Paediatric elbow injuries.
This teenage girl has dislocated her elbow. How would you test her median nerve sensation?
The sensory component of the median nerve covers the palmar surface of the thumb and radial 2 and 1/2 fingers. It extends on the dorsal surface of the index and middle fingers to about the level of the proximal interphalangeal joint.
This child has fallen onto his outstretched arm. It shows a posterior fat pad sign. What does this mean.
Technically the posterior fat pad sign means the patient has a joint effusion. In this case the fluid will be blood from an intra articular fracture and with this age group and mechanism you need to exclude a supracondylar fracture---which he has.
Approximately what percentage of people can lick their own elbows?
However 100% of people can lick someone else's elbow.
Illustrated is the radiocapitellar line. Where is it meant to go in a lateral elbow x-ray?
The radiocapitellar line is best described as going along the axis of the radial neck and intersects the middle of the capitellum. In this case the radial head is dislocated.
This child fell on a flexed elbow. What best describes this injury?
This flexion type supracondylar fracture only occurs in about 5% of supracondylar fractures.
What does this x-ray show?
The dislocation is described from where the distal bone (s) is in relation to the proximal bone. So it is therefore a posterior dislocation of the elbow because the radius and ulnar are posterior to the humerus.
What is the skin over your elbow known of in "slang".
Known variably as Wenis, Wenus, Weenus.
What does this mnemonic help you remember?
Thanks to Dr Mana Ittimani. Capitellum (Comrades), Radial head (Remember), Medial epicondyle (My), Trochlea (Thoughts), Olecranon (On), Lateral epicondyle (Love). Always thought it was much more cute than CRITOE.
Dates of closure are approximately in years---1,3,5,7,9,11.
The red line is the anterior humeral line and is used to see if the patient has a displaced supracondylar fracture. Which part of the capitellum is it meant to go through?
In this lateral view of the elbow the anterior humeral line goes through the anterior third of the capitellum rather than the middle third where it is meant to go. This means the humerus has been pushed posteriorly due to a supracondylar fracture which you can hardly see.
This cute animal is the only venomous mammal. It has venomous glands over its elbows. What animal is it?
It has venom in pads on its elbows which it licks adding it to its saliva. Then it has sharp grooved canines that the venom drips down if it bites you. Charming.