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Elbow fractures

Elbow fractures. Theatre staff course Mr Lee Van Rensburg March 2012. . . Anatomy. Bones Distal Humerus Proximal radius Radial head Proximal ulna Olecranon. . . Anatomy. Joints Hinge – Flex and extend Ulna and trochlea Rotation – Supinate and pronate. . . Anatomy.

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Elbow fractures

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  1. Elbow fractures Theatre staff course Mr Lee Van Rensburg March 2012

  2.  Anatomy • Bones • Distal Humerus • Proximal radius • Radial head • Proximal ulna • Olecranon

  3.  Anatomy • Joints • Hinge – Flex and extend • Ulna and trochlea • Rotation – Supinate and pronate

  4.  Anatomy • Joints • Hinge (Flexion and extension) • Ulna and trochlea • Rotation – Pronation and supination • Capitellum and radius

  5. Proximal ulna shape Greyhen; VOL. 89-B, No. 6, JUNE 2007

  6. Anatomy - Ligaments Medial view Ulnar collateral ligament Lateral view Radial collateral ligament Annular ligament

  7. Anatomy • Nerves • Ulnar nerve • Median nerve • Radial nerve

  8. Radiology Radial head points to capitellum Anterior humeral line Shaft condylar angle ~ 40 degrees

  9. 40 YO Fall Diagnosis? Treatment ?

  10. 23 YO fall Treatment? Diagnosis?

  11. TBW

  12. 42 YO motorcycle NO TBW, needs more stability No Ex Fix in this case Early ROM Diagnosis ? Treatment ?

  13. 24 YO car roll over, open Treatment ? 2 weeks

  14.  65 YO bicycle Avulsed radial collateral ligament and common extensor origin Treatment ? Diagnosis?

  15. 65 YO bicycle

  16. 45 YO Fall steps Removable slab 6 weeks Free ROM Radiograph at 6 months

  17. 40 YO Fall Post Reduction EUA Stable full extension What do you see?

  18. 80 YO Fall Don’t be tempted Treatment ?

  19. 74 YO Fall

  20. 70 YO Fall Classify ? Descriptive Treatment ? What is the problem ? 9 Proximal At most 2 distal screws

  21. 20 YO Classify ? Descriptve Treatment ?

  22. Distal humerus2 Philosophies

  23. 32 YO 4 months No infection 3 months

  24. External fixatorsaround the elbow

  25. • Minor complications (15%) • Erythema and nonpurulent drainage >5 days, 9% • Skin release 6% (reduce tension) • Major complications (10%) • Purulent pin site drainage in 1% • Fixator malalignment 1% • Pin loosening in 4% • Deep infection 4%. • No nerve injuries JSES; May 2008 (Vol. 17, Issue 3, Pages 447-453)

  26. 45 YO RTA

  27. Questions www.easytrauma.co.uk

  28. 32 YO Fall Classify ? Early ROM Radiograph at 3 Months Treatment ?

  29. 32 YO fall Classify ? 6 weeks Full pronation and supination 10⁰ FFD Treatment ? Approach ?

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