injuries to the elbow - orthosurgery · brachioradialis – only muscle to extend from distal end...

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Elbow Anatomy

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Page 1: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Elbow Anatomy

Page 2: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

The Elbow Joint

Page 3: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Bones of the Elbow

Humerus- medial epicondyle- lateral epicondyle

RadiusUlna

- olecranon process

Page 4: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Joints of the Elbow

• Hinge joint• Composed of 3 articulations:

1. Humeroulnar joint2. Humeroradial joint3. Radioulnar joint

Page 5: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Motions

• Flexion/Extension• Supination/Pronation

Supination – palm up Pronation – palm down

Page 6: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Muscles Affecting the Elbow

- Elbow Flexors1. Brachialis

2. Biceps brachii3. Brachioradialis

- Elbow Extensors1. Triceps 2. Anconeus

Page 7: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Muscles Affecting the Wrist Joint

- Wrist Flexor-Pronator group1. Pronator teres2. Flexor carpi radialis3. Palmaris Longus4. Flexor carpi ulnaris

These muscles originate on the medial epicondyle of the humerus as a single tendon

Page 8: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little
Page 9: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little
Page 10: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

- Wrist Extensors1. Brachioradialis – only muscle to extend from distal end of one bone to distal end of another2. Extensor carpi radialis longus3. Extensor carpi radialis brevis

These muscles originate on the lateral epicondyle

* The mobile wad of 3

Page 11: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little
Page 12: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Supination Pronation1. Biceps 1. Pronator teres2. Supinator 2. Pronator Quadratus

Page 13: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Ligaments of the ElbowUlnar Collateral Ligament medial side – connects humerus to ulna

Radial Collateral LigamentLateral side – connects humerus to radius

Annular LigamentSurrounds radial head/holds it tight to ulna

Page 15: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Elbow Dislocation

• Usually occur as a result of a fall on an outstretched arm

• May be associated nerve or vascular injury• Usually dislocates posteriorly• Anterior Dislocations – very rare Possible olecranon fractureMedial and Lateral dislocations are rare

Page 16: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little
Page 17: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little
Page 18: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

• Divergent Dislocation the forearm bones are separated and the

humerus slips between them

Page 19: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little
Page 20: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Dislocation of the Radius

• The radial head may be displaced forward, backward, or outward

• Children under 5 are prone to subluxation of the radial head due to a “pulling” on the forearm

Pulled elbow or Nursemaid’s arm

Page 21: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little
Page 22: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Medial Epicondylitis

- “Little League Elbow”- Medial elbow pain and

pain with flexion of the wrist flexor muscles

- May see an avulsion of the medial epicondyle

Page 23: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Lateral Epicondylitis

- “Tennis Elbow”- Caused by excessive

wrist extension, especially with a clenched fist

- Pain over outer part of the elbow

Page 24: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little
Page 25: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Olecranon Bursitis

• A collection of fluid in the olecranon bursa that covers the posterior tip of the elbow. Is the result of direct trauma to the elbow.l

Page 26: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Olecranon Bursitis

Page 27: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Tear of Medial Collateral Ligament

• Occurs when the inside of the elbow is stressed during the throwing motion.

• Pain and swelling over the medial portion of the elbow

Page 28: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

Ulnar Nerve Injuries

• Occurs with throwing athletes and from direct trauma

Page 29: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little

• Ulnar nerve provides sensation to the little finger and the medial portion of the ring finger

Page 30: Injuries to the Elbow - OrthoSurgery · Brachioradialis – only muscle to extend from distal end of one bone to distal end of another 2. Extensor carpi radialis longus ... - “Little