Elbow Anatomy & Pathology

Elbow Anatomy & Pathology
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Elbow Anatomy & Pathology
1. How would you explain in anatomical terms the client’s diagnosis during the initial assessment visit?
R.M was diagnosed with anterior dislocation of the right elbow that occurred he fall from a three feet high wall. Radiological examination leads to the confirmation of same whereby his radius and ulna have shifted backward relative to the humerus. This results from a direct posterior blow of the humerus resulting in a forward shift or a heavy impact on the palm causing stress to the olecranon. The examination also indicated that there were no associated fractures, edema or other tissue damage that can result in serious neurological injury. Anterior dislocation is a rare and more critical type of elbow dislocation compared to posterior elbow dislocation.
2. How would you educate the client on THREE “red flags” specific to that diagnosis and what would you tell him to do?
Various signs can indicate to a patient the existence of anterior elbow dislocation. Anterior dislocation causes uncontrolled movements, reduced flexion than normal which would be less than 180º and intense pain. In the case of an anterior dislocation, the patient ought to be subjected to a gentle reduction maneuver with an aim to fix the radial head into olecranon. Secondly, the patient out to perform regular gentle hand exercise involving elbow extension and pronation. This enables ligaments to adjust and assume their rightful length and full control.

3. Explain why he has those two specific contraindicated movements in relation to the anatomy of the elbow and his injury.
When the radial head is dislocated from the ulna, the medial collateral ligaments lose the support of the ulna and the radius. Reduced flexion results from shortness of the medial collateral ligament. When the patient tries to increase flexion, the ligaments pulls the adjacent tissue attaching it to the humerus and radius. Annular ligaments attached to the radius head fails to control lateral movement of the lower hand. When the radial heals jerks out of olecranon, annular ligaments losses control due to their shortness resulting in unprecedented lateral lower hand movements.

References
Cooper, C. (Ed.). (2013). Fundamentals of hand therapy: clinical reasoning and treatment guidelines for common diagnoses of the upper extremity. Elsevier Health Sciences.