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1-etiologies of elbow cause DJD? MC?#2MC2-Most important primary stabilizer of elbow? name the (3) 1^ stabilizers of the elbow? name the 2^ stabilizers of elbow?3-what structure stabilizes to both valgus and distraction forces? unilateral arthrodesis vs bilateral arthrodesis Optimal position?4-MC location for osteophytes in elbow, MC co-morbidity in pt w/ elbow DJD and ligamentous incompetence5-patients with severely limited preoperative motion (extension > 60 degrees and flexion of < 100 degrees are at risk for?6-Outerbridge-Kashiwagi procedure aka indications7name the 2 types of TEA? what are the indications of UTEA & CTEA
1-MC-RA, #2 MC=post-traumatic arthritis, 1^ arthritis, hx of OCD, MUCL insufficiency2-anterior oblique fibers of ant band MCL;, LCL, coronoid;2^ stabiliz=radial head, lateral capsule, aconeus, LCL3-anterior oblique fibers of ant band MCL;uni-flex-90, valgus-74-PM olecranon fossa; RAb/l-elb-110 & 655-ulner nerve dysfunction6-olecranon fossa debridement, younger patients with decreased ROM7-UTEA=competent elbow ligaments and adequate bone stockCTEA=incompetent elbow ligaments
A 66 year old woman has chronic elbow pain and loss of function. She has severe morning stiffness and takes several medications for this. Exam reveals a flexion arc from 35-100 degrees with markedly limited rotation. What is the most appropriate definitive treatment?1. Total elbow arthroplasty2. Radial head replacement3. Radial head excision4. Corticosteroid injection5. Elbow arthroscopic debridement and removal of loose bodies
middle aged laborer c/o progressive pain, loss of terminal extension, & PE=loss of elbow ROM, ulnar neuropathy.1.1-KIF(key image finding & R/O (3))? -->Dx1.2 3 sxf w/ the Dx1.3 3 pef w/ the dx?1.4 other imaging2-(indications--->Tx2.1 if mild to moderate sx then2.2 if mild dz w/ bone spurs, mechanical block to motion, pts w/ >90 deg of motion THEN?2.3 if young high demand pts THEN?2.4 if younger pts w/ decreased ROM2.5 if older patients >65 years with severe elbow arthritis2.6 if complex distal humerus fracture in elderly with poor bone stock w/ RA (with incompetent elbow ligaments)3-Complication if patients with severely limited preoperative motion (extension > 60 degrees and flexion of < 100 degrees are at risk for then tx?
1.1 Ap/Lat elbow:r/o (1)elbow joint space narrowing, (3)osteophytes @ coronoid process/fossa & olecranon tip / posteromedial olecranon fossa, (3)loose bodies1.2sxf=progressive pain; loss of terminal extension;painful locking of elbow1.3PEF=loss of elbow ROM, ligamentous incompetence especially in RA, ulnar neuropathy present =50%1.4CT-r/o define osteophytes & loose bodies2.1-NSAIDS, cortisone injections, resting splints, and activity modification2.2-arthroscopic debridement & capsular release2.3-ulnohumeral distraction interposition arthroplasty, autogenous tensor fascia lataachilles tendon allograft2.4-olecranon fossa debridement (Outerbridge-Kashiwagi procedure)2.5 unconstrained TEA2.6 constrained TEA3-ulnar nerve dysfunction tx=ulnar nerve decompression
2-(indications--->Tx 2.1-NSAIDS, cortisone injections, resting splints, and activity modification 2.2-arthroscopic debridement & capsular release 2.3-ulnohumeral distraction interposition arthroplasty, autogenous tensor fascia lata achilles tendon allograft 2.4-olecranon fossa debridement (Outerbridge-Kashiwagi procedure) 2.5 unconstrained TEA 2.6 constrained TEA
A 22-year-old collegiate pitcher sustains a medial collateral ligament (MCL) rupture of his throwing elbow requiring surgical reconstruction. Anatomic restoration of the MCL is desired to maximize function. Which of the following best describes the kinematics of the native MCL? 1. Anterior bundle becomes tight in flexion and lax in extension 2. The posterior bundle demonstrates the greatest change in tension from flexion to extension 3. Posterior bundle becomes lax in flexion and tight in extension 4. Posterior bundle is isometric 5. The posterior bundle is isometric, but the anterior is not
MLP c/o acutely injuries may result in a "pop" and then sudden drop in velocity, decreased throwing performance w/ loss of velocity, loss of control (accuracy) & pain PE=medial tenderness at or near MCL origin & moving valgus stress test is (+) 1-KIF(key image finding) -->Dx 1.1other KIF? 1.2 KIF xray 1.3 SxF (5)= 1.4 PeF (3 palp & provocative test 3) 2-(indication) Tx & Rehab/Time 2.1-first line treatment in most cases & Rehab 2.2-high-level throwers that want to continue competitive sports & Rehab 2.3 what autograft being used? describe reconstruction tech (4)?
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