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

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



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 .