Elbow Injuries
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Transcript of Elbow Injuries
The Injured ElbowDavid Moss, MD
Washington Orthopaedics & Sports Medicine, PA
overview
• Anatomy
• Fractures
• Olecranon
• Radial head
• Tenodonopathies
• Lateral epicondylitis
• Medial epicondylitis
• Biceps tear/rupture
• Nerve compression
• Cubital tunnel
anatomy
Elbow fractures
Olecranon fracture
• Usually result from eccentric muscle contracture
after a fall onto outstretched hand, or direct trauma
• Results in loss of active elbow extension
• Best treated with surgery
• Outpatient
• Takes about 1 ½ hours
Radial head fractures
• Usually result from a fall
onto outstretched hand
• Painful elbow
• Can cause loss of forearm
rotation
• Turning door handles
• Turning keys
• Screwdriver
treatment
Splint &/or sling
surgery
tendonopathies
“Tennis elbow”
• Lateral epicondylitis
• Pain on the “outside”
of the elbow
• Inflammation and
microtears of
common extensor
tendon origin
• Rarely a result of
playing tennis!
Signs & symptoms
• Elbow pain with gripping
• Shaking hands
• Lifting heavy objects
• Turning door handles
• Brushing teeth
Physical exam
• Tender at lateral elbow
• Pain with resisted wrist
extension
• Pain with resisted
supination
treatment
• Anti-inflammatory medication
• Wrist splint
• Forearm strap
• Physical therapy
Cortisone injection
• Immediate pain relief
• Lasts 2-3 months
• Does not “cure” the
underlying problem
PRP
• Platelet-rich plasma
• Uses your own blood
• New technology
• Safe
• Unproven long-term
track record
surgery• For recalcitrant pain
• Good track record
• “In & out” surgery
• Open
• Arthroscopic
• Takes about an hour
“golfer’s elbow”
• Medial epicondylitis
• Pain on the “inside” of the
elbow
• Inflammation and
microtears of common
flexor tendon origin
• Rarely a result of playing
golf!
Treatment
• Similar to treatment of
lateral epicondylitis
• NSAIDs
• Splints & straps
• Physical therapy
• Cortisone injection
• PRP
• Surgery
Biceps rupture
• Usually men >40 years old
• Chronic tendon breakdown weakens tendon fibers
• Heavy lifting “pop”
• Lifting furniture
• Water skiing
Presentation & exam
• Deformity anterior elbow
• Bruising
• Swelling
• Hook test
• Weakness in supination
• Screw driver, keys, etc.
• NOT elbow flexion
weakness!
treatment• Observation
• Results in loss of
supination and flexion
strength
• Surgical repair for active
• “In & out” surgery
• Takes about an hour
• Multiple fixation techniques
Cubital tunnel syndromeCompression of the ulnar nerve at the elbow
presentation
• Numb/pain small finger and
ring finger
• Hand/grip weakness
• Numb worsens with elbow
flexion
• Holding the phone to ear
• Driving
• Claw hand
• Muscle wasting
Treatment
• Elbow extension splint
• EMG
• Surgical release
Thank youDavid Moss, MD
Washington Orthopaedics & Sports Medicine, PA
-Sibley Medical Office Building
-The Barlow Building, Chevy Chase
-2021 K Street, NW