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4 Cards in this Set
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Hx:10yo little league pitcher has the triad of med elbow pain in his throwing arm, dec throwing effectiveness, dec throwing distance. What is the pathogenesis of the condition occuring? 1- Acute frag of capitellar ossific nucleus; 2-Rupture of the ant band of the ant bundle of the UCL; 3-Repetitive contraction of the flex-pron mass stresses the chondro-osseous origin, ->apophysitis; 4-Microtraumatic vascular insuff of the capitellum from chronic compr & rotatory forces; 5-Repetitive triceps contraction during extension
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Little League elbow = repetitive valgus stresses & tension overload of the med structures, repetitive contraction of the flexor-pronator mass stresses the chondro-osseous origin at the medial epicondyle, leading to inflammation and subsequent apophysitis, tx is initially nonop w/ rest followed by a gradual return to activities.Ans3
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Hx:18yo F x 9 mths of ant knee pain recalcitrant to PT that includes VMO strengthening, NSAIDS, lifestyle modification. PE: she has no effusion in the knee, her Q ang is measured at 15 deg. < 1 quad of med patella translation & < 2 quad of lat patella translation. lat edge of the patella is unable to be everted. A merchant view xray Fig A. The tibia tubercle-trochlear groove dist is measured as 14mm on a CT scan. Which procedures is MOST appropriate? 1-Lat retinacular release; 2-Anterolateral tibial tubercle osteotomy; 3-Ant tibial tubercle osteotomy (Maquet);
4-Med tibial tubercle osteotomy (Elmslie-Trillat);5-Med plica resection |
lat patellar tilt and lateral facet compression synd, respectively. lateral retinacular release is the most appropriate tx, surgical tx for this condition is rare and used only in cases that are recalcitrant to conservative measures, TT-TG distance > 20mm is an indicator that a medializing tibia tubercle osteotomy is needed.Ans1
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Hx:24yo M c/o R elbow injury Fig A & B. He promptly undergoes op I & D, Opn Redctn, vascular bypass of the brachial artery, and hinged elbow fixator placement x 6 wks. 3 yrs later c/o of clicking, locking w/ elbow exten & diff performing arm triceps dips while attempting exerz. Which recon is MOST appropriate? 1-Elbow scopy w/ ext tendon insertion debridement; 2-Lat ulnar collateral lig recon w/ palmaris tendon graft; 3-Rad collateral lig recon w/ palmaris tendon graft; 4-Med ulnar collateral lig recon w/palmaris tendon graft woven in a fig-8 fashion (Tommy John procedure); 5-MCL recon w/ palmaris tendon graft woven using Docking procedure
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PLRI of the elbow = 2^ open elbow dislocation, tx is LUCL recon w/ palmaris tendon graft.Ans2
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Hx: 11yo soccer player c/o snapping, discomfort along the lat jnt line of the knee. PE-10 deg loss of active ext. xray Fig A. Sequental sag MRI - lat compartment of the knee Fig B. What is the course of Tx? 1-PT w/ a focus on concentric knee strengthening
2-NWB x 6 wks; 3-scopic saucerization of the lat meniscus and/or meniscal repair; 4-Open lat menisectomy; 5-scopic microfracture tx of the defect on the lat fem condyle |
op tx= discoid menisci for persistent pain or motion loss-> prevent further meniscal damage, repair of a detached posterior or peripheral attachment, w/ saucerization of the discoid morphology depending on the underlying meniscal shape & presence of a meniscal tear, Type III discoid menisci, so-called Wrisberg lig type, lacking pos capsular attachments w/ the exception of the pos meniscofemoral ligament, =the classic “snapping knee” synd.Ans3
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