elbow

Definition

Radius rotates externally in relation to the ulna

- posterior displacement of the radial head relative to the capitellum

- in flexion

Anatomy LCL

Aetiology

Throwing injury

- seen in the throwing athlete

- repetitive microtrauma / valgus stress

- develop laxity

History

Initially

- lose velocity / accuracy

Develop medial pain

40% ulna nerve symptoms

Indications

1. Removal Loose body

2. Excison of osteophytes

- coronoid

- olecranon

- aiming to improve ROM / prevent impingement

Indications

RA 

- very good results

- 97% 10 year survival Coonrad-Morrey prosthesis

Other Dx 

- OA / post-traumatic arthritis / nonunion

- tend to have worse survival than RA

Haemophilia

- elbow joint commonly involved

- 90% of haemophiliacs

Acute unreconstructable fracture > 60

Indications

Very few

- young labourer with severe disabling elbow pain

- trial in POP at 90^o for 6 weeks

Poor function

- adjacent joints cannot compensate for loss of function

Contraindications

RA

- high failure rate especially flail elbow with poor bone stock

DDx

Parosteal OS

- bone is not continuous with cortex in MO

Aetiology

3% incidence in elbow joint trauma to some degree

Epidemiology

Relatively rare

Average age 50

Men 4:1 Women

Usually dominant arm

Aetiology

Primary

- associated with strenuous manual labour

Secondary

- trauma

- OCD

- synovial chondromatosis

- valgus extension overload / MCL insufficiency

Problems

1.  Lower limb

All walk

- Ankle > knee > hip

Ankle

- most require operations for ankles

LLD

- unilateral underdevelopment

- LLD 0-5cm (average 2cm)

2.  Lower limb

- one handedness

- decrease movement in swing

- astereogenesis

- usual upper limb contractures