Musculoskel Bone Pathology Of The Elbow And Forearm

Front 1

fractures at the elbow

Back 1

distal humerus
supracondylar
radial head
radial and ulnar (M and G)
olecranon

Front 2

intervention
surgical fixation for bony fractures

Back 2

thru the skin, age, BS, other associated tissue pathologies (nervous tissue, fracture created instability w/ lig structure), comminuted (lots of fractures), displacement, PROM of elbow joint unstable during arc of motion

Front 3

cast immobilization
intervention at the elbow

Back 3

immobilization causes stiffness
recovery is anywhere from 4-16 weeks
max you should be in a cast is 3 weeks

Front 4

the cast helps by

Back 4

forming a good callus

Front 5

what should a pt feel like 3 weeks after fracture?

Back 5

bone is still healing, pain should only be w movement especially at the end of the day, swelling shouldnt be warm or painful

Front 6

what happens to swelling at 3 weeks post fracture

Back 6

swelling should not be warm or painful, you should be able to reduce some of it during treatment

Front 7

what are the stages of healing

Back 7

granulation stage (inflammation)
callous formation (reparative)
remodeling

Front 8

distal humeral fracture

Back 8

caused usually by FOOSH
could have hyperflexion injuries
radial capitulum could break in full flexion

Front 9

DHF
more common spot in kids

Back 9

above the condyle, supracondylar fracture

Front 10

what is the most common fracture in adults at the elbow

Back 10

radial head fracture

Front 11

radial head fracture

Back 11

FOOSH
can also happen in hyperflexion
associated more commonly with pronation of the FA b/c radius is twisted over ulna and force isn't absorbed well

Front 12

radial head injuries and such can also

Back 12

hyperstretch tendons, wrist joint capsule, stabilize ligaments, median n
you could also tear your RTC because humerus is going upwards

Front 13

fractures with elbow are often times accompanied by

Back 13

dislocations of other joints

Front 14

galeazzi fracture

Back 14

fracture of the radius w dislocation of ulna (wrist joint is dislocated)

Front 15

monteggia fracture

Back 15

fracture of the ulna w dislocation of proximal radius (at proximal joint)

Front 16

fracture and dislocation causes

Back 16

soft tissue injury , bone heal, lig heal, everything is hurt, neuromuscular disorders too, ulnar n and a
muscles: brachialis, PT
brachial a, capsule, median n

Front 17

with impact fractures w dislocations we always fear

Back 17

vascular and neurological pathologies

Front 18

G and M usually occur

Back 18

in younger people who have not fully formed bony tissue

Front 19

Olecranon fractures

Back 19

fracture by direct trauma, fall on elbow
you can break with hyperextension too
these are the ones they worry about stability of joints so fix with wires and surgical pins (pins allow for very quick motion exercises)

Front 20

radial head fracture examination findings??
is this even right?

Back 20

limited in elbow flexion, extension
pronation and supination
limited or immobilized at the wrist proabbly for 2 weeks too

Front 21

what heals best with radial head fracture

Back 21

full extension and full supination

Front 22

video: man opening door
test of function
what is missing?

Back 22

wrist motion is missing,
immobilize elbow for 2 weeks
then immobilize FA thru hand and thumb for 1.5 more weeks
he doesnt ulnar or radial deviate or flex extend his wrist

Front 23

video: man opening door
test of function

Back 23

done when allowed
limited in motion in wrist,
supination, pronation, elbow flexion and extension

Front 24

if capsular pattern of loss

Back 24

more loss in flexion
if immoblized, check shoulder ER

Front 25

video: man opening door
ROM

Back 25

check total ROM at the shoulder too
more importantly check it at wrist, FA, elbow

Front 26

do muscle strength tests at the elbow? MMT?

Back 26

no isometric break test,
check ability to move against gravity
on the uninvolved side you can do normal MMT
at the wrist: MMT, use grip dynanometry?

Front 27

Joint play

Back 27

you can do it at the shoulders when ROM is abnormal or increased
if there is fracture at wrist: don't do JP

Front 28

systems review

Back 28

sensation testing
not concerned at interpretation at the brain level
could do light-crude touch
pain

Front 29

tissue healing for fracture

Back 29

intermittent compression
-get muscles to contract
-isometrics, squeezes, or grip (a lot)
AROM of elbow, FA, wrist and hand
AROM of shoulder as long as not contraindicated (will be some pain)
-use AROM to provide intermittent compression

Front 30

stage 2 tissue healing of fracture

Back 30

has to be gentle, submax, close to no work

Front 31

stage 3 healing

Back 31

restoration of strength

Front 32

reduction of pain

Back 32

AAROM or active mobility
soft tissue mobes
massage (pump, gentle eff)
pulldowns 2 hands (low wt submax)

Front 33

restoration of ROM

Back 33

soft tissue stretching, joint mobe if tolerable
pulley assisted movement

Front 34

restoration of strength

Back 34

done when out of pain
and mobility is back, swelling should be gone, improving in fx

Front 35

distal humeral fracture complications

Back 35

immobiilty
deformity

Front 36

what is gunstock deformity

Back 36

medial side of humerus doesn't grow so now pt is varus not valgus

Front 37

the functional arc

Back 37

30-120
extension is a bigger functinoal loss than flexion is

Front 38

ossification centers

Back 38

CRITOE
capitellum
radial head
internal epicondyle
trochlea
olecranon
external epicondyle (lateral)

Front 39

medial apophysitis

Back 39

happens in growing children at a sectino of the bone where it is meeting a tendon or ligamentous structure
commonly at elbow, knee, heel, achilles

Front 40

medial apophysitis causes

Back 40

abnormal inflammation process that is occurring at this aophysis
caused by aberrant stress
or by acceleration in growth

Front 41

medial apophysitis occurs in

Back 41

little boys throwing
due to length of time and lack of rest

Front 42

medial apophysitis symptoms

Back 42

pain
loss of accuracy, fatigue in arm, inability to throw best pitch anymore
presents much like a muscular pathology MEC or tendinosis of flexor/pronator group
looks like contractile

Front 43

medial apophysitis treatment

Back 43

rest
soft tissue shortening of lats
where do we want to stretch?
at the wrist and fingers, put elbow in position of rest

Front 44

Osteochondritis dissecans

Back 44

some sort of fragmentation of articular cartilage that reheals

Front 45

Panner's disease (OD)

Back 45

avascular necrosis of distal humerus
idiopathology
happens most commonly at the capitulum in 4-8 yr old group (not diagnosed til later?)

Front 46

OD most commonly at

Back 46

end range extension, there is a snapping, popping of arm, potential swelling and painful
can cause OA which is uncommon at elbow but is a result of injury to articular cartilage

Front 47

rheumatoid arthritis

Back 47

chronic systemic inflammatory disease of unknown etiology
-morning stiffness lasting at least 1 hour
-3 or more joints involved
-hand involvement with swelling
-a pt has RA if 4/7 criteria has been satisfied