Elbow anatomy
Relations of elbow joint
Antecubital fossa anatomy
Supracondylar fracture
Fracture healing
100
Classification + sub-classification of elbow joint
Synovial hinge joint
100
Which muscle is responsible for elbow extension?
Triceps brachii.
100
Which artery bifurcated near the apex of the antecubital fossa?
Brachial artery
100
In what circumstances does a supracondylar fracture usually occur (95% of cases)?
Fall onto outstretched, extended hand in a child
(FOOSH = fall onto outstretched hand)
100
Name the three phases in fracture healing
Inflammatory phase.
Reparative phase.
Remodelling phase.
200
Which articulation in the elbow joint allows pronation and supination movements?
Superior radioulnar joint
200
Which is the two-head muscle that originates on the scapula and inserts at the radial tuberosity on the olecranon?
Biceps brachii.
200
Structure indicating the medial border of the antecubital fossa
Pronator teres muscle
200
What type of bone fracture is a supracondylar fracture usually?
Transverse fracture (horizontally perpendicular to bone)
200
What processes occur in the inflammatory phase of fracture healing?
Cytokines, growth factors and prostaglandins released.
Fracture haematoma becomes organised and is infiltrated by fibrovascular tissue. Forms matrix for bone formation + primary callus.
300
Name the three bursae located in the elbow
Intratendinous olecranon bursa
Subtendinous olecranon bursa
Subcutaneous olecranon bursa
300
Which nerve lies medially to the elbow joint?
Ulnar nerve.
300
Structure indicating the lateral border of the antecubital fossa
Brachioradialis muscle
300
If damage has occurred to the medial, ulnar or radial nerve in a supracondylar fracture, how will the patient present?
Pale, pulseless limb
300
How long can the remodelling phase of fracture healing take?
Months to years.
400
Innervation of the elbow joint (4)
Radial, ulnar, medial, musculocutaneous nerves.
400
What are the three primary elbow flexors?
Biceps brachii.
Brachialis.
Brachioradialis.
400
Vein in the roof of the antecubital fossa, which connects the basilic and cephalic veins
Median cubital vein
400
Damage to brachial artery in supracondylar fractures can lead to what type of deformity?
Volkmann's Ischaemic Contracture
= uncontrolled flexion of the hand. Forearm flexor muscles become fibrotic + short)
400
What processes occur in the reparative phase of fracture healing?
Thick mass of callus forms around bone ends, from the fracture haematoma.
Bone-forming cells enter the area to form new bone (within 7-10 days after injury).
Soft (cartilaginous) callus is organised, using fibroblasts and osteoblasts. Composed of hyaline +fibrocartilage.
Remodelled into hard callus (over several weeks). Similar to endochondral formation of bone when cartilage becomes ossified; osteoblasts, osteoclasts, and bone matrix are present.
Hard callus is weaker than normal bone, but withstands external forces better + equates to stage of clinical union = fracture not tender to palpation.
500
Which ligament does the radial ligament (located on lateral side of joint) blend with?
Annular ligament.
500
Which is the two-head muscle that originates on the humerus + scapula and inserts posteriorly on the olecranon?
Triceps brachii.
500
Name the five contents of the antecubital fossa
Median nerve
Brachial artery
Biceps tendon
Radial nerve
Posterior interosseous branch of radial nerve
(My Brother Throws Rad Parties)
500
How are supracondylar fractures classified (3 classes), and using what system?
Gartland classification system:
Type I: minimally displaced
Type II: displaced (no radial rotation or ulnar translation) but with an intact posterior cortex
Type III: completely off-ended
500
On average, what is the healing time for a fracture of the humerus compared to the phalanges?
- phalanges: 3 weeks.
- metacarpals: 4-6 weeks.
- distal radius: 4-6 weeks.
- humerus: 6-8 weeks.
- lower arm: 8-10 weeks.