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FOOSH Injury - Elbow
Extended Elbow
Valgus Load
Postero lateral Rotation (SUPINATION)
Body Rotates around fixed hand
FOOSH Injury -Mechanism - Elbow
Grade 1 Compression & rotation Sprain/ Strain
Capsule/Ligament Failure from LCL --> MCL
Ligament Instability
Dislocation of HumeroUlnar Joint
Fractures of Radial Head: Coronoid Process; Humerus supracondylar region.
Humerus driven forward over coronoid of ulnar
Risk of develp of Myositis ossificans
Dislocation OBVIOUS but still NEED XRAY to exclude fracture
Stage 1-3 Acute but more for Orthopaedics not us!
FOOSH Injury - Elbow - Treatment
Closed manipulation & reduction asap
Ensure elbow capable of full extension
Full Flex/Ext to confirm within Trochlear groove
Re Xray - Confirm Reduction
3 weeks immobilisation; 90Deg Forearm Pronation
Begin Gentle Exercise after 1 week
What is terrible Triad? (relating to elbow)
Radial head fracture
Posterlateral Disclocation
Coronoid fracture
Foosh Fractured Radial Head
Common in adults
May split or Break
Cartilage of Capitulum may be bruise or chipped
(cannot be seen on xray but important)
Local Pain
Limitation of Movements...Supination
Surgical correction for fragments
Comminuted fracture - Radial head taken out and replaced with prosthesis
Aspiration of joint to remove blood
Immobilise for 7 days
Active exercise to that the joint doesnt have permanent limitations later.
Early movement Key!
Foosh - Elbow Coronoid Fracture
May lead to Varus Posteromedial rotatory instability if left untreated
Treat open reduction(surgery needed) internal fixation
Foosh injuries - Elbow Supracondylar Fracture
Common on kids
Displacement of proximal Fragment may injure the brachial artery/vein; median, ulnar or deep muscular branch radial nerve
Appears similar to Posterior Dislocation
Treatment
If no displacement - Sling 2-3 weeks
Flexion allowed after 3 weeks
Extension after 6 weeks
If displacement - reduce ASAP - traction immobilisation best for unstable elbow
continously examine fracture in case of Volkmans Iscaemic fracture.
In cases of irreducible fractures Kirschner method of 2 wires is used.
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