >2mm
type 3 comminuted and displaced
type 4 radial head fracture

53
Q

what does the lateral pivot shift test

A

lateral ulnar colateral ligament

54
Q

what does the valgus stress test

A

medial collateral ligament

Year 5 Acute Care & Trauma (35 decks)

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