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A 50-year-old male laborer has persistent pain in the right elbow and has been having difficulty with some activities of daily living over the last year. He has not seen any progress after 3 months of using the extension splint from his ulnar nerve transposition 10 years ago. He currently denies numbness or tingling in the 4th and 5th digits and has a negative Tinels at the elbow. His elbow range of motion is 45-110° of flexion/extension and 130° of total prono-supination. Which of these factors is a relative contraindication to arthroscopic release?
Age over 40 years
Osteophyte formation in ulnohumeral joint
Prior ulnar nerve transposition
Heavy labor occupation
Select Answer to see Preferred Response
A 52-year-old man sustained the left elbow injury shown in Figure A while playing basketball 2.5 months ago. He underwent the procedure shown in Figure B. Post-operatively he was mobilized in a hinged brace. On examination today, his arc of elbow flexion is 75 degrees with loss of 45 degrees of full extension. His Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure score is 45 points. What initial treatment option will likely provide the greatest improvement in this patients DASH score and functional range of motion?
Self-directed exercise therapy
Supervised exercise therapy
Supervised exercise therapy with static progressive elbow splinting
Continuous passive motion device
Closed manipulation under anesthesia
A 49-year-old man sustains a dislocation of his left elbow that is successfully reduced and splinted. He misses his scheduled follow-up appointments and returns 6 weeks later. He is immediately enrolled in a course of vigorous physical therapy. At a repeat visit at 6 months, examination reveals that he lacks 40 degrees of elbow extension, and has flexion to 80 degrees. He is taken to the operating room for surgical release. Figures A and B are diagrams depicting the ligamentous attachments about the elbow. To restore elbow flexion, in addition to releasing the articular capsule, which ligament should be released?
Which of the following statements is true regarding the posterior oblique portion of the medial collateral ligament of the elbow?
Can be released to gain flexion in patients with post-traumatic contracture
Has the highest tensile strength of any elbow ligament
Is reconstructed in the Tommy John procedure
Is the primary ligamentous restraint to valgus force during throwing
Is responsible for the pivot shift of the elbow
Static progressive turnbuckle splinting is most appropriate for which of the following patients?
3 months after ORIF of a distal humerus fracture with a flexion arc of 45° to 100° with no further improvement with physical therapy
4 weeks after nonoperative treatment of a displaced radial head fracture with block to supination
1 week after simple elbow dislocation with flexion arc of 10° to 140°
Presence of extensive heterotopic ossification after a complex elbow dislocation with associated ankylosis of the joint
Immediatly after elbow arthroscopy for loose body removal and debridement