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The Elbow ANATOMY Bones • Humerus - upper arm bone – Medial epicondyle medial bony prominence – Lateral epicondyle lateral bony prominence BONES • Ulna - Medial, on the little finger side – Olecranon process posterior elbow • Radius - lateral, on thumb side JOINTS - 3 • Humerus and Ulna – True elbow joint – Flexion and extension occur here • Humerus and Radius – Gliding joint • Radius and Ulna – Allows supination and pronation – Proximal and Distal joints – Radius goes around Ulna LIGAMENTS • Ulnar Collateral Ligament – From medial epicondyle of humerus to ulna • Radial Collateral Ligament – From lateral epicondyle of humerus to radius • Both prevent valgus and varus (side to side) stress MUSCLES • Anterior Humerus/Elbow – flex elbow – Biceps Brachii – Brachialis – Brachioradialis • Posterior Humerus/Elbow – extend elbow – Triceps • Forearm – Pronator Teres – Pronator Quadratus – Supinator INJURIES Olecranon Bursitis • Cause – Direct hit or multiple hits to tip of elbow • S/S – Looks like a golf ball is in elbow • Olecranon bursa swells – Pain and tenderness over tip of elbow • Care – RICE Ulnar Nerve Contusion • Hitting your funny bone • If severe enough can cause numbess, tingling and weakness (known as paresthesia) in hand for a long time • Be careful using ice -- can cause ulnar nerve palsy Lateral Epicondylitis • “Tennis Elbow” • Causes – Poor backhand technique, too small a racket handle, too tight a grip, muscle imbalance, repetitive extension of the wrist • S/S – Pain directly over lateral epicondyle – Weakness with grip and wrist extension • Care – RICE – Anti-inflammatory medication – Rehab for strength and range of motion Medial Epicondylitis • “Golfers Elbow” • Cause – Repeated elbow flexion or wrist flexion • S/S – Pain over medial epicondyle – Pain with wrist flexion • Care – Same as lateral epicondylitis Little Leaguers Elbow • Epiphyseal (growth plate) injury • Term that can represent various injuries in adolescent thrower • Now there are rules that limit the number of pitches a young athlete can throw in a game ULNAR COLLATERAL LIGAMENT SPRAIN • Cause – Hyperextension, can be with a medial force – Overhead throwing (off speed pitches) • S/S – Pain and swelling in medial elbow – Feel or hear a pop – May not be able to grasp object • Treatment: – RICE, possibly in sling – Tommy John surgery DISLOCATIONS • Cause – Hyperextension or falling on an outstretched arm – Happens in wrestling and football most often • S/S – – – – – – the ulna will go posteriorly very painful rapid, severe swelling forearm will look shorter big, posterior lump in arm elbow will be bent DISLOCATION • Care – Immobilize in position found and call EMS. – It will be x-rayed before and after reduction – In a splint for 4-6 weeks Supracondylar Fracture • Rare – more likely to happen in high contact sports • Signs and symptoms include: severe pain, deformity, snap or pop, loss of sensation in hand • Treat for shock and transport to the ER Volkmann’s Contracture • Fracture Complication • Can be as a result of mishandled fracture • Artery is trapped or pinched shutting off blood flow to hand • Permanent deformity at the hand can result
