Elbow Injuries
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INJURIES AROUND ELBOW
DR. ASHISH GOHIYA ASST. PROFESSOR DEPT. OF ORTHOPAEDICS GANDHI MEDICAL COLLEGE BHOPAL
www.esnips.com/web/gohiya
ANATOMY
www.esnips.com/web/gohiya
SEARCH
Gohiya
Feedback at [email protected]
www.esnips.com/web/gohiya
ANATOMY
www.esnips.com/web/gohiya
OSSIFICATION CENTRES
CRITOE C 2 R 4 I 6 T 8 O 10 E - 12
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www.esnips.com/web/gohiya
1
Epidemiology
Why complications
Boys 5 8 years High incidence of neurovascular complications High incidence of deformities
www.esnips.com/web/gohiya
Why deformities ? Inability to interpret X ray Due to poor quality of XX-ray Due to lack of knowledge
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Mode of trauma FOOSH
Loss of reduction
FALL ON OUT STRETCHED HAND
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OTHER INJURIES BY FOOSH
Clinical presentation
# LOWER END RADIUS # DISLOCATION ELBOW # S/C HUMERUS # NECK HUMERUS DISLOCATION SHOULDER # CLAVICLE
Pain Swelling Deformity
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2
On examination
Three point relationship
Swelling Deformity Tenderness Bony crepitus Abnormal movement Loss of transmitted movements Three point bony relationship maintained
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X
Ray X
Ray Rt elbow AP and lateral view
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Displacement AP View Proximal shift Medial shift or tilt Lateral shift or tilt Rotation
Lateral View Proximal Shift Post shift or tilt Rotation
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Fat pad sign
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Crescent sign
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3
Fish tail sign
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Classification Extension type (98%) Flexion type (2%)
Baumann angle
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Gartland Classification Type I
Undisplaced fracture
Type II
Displaced with post. Cortex intact
Type III
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Completely Displaced
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Type I
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4
Type II
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Type III
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Management Type I
above elbow slab (< 90 0 Flexion)
Type II
close reduction with /without per cutaneous pin fixation Type III Close reduction PCP Open reduction with pinning
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www.esnips.com/web/gohiya
Follow up After 1 week At 3 week wire removal At 4 week physiotherapy
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www.esnips.com/web/gohiya
5
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Complication
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Immediate complication
Immediate Early Late
Injury to brachial artery Injury to nerves
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Early complication
Radial Median Ulnar
Late complication
Volkman s Ischemia Pain Pulslessnes Pallor Paraesthesia Paralysis
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Malunion Myositis ossificans VIC
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6
Malunion - Cubitus Varus
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French osteotomy
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Feedback at [email protected]
www.esnips.com/web/gohiya
7
This document was created with Win2PDF available at http://www.win2pdf.com. The unregistered version of Win2PDF is for evaluation or non-commercial use only. This page will not be added after purchasing Win2PDF.
DR. ASHISH GOHIYA ASST. PROFESSOR DEPT. OF ORTHOPAEDICS GANDHI MEDICAL COLLEGE BHOPAL
www.esnips.com/web/gohiya
ANATOMY
www.esnips.com/web/gohiya
SEARCH
Gohiya
Feedback at [email protected]
www.esnips.com/web/gohiya
ANATOMY
www.esnips.com/web/gohiya
OSSIFICATION CENTRES
CRITOE C 2 R 4 I 6 T 8 O 10 E - 12
www.esnips.com/web/gohiya
www.esnips.com/web/gohiya
1
Epidemiology
Why complications
Boys 5 8 years High incidence of neurovascular complications High incidence of deformities
www.esnips.com/web/gohiya
Why deformities ? Inability to interpret X ray Due to poor quality of XX-ray Due to lack of knowledge
www.esnips.com/web/gohiya
Mode of trauma FOOSH
Loss of reduction
FALL ON OUT STRETCHED HAND
www.esnips.com/web/gohiya
www.esnips.com/web/gohiya
OTHER INJURIES BY FOOSH
Clinical presentation
# LOWER END RADIUS # DISLOCATION ELBOW # S/C HUMERUS # NECK HUMERUS DISLOCATION SHOULDER # CLAVICLE
Pain Swelling Deformity
www.esnips.com/web/gohiya
www.esnips.com/web/gohiya
2
On examination
Three point relationship
Swelling Deformity Tenderness Bony crepitus Abnormal movement Loss of transmitted movements Three point bony relationship maintained
www.esnips.com/web/gohiya
X
Ray X
Ray Rt elbow AP and lateral view
www.esnips.com/web/gohiya
Displacement AP View Proximal shift Medial shift or tilt Lateral shift or tilt Rotation
Lateral View Proximal Shift Post shift or tilt Rotation
www.esnips.com/web/gohiya
Fat pad sign
www.esnips.com/web/gohiya
www.esnips.com/web/gohiya
Crescent sign
www.esnips.com/web/gohiya
3
Fish tail sign
www.esnips.com/web/gohiya
Classification Extension type (98%) Flexion type (2%)
Baumann angle
www.esnips.com/web/gohiya
Gartland Classification Type I
Undisplaced fracture
Type II
Displaced with post. Cortex intact
Type III
www.esnips.com/web/gohiya
Completely Displaced
www.esnips.com/web/gohiya
Type I
www.esnips.com/web/gohiya
www.esnips.com/web/gohiya
4
Type II
www.esnips.com/web/gohiya
Type III
www.esnips.com/web/gohiya
Management Type I
above elbow slab (< 90 0 Flexion)
Type II
close reduction with /without per cutaneous pin fixation Type III Close reduction PCP Open reduction with pinning
www.esnips.com/web/gohiya
www.esnips.com/web/gohiya
Follow up After 1 week At 3 week wire removal At 4 week physiotherapy
www.esnips.com/web/gohiya
www.esnips.com/web/gohiya
5
www.esnips.com/web/gohiya
Complication
www.esnips.com/web/gohiya
Immediate complication
Immediate Early Late
Injury to brachial artery Injury to nerves
www.esnips.com/web/gohiya
www.esnips.com/web/gohiya
Early complication
Radial Median Ulnar
Late complication
Volkman s Ischemia Pain Pulslessnes Pallor Paraesthesia Paralysis
www.esnips.com/web/gohiya
Malunion Myositis ossificans VIC
www.esnips.com/web/gohiya
6
Malunion - Cubitus Varus
www.esnips.com/web/gohiya
French osteotomy
www.esnips.com/web/gohiya
Feedback at [email protected]
www.esnips.com/web/gohiya
7
This document was created with Win2PDF available at http://www.win2pdf.com. The unregistered version of Win2PDF is for evaluation or non-commercial use only. This page will not be added after purchasing Win2PDF.
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