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104 Cards in this Set
- Front
- Back
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What is considered lateral; radius or ulna
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radius
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What does the capitellum of the humerus articulate with
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the radius
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What does the trochlea of the humerus articulate with
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the ulna
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Which bone contains the olecrannon
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the ulna (this wraps around the trochlea)
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What is inbetween the olecrannon and the trochlea
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Not best picture...see next slide for the location
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Where is the coronoid process of the elbow
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not labeled but is opposite the olcranneon process and forms the groove for the trochlea
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What is the bigger bone at the elbow
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the ulna
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What bone articulates with the capitellum of the humerus
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radius
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What is the bigger bone at the elbow
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the ulna
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What bone articulates with the capitellum of the humerus
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radius
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Where is the trochlea and capitellum of the humerus
Where do the extensor and flexor tendons attach |
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Where is the trochlea and capitellum of the humerus
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Where is the radialcapitellum line
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Can a radialcapitellum line be drawn on any view of the elbow
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yes, it should always pass through the capitellum no matter what view
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When is the anterior humeral line normally drawn
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a true lateral along the anterior aspect of the distal humerus
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What should the anterior humeral line pass through when it is drawn on the lateral elbow xray
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middle 1/3 of capitellum
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What is the location of the fat pads around the elbow
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extrasynovial and intracapsular
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Where are the two fat pads located
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anterior and posterior (distal humerus)
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What does the normal anterior fat pad look like
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a triangular shaped radiolucency just above the capitellum seen on the lateral view of the elbow
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Should a posterior fat be normally visualized on lateral x ray
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no
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What does the anterior fat pat look like in the presence of a joint effusion
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elvated and convex outwards
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What is the anterior fat pad in the presence of a joint effusion said to look like
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a spinnaker sail of a sail boat
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Where is the posterior fat pad located
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distal posterior humerus just above the distal portion of the olcreanon process
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What % of people with a posterior fat pad sign have a fx
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70-90%
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What is the MC elbow fracture in children
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supracondylar fracture
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What percent of all fractures in children are supracondylar fractures
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60%
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What is the mc age of children that have supracondylar fractures
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3-10
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What is the MC mechanism of injury of a supracondylar fracture
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fall on outstretched arm with extension at the elbow
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What are 2 complications of supracondylar fractures
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cubitus varus ( bowed inward angulation of the distal segment of a bone or joint) and brachial artery injuries
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What is the anterior humeral line important for diagnosing
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displacement of the capitellum, dislocation
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What commonly happens to the capitellum in supracondyar fractures
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the capitellum is displaced posteriorly so the anterior humeral line will pass through the anterior 1/3 or miss the capitellum completeley
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what is the mc elbow fracture of an adult
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fracture of the radial head
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What is the MC mechanism of injury of a radial head fracture
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fall on outstretched hand
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What is a chisel fracture
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a longitudinal fracture through the radial head
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What is the 2nd MC fracture in adults
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olecranon fractures
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What are the 2 mc mechanism of injury of an olecranon fracture
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FOOSH (fall on outstretched hand) or direct blow
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What does the olecranon and coronoid process form
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the trochlear notch
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Is an olecranon fracture intrarticular
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yes bc it passes into the trochlear notch
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What is the mc direction of an olecranon fracture
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transverse
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Does a transverse olecranon fracture cause a wide space
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yes, there is distraction of the distal portion of the olecranon fracture bc it is being pulled by the tricep
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What is the radial capitaleum line useful for finding
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capitellum movement bc of a supracondylar fracture or dislocation of the elbow,
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Are olcraneon fractures association with elbow dislocation
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yes
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What is a potenial problem of an olecranon fracture
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non-union
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What is the 3rd mc fracture of the elbow in adults
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fracture of the coronoid
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What 2 other injuries is a coronoid process fracture associated with
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radial head fractures and elbow dislocations
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What happens to the elbow if the coronoid process fracture is left untreated
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instability leading to dislocation. Greater than 50% of the coronoid must remain intact for stability to be intact
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What is the MC dislocation in children
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elbow dislocation
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What is the 1st and 2nd MC dislocation in adults
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1-shoulder
2-elbow |
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How do elbow dislocations MC occur
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fall on extended/abducted arm
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How is an elbow dislocation classified
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by the ulna relative to the humerus
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What is MC; anterior or posterior elbow dislocations
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posterior (80-90%)
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What is the MC mechanism for an anterior dislocation
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strong blow to posterior aspect of flexed elbow
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What is associated with neurovascular injuries; anterior or posterior dislocations
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anterior
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What is a monteggia fracture dislocation
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fracture of the proximal ulna with anterior dislocation of the radial head
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What is a nursemaids elbow
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this is when the radial head slips out of a loose annular ligament in a child
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What age do nursemaids elbows most commonly occur
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2-4 years of age
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What is the mechanism of injury of a nursemaids injury
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tugging of an extended arm
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Are x-rays sensitive for detecting nursemaids elbow
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no, it is mostly a clinical diagnosis and often will see nothing on x-ray or maybe mild subluxation
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What should be done when examining a pediatric elbow
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get a normal opposite side for comparison
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What are 3 areas that lead to pitfalls in patholgoy
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trochlea
lateral epicondyle olecranon |
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What is the appearance of the trochlea in a child
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fragmented
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What is the appearance of the lateral epicondyle in a child
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1 or more ossification centers
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What is the appearnance of the olecranon
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2 or more ossification centers
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What is the order of ossification of the elbow (CRITOE)
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capitellum
radial epiphysis internal (medial) epicondyle (closer to the ulna) trochlea olecranon external (radial) epicondyle |
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What is the age of critoe
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C- 1
R- 3 I- 5 T-7 O-11 |
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Why is it important to know the order of ossification of the pediatric elbow
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because if these are out of order then there is a fracture
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What is the cause of a fracture of the medial epicondyle
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pull of the ulnar collateral ligament
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What is the cause of a fracture of the medial epicondyle
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cause by throwing motion
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What age does a fracture of the medial epicondyle occur
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around the age of 12 years (little league)
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What is a fracture of the lateral condyle considered in a child
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a salter 4 injury
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What is the mechanism of injury of a fracture of the lateral condyle
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traction/avulsion
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What is the MC age for a lateral condyle injury
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4-10
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Why are condyle fractures of the elbow worrisome
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they may be associated with growth abnormalities
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When does the apophysis of the olecranon fuse
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18 years
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When does the apophysis of the olecranon appear
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9 years
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Can the apopyhsis become fractured
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yes, associated with throwing
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What is a pitfall of the olecranon apophysis fusing
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it fuses anterior to posterior and therefore there may be a small cleft of lucency posteriorly as the olecranon is fuses on the posterior margin which may be mistaken for a fracture
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What percent of fractures are upper extremity
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almost 50%
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What is the most common injury of upper extremity injuries
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FOOSH or direct blow
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What is the most common body part injured in skate boarding
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forearm
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What is the appearance of the radius and ulna on lateral view
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superimposed on eachother
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What is the appearance of the radius and ulna in supination view
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the radius and ulna are parellel to eachother
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What portion of the forearm is most commonly fractures
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the distal 1/3 (75%)
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What does a monteggia and galleazzi fracture have in common
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a fracture and dislocation of other bone
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What is the mechanism of a monteggia fracture
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direct blow or forced pronation during a fall
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What is a monteggia fracture
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fracture of proximal ulna (with distal fragment angulated dorsally) and an anterior dislocation of the radial head
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What is a monteggia equivalent
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combination of proximal radial fracture and ulnar shaft fracture
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What are the complications of the monteggia fracture
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limitation of movement and non-union
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What is more common: galeazzi fracture-dislocation or monteggia fracture-dislocation
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galeazzi
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What is a galeazzi fracture
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fracture of the distal 1/3 of the radius with shortening and posterior dislocation of the distal ulna
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What are the complications of a galleazzi frx
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non-unionn or delayed union
malunion |
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What bone is fractured in a monteggia fracture
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ulna
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What bone is fractured in a galeazzi fracture
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radius
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What is acute plastic bowing
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deformation of the bone secondary to longitudinal stress
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What is the age group that acute plastic bowing occurs
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2-5
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What is the pathophysiology of acute plastic bowing
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numerous microfractures on concave surface of the bone with intact cortex and convex surface
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What is the mc location of acute plastic bowing
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forearm
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What is the most common radiographic finding of acute plastic bowing of the elbow
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bowing of the ulna with fracture of the radius
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What is the mechanism of acute plastic bowing
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FOOSH
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What is seen on bone scan of a pt with acute plastic bowing
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increased uptake on the concave surface of the bone where numerous microfractures have occured
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What is a nightstick fracture
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a fracture of the ulna from direct trauma
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What portion of the ulna do nightstick fractures most commonly occur
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the middle 1/3rd
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What is an apophysis
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growth plate
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What is an apophysis
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growth plate
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