Biomechanics Lecture 05

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Common injuries of the Elbow

COMMON INJURIES OF THE ELBOW

  • Dislocation
  • overuse injuries

Dislocations

  • Forced hyperextension of elbow…posterior displacement of coronoid process of ulna with respect of trochlea of the humerus
  • This displacement stretches the ulnar collateral ligament which my rupture anteriorly mostly.
  • Occurs in individuals under age 30 mostly during sports

PULLED ELBOW or NURSEMAID’S ELBOW

  • dislocation in younger children age 1-3
  • More common in boys

NURSEMAID’S ELBOW

  • dislocation of the elbow joint caused by a sudden pull on the extended pronated forearm, such as by an adult tugging on an uncooperative child or by swinging the child by the arms during play.
  • The technical term for the injury is radial head subluxation.


OVERUSE INJURIES

  • After knee it is common in elbow
  • Fist symptom is inflammation and swelling then scarring occur

EPICONDYLITIS

“Inflammation and sometimes microrupturing of the collagenous tissues on either the lateral or the medial side of the distal humerus; believed to be an over use injury”

 

2 types:

  1. Lateral epicondylitis
  2. Medial epicondylitis

Lateral epicondylitis/ tennis elbow

Inflammation or micro damage to tissue on lateral side of distal humerus

  • 30-40% common injury in tennis players
  • Age 35-50
  • Overuse of wrist extensors

The amount of force subjected to lateral epicondyle increases…

  • Due to poor technique and improper equipment
  • activities that over stresses the involved tendon, the extensor  carpi radialis brevis and extensor digitorum can cause this

EXAMPLES of lateral epicondylitis

  • Hitting off-centre shots and using an overstrung racquet increases the amont of force transmitted to elbow.
  • Activities like swimming, fencing and hammering can also contribute to this.

Medial epicondylitis

  • little leaguer’s elbow/golfers elbow
  • Injury at medial aspect of distal humerus
  • Medial epicondyle avulsion fracture ….forceful terminal wrist flexion
  • In right handed golfers, lateral epicondylitis on left side and medial epicondylitis on right side

During pitching Valgus strain imparted to the medial aspect of the elbow during initial stage ,when trunk and shoulder are brought forward ahead of forearm and hand ,results in epicondylitis

Cubitus valgus and varus

  • Cubitus varus (Gunstock injury):  inward deviation of forearm at elbow
  • Cubitus valgus: outward deviation of forearm at elbow
  • Valgus instability is common in repetitive throwing

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