Please enable JavaScript.
Coggle requires JavaScript to display documents.
Elbow (Radial Head Fracture (Mechanism (FOOSH with elbow extended and…
Elbow
Radial Head Fracture
- a common fracture of the upper limb in young adults
- Terrible Triad: Radial head fracture, Coronoid fracture, Elbow dislocation
-
Clinical Features
- local tenderness on palpation over radial head.
- decreased ROM at elbow
- pain on pronation / supination
-
- type I, undisplaced segmental (marginal) fracture
- type II, displaced segmental fracture;
- type III, comminuted fracture;
- type IV fracture associated with posterior dislocation of the elbow.
Specific Complications
- myositis ossificans – calcification of muscle.
- recurrent instability
treatment
- open reduction & intenal fix.- conservative
Supracondylar Fracture
- subclass of distal humerus fracture.
- most common in pediatric population
- median nerve injury commonly associated with extension type
-
Clinical Features
pain, swelling, point tenderness
neurovascular injury: assess median and radial nerves, radial artery
Investigations
x-ray: AP, lateral of elbow
Treatment
- reduction indications: evidence of arterial obstruction.
- non-operative: long arm plaster slab in 90o flexion
- operative:
indications: displaced, vascular injury, open fracture
percutaneous pinning followed by limb cast with elbow flexed <90o
in adults, ORIF is necessary
Specific Complications
- stiffness is most common.
- brachial artery injury (kinking can occur if displaced fracture), median or ulnar nerve injury, compartment syndrome (leads to Volkmann’s ischemic contracture), malalignment cubitus varus (distal fragment tilted into varus)
Olecranon Fracture
- direct trauma to posterior aspect of elbow or FOOSH
- localized pain, palpable defect ±loss of active extension
-
Treatment
- non-operative: cast
- operative: ORIF
Open reduction internal fixation by Webber wire loop
Open reductionand internal fixation by cortical screw
Epicondylitis
- lateral epicondylitis =“tennis elbow”, inflammation of the common extensor tendon as it inserts into the lateral epicondyle
- medial epicondylitis = “golfer’s elbow”, inflammation of the common flexor tendon as it inserts into the medial epicondyle
Features
tenderness over humeral epicondyle, pain upon resisted wrist extension (lateral epicondylitis) or wrist flexion (medial epicondylitis), generally as elf-limited condition
Treatment
- non-operative (very good outcomes): rest, ice, NSAIDs, physiotherapy, corticosteroid injection
- operative:
percutaneous or open release of common tendon from epicondyle
indication: failed 6-12 mo conservative therapy
Elbow Dislocation
- third most common joint dislocation after shoulder and patella
- Mechanism: elbow hyperextension, or valgus / supination stress during elbow flexion
- Clinical Features: elbow pain, swelling, deformity, flexion contracture
- Investigations: x-ray: AP and lateral views.
- Treatment:
non-operative:
closed reduction under conscious sedation
Parvin’s method
long-arm splint with forearm in neutral rotation and elbow in 90° flexion
operative: ORIF
indications: complex dislocation or persistent instability after closed reduction