www.glenelgorthopaedics.com.au Assessment of the Elbow Dr. Gavin Nimon Head of Upper Limb Surgery- QEH Senior Lecturer- University of Adelaide MBBS FRACS (Orth) FRCS (Ed)
www.glenelgorthopaedics.com.au Profile Gavin Anthony Nimon University of Adelaide-intern 1990 bst 91-93 Edinburgh/ Newcastle –Orthopaedic Registrar 1994 Advanced Trainee –Orthopaedics 1995-1998 Senior Registrar Year 1999 QEH Senior Registrar/ Consultant PMR Edinburgh Consultant DGRI 2000-2005 Senior Lecturer University of Adelaide- QEH Head of Upper Limb Specialty- The Queen Elizabeth Hospital
www.glenelgorthopaedics.com.au My Approach to Assessing and treating Orthopaedic Issues
www.glenelgorthopaedics.com.au
www.glenelgorthopaedics.com.au Olecranon Bursitis • Inflamation of lining of lubricating sac underskin • Can be infected or gouty • Often from direct Trauma, or pressure ( student’s elbow) • Can settle by avoiding pressure and irritation • May need aspiration / +/- steroid if not infected • If infected may need drainage
www.glenelgorthopaedics.com.au Radial Head Fractures
www.glenelgorthopaedics.com.au Olecranon Fracture ( Triceps avulsion in simple cases)
www.glenelgorthopaedics.com.au Elbow Dislocation
www.glenelgorthopaedics.com.au Fracture/ Dislocation Elbow- Terrible Triad Very Unstable • Mixture of bony and ligamentous damage • Need to stabilise both to restore anatomy • Can be quite challenging
www.glenelgorthopaedics.com.au Tennis/ Golfer’s Elbow ( Epicondylitis) • Very Common • Usually self limitting • Modify other factors, smoking/ weight/ expectations • Avoid tight grip, twisting, knocking • Physio/ Hand Therapy • Consider injection • U/S demonstrates a tear often ( not an issue ) • Surgery last resort
www.glenelgorthopaedics.com.au Cubital Tunnel Syndrome • Exclude Cervical C8 • Bigger Incision Required • protect in sling for 2-4 weeks • Good Results • Can be Day Surgery
www.glenelgorthopaedics.com.au Distal Biceps Rupture • Previously Rare ( but must have existed ?? ) • Complete rupture - literature says better with repair • But older male with achy arm and u/s partial tear • ? Latter just aging • Same principles as cuff tear • Tricky procedure, best done by specialist Upper Limb Surgeon • Difficult after 1st 6 weeks after injury
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