ELBOW

Anatomy

The elbow and forearm form a functional unit whose primary role is to accurately position the hand in space. view 

Elbow Contusion

An elbow contusion results from blunt direct trauma and produces muscle strains and ligament sprains. view 

Ligament Tears and Elbow Fractures

Fractures about the elbow are the result of high energy injuries. view 

Forearm Compartment Syndrome

Compartment syndrome in all extremities is an orthopedic emergency. view

Elbow/Forearm Wounds/Amputations

Wounds occurring in the forearm and elbow must be treated as an emergency because the risk of infection if left open increases about 7 hours after an injury has occurred. view

Elbow Arthritis

Arthritis in the elbow can occur after an injury (post-traumatic arthritis), congenital lack of blood supply to the bone causing flaking off of the cartilage called Osteochondritis Dessicans. view

Cubital Tunnel Syndrome

Cubital tunnel syndrome is the compression of the ulnar nerve at the level of the elbow. view

Pronator Syndrome

Pronator syndrome is the compression of the median nerve around the elbow and palmar side of the forearm. Because it is the same nerve that causes carpal tunnel syndrome, there is overlap in the symptoms making the diagnosis difficult, at times. view

RTS & PIN Palsy

Radial tunnel syndrome and posterior Interosseous Nerve palsy are both a result of compression of the Posterior interosseous nerve with a more severe compression occurring in posterior interosseous nerve palsy. view

Lateral Epicondylitis, Medial epicondylitis, Distal Biceps Tendon Rupture

Lateral epicondyltis also called tennis elbow and medial epicondylitis called golfers elbow is a condition affecting the forearm muscles’ on the humeral bone at the elbow called the lateral and medial epicondylitis respectively. view

Elbow Stiffness

The cause of a stiff elbow is either at the bony level or the collagen capsule/ligament level or both. view

Elbow and Forearm Infections

The elbow, like the shoulder is well perfused with ample blood supply allowing for circulating white blood cells to offer excellent protection against infection and, consequently an elbow infection is uncommon. view

Elbow Tumors

Tumors are divided into benign and malignant types. A benign tumor is an abnormal growth of a particular cell type presenting as a mass. view

ELBOW STIFFNESS

Pathology

The cause of a stiff elbow is either at the bony level or the collagen capsule/ligament level or both.

Common Causes of Stiff Elbow

  • Major trauma secondary to a fracture or fracture-dislocation
  • Repetitive microtrauma

 

Heterotopic Ossification

When elbow trauma is associated with a close head injury, a buildup of abnormal bone can develop in locations where it is not normally found. This is called heterotopic ossification.

If the bone develops in muscle, it is called myositis ossificans. When bone develops in the elbow, it can bind the humerus to the radius or ulna. This affects flexion, extension and forearm rotation. To make the diagnosis, a physical exam and plain x-rays are all that is required prior to proceeding with surgery.

 

Treatment

The treatment of a stiff elbow depends on the cause of the stiff joint. When the problem is the joint capsule and only minor spurs are present in the elbow, the contracture can be removed arthroscopically through small incisions.

If there is heterotopic bone, the procedure involves an open incision and within 24 hours of surgery, it is common to use a small dose of radiation to limit the recurrence rate of the heterotopic bone. Aggressive therapy to maintain the motion obtained during surgery is critical to ensure a lasting result. The use of splints to assist in the maintenance of the motion is also common.

Arthroscopic soft tissue procedures are at maximum improvement within 2 months but open procedures involving bone removal may take as much as 4-6 months to reach maximum medical improvement.