Orthopedics
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| Ulnar n. symptoms | numbness, paresthesia, thenar wasting
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| Carrying angle (M/F) | Men 5 degrees, women 10-15 degrees
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| Elbow Radiographs: Order: | AP, lateral, oblique
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| Elbow Radiographs: Inspect for: | Cortical defects; Radiocapitellar line; Ant. humeral line; fat pad sign
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| Anterior fat pad = | Usually normal (Sail sign)
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| Posterior fat pad = | Always pathologic
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| Posterior fat pad sign in adults may indicate: | radial head fx
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| Posterior fat pad sign in kids = | supracondylar fx
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| Lateral Epicondylitis: Hx: | Elbow pain from repetitive wrist extension
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| Lateral Epicondylitis: Anatomy: | Site of origin of wrist extensors-supinators
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| Lateral Epicondylitis: PE: | Pain over lateral epicondyle with resisted wrist extension & supination
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| Lateral Epicondylitis: Other Care: | Ice, stretch, strap, iontophoresis, surgical release
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| Lateral Epicondylitis: Injection: | At the tender pt at lateral epi.; Marcaine, Kenalog, 25 g needle, down to the bone
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| Radial Head Subluxation AKA | Nursemaids Elbow
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| Radial Head Subluxation = | Annular ligament entrapment
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| Radial Head Subluxation MOA: | Traction (swinging kids by wrists)
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| Radial Head Subluxation Presentation: | Flexed and IR
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| Radial Head Subluxation Rx: | Tx x-ray; Hyper-pronation; Flexion/ supination/ extension; Feel a pop; Quick relief
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| Elbow Instability: | UCL sprain or tear (UCL primary valgus stabilizer)
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| Elbow Instability: Seen in: | throwing athletes
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| Elbow Instability S/S: | Pop while throwing & medial elbow pain & hand paresthesia; Pain on valgus testing
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| Elbow Instability tests: | X-ray, MRI
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| Elbow Instability Rx: | Rest, NSAIDs, PT, slow return to sports; poss Tommy John Surgery; education
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| Olecranon Bursitis: Hx: | May be traumatic or insidious
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| Olecranon Bursitis: Diff Dx: | Infection, Gout, triceps rupture
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| Olecranon Bursitis: PE: | Red, swollen joint, + pain
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| Olecranon Bursitis: Other Care: | Compressive sleeve; ant. splint if recur; Bursectomy if chronic
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| Olecranon Bursitis: Caution: | infection
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| Olecranon Bursitis: Aspiration | (high threshold for this): 18g needle, poss 60 ml syringe
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| Olecranon Bursitis: Aspiration: if cloudy: | suspect infection; send for crystal, cx, gm stain
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| Olecranon Bursitis: Injection (high threshold for this): | Marcaine/ Kenalog
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| TEA = | Total elbow arthroplasty
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| Distal Humerus Fx: use ____ Classification | Mehne & Matta
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| Distal Humerus Fx: Location | Supracondylar; Transcondylar; Intracondylar; T condyle fracture; lateral, medial condylar fractures
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| Stable, non-displaced fx may be tx with: | splinting for 10 days, then protected ROM
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| Distal Humerus Fx: stability | Most are unstable and require ORIF
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| Most common elbow fracture in children | Supracondylar Fx
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| Supracondylar Fx: MOA | Extension, distal fragment posterior; N/V injury common
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| Supracondylar Fx: Tx | Casting vs. ORIF vs. CRPP
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| 3rd most common child fx = | Medial epicondyle fx
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| Epicondyle Fx: which is uncommon? | Lateral epicondyle fx
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| Epicondyle Fx: Rx: Non displaced | Cast immobilization
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| Epicondyle Fx: Rx: Displaced (>30 degree angulation, or 1mm) | CRPP vs. ORIF
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| CRPP = | closed reduction & percutaneous pinning
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| Radial Head Fx: Hx | FOOSH, valgus force
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| Radial Head Fx: PE | Swelling lateral elbow; Pain over radial head; Limited pronosupination & extension
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| Radial Head Fx: Radiographs: | AP, lat, obliq
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| Radial Head Fx: Mgmt: Type I (non-displaced) | Posterior splint/sling for 3-5 days; Early ROM exercises
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| Radial Head Fx: Mgmt: Type II (displaced) | Tx as in Type I if < 30% head displaced (Otherwise: ORIF)
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| Radial Head Fx: Mgmt: Type III (comminuted) | Excision of frags or complete radial head
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| Radial Head Fx: Mgmt: Type IV (dislocated) | Same as III
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| Olecranon Fx: Check: | N/V function; Ulna n.
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| Olecranon Fx: Rx: Non-displaced: | Posterior splint @ 45 degrees; Re-image 1 week; ROM at 2 wks
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| Olecranon Fx: Rx: Displaced: | ORIF
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| Olecranon Dislocation: MOA | FOOSH
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| Olecranon Dislocation: 90% are: | posterior
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| Olecranon Dislocation: May also have | radial head or distal humerus fracture
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| Olecranon Dislocation: Check: | N/V status
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| Olecranon Dislocation: Tx | Reduction / fx care
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| Lateral Epicondylitis: Other Care: | Ice, stretch, strap, iontophoresis, surgical release
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| Radial Head Subluxation AKA | Nursemaids Elbow; Annular ligament entrapment
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| Radial Head Subluxation Presentation: | Flexed and IR
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| Radial Head Subluxation Rx: | Tx x-ray; Hyper-pronation; Flexion/ supination/ extension; Feel a pop; Quick relief
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| Olecranon Bursitis: PE: | Red, swollen joint, + pain
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| Olecranon Bursitis: Caution: | infection
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| Olecranon Bursitis: Aspiration | (high threshold for this): 18g needle, poss 60 ml syringe
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| Distal Humerus Fx: use ____ Classification | Mehne & Matta
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| Stable, non-displaced fx may be tx with: | splinting for 10 days, then protected ROM
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| Distal Humerus Fx: stability | Most are unstable and require ORIF
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| Most common elbow fracture in children | Supracondylar Fx
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| Supracondylar Fx: MOA | Extension, distal fragment posterior; N/V injury common
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| Supracondylar Fx: Tx | Casting vs. ORIF vs. CRPP
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| Epicondyle Fx: which is uncommon? | Lateral epicondyle fx
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| Epicondyle Fx: Rx: Non displaced | Cast immobilization
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| Epicondyle Fx: Rx: Displaced (>30 degree angulation, or 1mm) | CRPP vs. ORIF
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| Olecranon Fx: Rx: Non-displaced: | Posterior splint @ 45 degrees; Re-image 1 week; ROM at 2 wks
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| Olecranon Fx: Rx: Displaced: | ORIF
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| Olecranon Dislocation: MOA | FOOSH
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| Olecranon Dislocation: 90% are: | posterior
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| Olecranon Dislocation: May also have | radial head or distal humerus fracture
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| Olecranon Dislocation: Check: | N/V status
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