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Olecranon Bursitis- Etiology
- ⇾Most frequently injured bursa in the elbow
- ⇾prone to acute and chronic injury from direct blow
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Olecranon Buritis-S&S
- ⇾pain, swelling, point tenderness
- ⇾possibly w/out pain or heat
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Olecranon Bursitis-Mgmt
- ⇾Acute: cold compress for 1 hour
- ⇾Chronic: some type of compression to reduce swelling....aspiration if swelling persists
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Ulnar Collateral Ligament Injuries-Etiology
- ⇾Resulting from a valgus force and/or repetitive trauma (overhead throwing, high velocity)
- ↳ulnar nerve can be damaged with the ligament injury
- ⇾may be misdiagnosed as muscle tendinitis or strain
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Ulnar Collateral Ligament Injuries-S&S
- ⇾pain along medial elbow over the collateral ligament (distal insertion mostly)
- ⇾parasthesia may be present
- ⇾laxity compared bilaterally
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Ulnar Collateral Ligament Injuries-Mgmt
- ⇾conservative: rest, NSAIDs, rehab after symptoms subside
- ↳monitor throwing motion during rehab
- ⇾surgical treatment: complete repair of the UCL (Tommy John), may involve a nerve transposition
- ↳recovery 18-24 months
- ⇾may have a regular reconstruction of UCL (not recommended for throwing athletes)
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Lateral Epicondylitis "Tennis Elbow"-Etiology
- ⇾one of the most common elbow problems
- ⇾repetitive microtrauma involving wrist extension, w/ overuse to the extensors
- ⇾tendinitis is likely
- ⇾AKA Tennis Elbow
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Lateral Epicondylitis "Tennis Elbow"-S&S
- ⇾complains of paind during and after activity with gradual increast
- ⇾point tenderness over lateral epicondyle
- ⇾pain with resistive extension
- ⇾decreased ROM
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Lateral Epicondylitis "Tennis Elbow"-Mgmt
- ⇾RICE, NSAIDs and analgesics
- ⇾work ROM, PRE and avoid pronation movements
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Medial Epicondylitis-Etiology
- -->repeated forceful flexion
- -->extreme valgus torques of elbow causing tendinitis of flexor tendons
- -->May have associated neuropathy of ulnar nerve
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Medial Epicondylitis-S&S
- -->pain over medial epicondyle with palpation and resisted wrist flexion
- -->swelling
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Medial Epicondylitis-Mgmt
- -->sling, rest
- -->cryotherapy
- -->ultrasound
- -->NSAIDs and analgesics
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Osteochondritis Dissecans-Etiology
- -->cause is unknown
- -->fragmentation and separation of articular cartilage and bone due to impairment of blood supply
- -->creates loose bodies within the joint
- -->seen mostly in patients 10-15 years old who engage in throwing and racquet sports (anything leading to radial head compression)
- -->patients younger than 10 with this is called "Panner's Disease"
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Osteochondritis Dissecans-S&S
- -->sudden pain and a locking of the elbow joint, ROM returns slowly
- -->swelling, pain and crepitation may occur
- -->decreased ROM in full extension, tenderness at radiohumeral joint
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Osteochondritis Dissecans-Mgmt
- -->beginning stage: restricted activity for 6-12 weeks and NSAIDs
- -->with increased degeneration: splint or cast, refer to Dr.---loose bodies removed with repeated locking
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Little League Elbow-Etiology
- -->occurs in 10-25% of young pitchers
- -->caused by repetitive microtrauma from throwing
- -->disorders caused:
- ----->an accelerated apopyseal growth region plus a delay in the medial epicondylar growth plate
- ------>a traction apophysitis with a possible fragmentation of the medial epicondylar apophysis
- ------>an avulsion of the medial epicondyle
- ------>osteochondrosis of the humeral capitellum
- ------>a non union stress fracture of the olecranon epiphysis
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Little League Elbow-S&S
- -->slow onset
- -->possible flexion contracture, including anterior joint capsule tightness
- -->locking or catching sensation
- -->decreased ROM of pronation and supination
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Little League Elbow-Mgmt
- -->RICE, NSAIDs, with analgesics as needed
- -->throwing is stopped
- -->loose bodies removed
- -->when throwing begins, observe proper mechanics
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Cubital Tunnel Syndrome-Etiology
- -->traction injury from a valgus force
- -->irregularites within the tunnel
- -->subluxation of the ulnar nerve
- ------>lax ligament (UCL)
- ------>torn retinaculum
- -->progressive compression of the nerve
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Cubital Tunnel Syndrome-S&S
- -->pain over medial aspect of elbow
- -->tenderness over the cubital tunnel with palpation
- -->intermittent parasthesia
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Cubital Tunnel Syndrome-Mgmt
- -->rest and immobilization for 2 weeks
- -->NSAIDs
- -->surgical decompression or transposition of a subluxing nerve
- -->avoid hyperflexion and valgu stresses
- -->immobilized in full extension
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Elbow dislocations-Etiology
- -->caused by FOOSH with hyperextension or a severe twist with elbow in flexion
- -->may displace posterior, anterior, or lateral (posterior displacement is more common)
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Elbow dislocations-S&S
- -->hemorrhage and swelling
- -->severe pain, disability and deformity
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Elbow dislocations-Mgmt
- -->apply cold and pressure immediately
- -->sling and swath
- -->check pulse above and below injured site, along with sensation
- -->Refer to Dr
- ----->should be in a sling for 3 weeks, if minimal ligament damage, start ROM at end of week 1
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Elbow Fractures-Etiology
- -->Cause:
- ----->FOOSH or fall on flexed elbow
- ----->direct blow
- -->young individuals are more prone
- -->can heppen in one or more of the 3 bones
- -->FOOSH can cause a fracture of the humerus
- ------>above the condyles
- ------>the condyles proper
- ------>the area between the condyles
- ------>condylar fx at the elbow may cause a gunstock deformity
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Elbow Fractures-S&S
- -->hemorrhage, swelling, muscle spasm
- -->may or may not have a visual deformity
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Elbow Fractures-Mgmt
- -->monitor circulation above and below injured site, as well as sensation
- -->refer to Dr.
- -->surgery required for an unstable joint
- -->splint 6-8 weeks
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Volkmann's Contracture-Etiology
- -->forearm ischemic contracture, resulting from brachial artery injury
- ----->assoc. with supracondylar fracture of humerus
- -->may have motor and sensory function loss
- ----->involving the median nerve
- -->insufficient arterial perfusion and venour stasis followed by degeneration of the muscle
- irreversible muscle necrosis begins 4-6 hours
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Volkmann's Contracture-S&S
- -->pain in the forearm that's greater when fingers are passively extended
- -->followed by ceasing of brachial and radial pulses
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Volkmann's Contracture-Mgmt
- -->with beginning signs of pressure reflected by pain, coldness and decreased ROM (mainly in wrist flexion)
- ----->remove any wraps, casts...do not elevate
- -->Refer to Dr.
- -->must be monitored closely
- -->can be permanent
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Pronator Teres Syndrome-Etiology
- -->entrapment of the median nerve at or above the elbow or between the 2 heads of the muscle
- -->can be entrapped due to edema and/or hypertrophy
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Pronator Teres Syndrome-S&S
- -->neuropathies
- -->numbness, tingling, pins/needles sensation in thumb and first finger
- -->motor deficiencies including thumb and first finger
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Pronator Teres Syndrome-Mgmt
- -->NSAIDs, rest and modification of activities
- -->pain reduction and splinting
- -->surgical decompression (results vary)
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