Elbow Injuries

  • November 2019
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INJURIES AROUND ELBOW

DR. ASHISH GOHIYA ASST. PROFESSOR DEPT. OF ORTHOPAEDICS GANDHI MEDICAL COLLEGE BHOPAL

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ANATOMY

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SEARCH

Gohiya

Feedback at [email protected]

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ANATOMY

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OSSIFICATION CENTRES

CRITOE C 2 R 4 I 6 T 8 O 10 E - 12

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Epidemiology

Why complications

Boys 5 8 years High incidence of neurovascular complications High incidence of deformities

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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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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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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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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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Follow up After 1 week At 3 week wire removal At 4 week physiotherapy

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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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Malunion - Cubitus Varus

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French osteotomy

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Feedback at [email protected]

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