stability and anatomy
Fractures and Dislocations
Throwing Elbow (UCL, VEOS, OCD)
"What's the Diagnosis?"
Soft Tissue Injuries
100

What is the primary bony articulation responsible for elbow stability? (what is the joint too)

The trochlea and olecranon (ulnotrochlear joint).

100

What is the most common mechanism for elbow dislocation?

FOOSH

100

What is the most common symptom of a UCL injury in a pitcher?

Medial elbow pain with loss of velocity and command.

100

A 45-year-old recreational tennis player presents with lateral elbow pain, decreased grip strength, pain opening jars, and pain with resisted wrist extension. What is the most likely diagnosis?

Lateral epicondylitis (tennis elbow)

100

Tennis elbow is now considered what type of pathology rather than an inflammatory condition?

Tendinosis/degenerative tendon pathology.

200

What structure is known as the "most valuable piece of real estate in the elbow"?

sublime tubercle

200

What percentage of elbow dislocations are posterior or posterolateral?

about 90%

200

How many newtons of force are required to tear the UCL?

34 Newtons

200

A 20-year-old collegiate pitcher reports medial elbow pain, decreased velocity, worsening command, and occasional numbness in the ring finger during throwing. What is the most likely diagnosis?

UCL pathology

200

Which tendon is most commonly involved in lateral epicondylitis?

Extensor Carpi Radialis Brevis (ECRB).

300

Name the medial border, lateral border, and superior border of the cubital fossa.

  • Medial border: Pronator teres
  • Lateral border: Brachioradialis
  • Superior border: Imaginary line connecting the medial and lateral epicondyles of the humerus 
300

What three injuries make up the "Terrible Triad"?

Posterior elbow dislocation, radial head fracture, and coronoid fracture.

300

During which throwing phases is valgus stress on the elbow greatest?

late cocking and early acceleration

300

An 18-year-old pitcher presents with posteromedial elbow pain, pain during follow-through, loss of terminal extension, and episodes of locking. What is the most likely diagnosis?

Valgus Extension Overload Syndrome (VEOS). 

300

What are the classic "6 P's" of compartment syndrome?

Pain, paresthesia, paralysis, pulselessness, pallor, poikilothermia.

400

A patient presents with sensory deficits over the dorsolateral hand and a positive Tinel sign where the brachioradialis and ECRL cross. What syndrome is most likely?

Wartenburgs syndrom

400

What are two contraindications to attempting an elbow reduction?

Obvious fracture and neurovascular compromise.

400

A pitcher has posteromedial pain, locking, and loss of extension. What pathology should be high on your differential?

Valgus extension overload syndrome

400

A former wrestler with a history of elbow dislocation reports clicking, catching, instability when pushing off a chair, and a sensation that the elbow is slipping. What is the most likely diagnosis?

Posterolateral Rotatory Instability (PLRI). 

400

What percentage loss of supination strength may occur with non-operative treatment of distal biceps rupture?

Approximately 40–50%

500

A patient develops a decreased carrying angle following a distal humeral fracture. What deformity is this called?

Cubitus varus (Gunstock deformity).

500

Which Gartland fracture type is most associated with neurovascular compromise?

Type III supracondylar fracture.

500

What factor matters most when managing an OCD lesion?

Whether the lesion is stable or unstable. 

500

A 52-year-old male feels a sudden pop while lifting a heavy object and develops immediate pain, bruising, weakness, and a visible defect in the antecubital fossa. What is the most likely diagnosis?

Distal biceps tendon rupture.

500

Which factor changes management the most in a distal biceps rupture?

Functional demand of the patient (athlete/manual laborer vs sedentary individual).