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Orthopedics 5th year, 3rd lecture (Dr. Ariwan)
 

Orthopedics 5th year, 3rd lecture (Dr. Ariwan)

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The lecture has been given on Dec. 15th, 2010 by Dr. Ariwan.

The lecture has been given on Dec. 15th, 2010 by Dr. Ariwan.

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    Orthopedics 5th year, 3rd lecture (Dr. Ariwan) Orthopedics 5th year, 3rd lecture (Dr. Ariwan) Presentation Transcript

    • Cubitus Valgus
      • The forearm deviated laterally over the arm.
      • Normal carrying angle is 10°-15° valgus.
      • Deformity obvious when the patient stand in the anatomical position.
      • The commonest cause is non-united fracture lateral condyle of the humerous.
      • Major risk is development of tardy ulnar nerve palsy .
      • To prevent this complication once signs of ulnar nerve neuritis appear we must do ulnar nerve transposition .
      • Osteotomy needed only for cosmetic reasons.
    • Pulled Elbow
      • Downward dislocation of the radial head from the annular ligament .
      • Commonly before the age of 6 years.
      • Caused by puling the arm in pronation .
      • Pain and inability to move the arm.
      • Limb is held with elbow fully extended, forearm pronated.
      • Reduce by quick supination and elbow flexion hearing a snap.
    • Tennis Elbow (Lateral Epicondylits)
      • Clinical condition causing pain on the lateral aspect of the elbow .
      • Repetitive elbow extension when forearm in pronation.
      • Tendinits, fibroses, microscopical tear in the origin of extensor carpi radialis brevis .
    • Clinical features
      • Active individual of 30-40 years age.
      • There is pain and tenderness over the lateral epicondyle (bony origin of common extensor tendon) after period of activity.
      • Pain may radiate down the forearm .
      • Pain aggravated by { Pouring out Tea , Shaking Hands , Turning Door Handle }.
      • Tenderness just below the lateral epicondyle.
      • Provoke the pain by extending the elbow, pronating the forearm, passively flexing the wrist.
    • Treatment
      • Conservative:
      • Avoid movement's aggravating the pain.
      • Friction, massage, local US.
      • Local injection of long acting steroid.
      • Operative treatments:
      • Resistant cases with persistent and relapsing symptoms need operation.
      • The origin of the common extensor muscles are detached from the bone .
    • Golfers Elbow (Medial Epicondylits)
      • Similar to tennis elbow causing pain and tenderness over the medial epicondyle (common flexor origin).
    • Olecranon Bursitis( Students Elbow)
      • Swelling and inflammation of the olecranon bursa.
      • Causes:
      • Friction or continuous pressure when the elbow flexed over a table.
      • Gout .
      • Rheumatoid arthritis.
      • Treatments:
      • Rest, bandaging.
      • Aspiration and steroid injection.
      • If chronic and painful nee surgical excision .