complications

AVN  

Largely related to degree of displacement

Incidence

Hawkins Type I

- 0% to 13% 

Hawkins Type II 

- 20% to 50% 

- usually only patchy and not a problem (rarely collapses)

Complications

1.  Flexor Tendon Rupture

2.  Adhesions

3.  PIPJ contractures

4.  Triggering

5.  Pulley failure

6.  Quadrigia

1.  Flexor Tendon Repair Rupture

Incidence

5%

Management Options

FDS only

Non operative Management

Indications

< 20^o sagittal

< 30^o coronal

< 3 cm of shortening

Options

Mechanism

Usually a direct blow 

- less commonly a fall on the outstretched hand

RTA / sporting accidents commonest causes

Can be pathological as a result of radionecrosis

- eg following radiotherapy for breast cancer.  

Incidence

Fractures of the clavicle are common

Radial Head Fracture

Mechanism

FOOSH

- axial load with a valgus force

Biomechanics

1.  Provides Valgus stability

- especially if MCL deficient

2.  Longitudinal stability

- aided by interosseous membrane

3.  Load Transfer

- 60% of load at elbow

Epidemiology

2 groups

- young patient with high velocity injury

- older patient with comminuted, osteoporotic fracture

In the second group fixation can be very difficult

Anatomy

Hinged Joint

- trochlea axis is centre of rotation

- 40^o anterior angulation in sagittal plane

Indications

1. Removal Loose body

2. Excison of osteophytes

- coronoid

- olecranon

- aiming to improve ROM / prevent impingement

Indications

RA 

- very good results

- 97% 10 year survival Coonrad-Morrey prosthesis

Other Dx 

- OA / post-traumatic arthritis / nonunion

- tend to have worse survival than RA

Haemophilia

- elbow joint commonly involved

- 90% of haemophiliacs

Acute unreconstructable fracture > 60

DDx

Parosteal OS

- bone is not continuous with cortex in MO

Aetiology

3% incidence in elbow joint trauma to some degree

Incidence

Lateral : Medial 9:1

Epidemiology

4th & 5th decades

- M = F

- 75% dominant arm 

50% of regular tennis players

- especially > 2 hrs / week

Aetiology

Insertion pathology / Enthesopathy

Over-extension of the elbow with supination / pronation

Anatomy

Lateral epicondyle

- anconeus from posterior face

- ECRB and EDC from anterior face (CEO)