CP VI Elbow/Wrist/Hand

Where does majority of the flexion and extension of the elbow occur?

humeroulnar

Where does the majority of supination and pronation occur?

radioulnar

Humeroulnar joint type and close packed position

hinge/ginglymus joint, full extension and supination

Humeroradial joint type and close packed position

plane joint/limited ball and socket, 90 deg of elbow flexion with 5 deg supination

Radioulnar joint type and close packed position

pivot/trochoid joint, full elbow extension with 5 deg supination

T/F: Men typically have a smaller carrying angle than women.

true

what is the typical carrying angle?

5-15 deg

T/F: Lateral epicondylitis aka tennis elbow is due to eccentric load on the wrist when the ball hits the racket.

true

T/F: Medial epicondylitis aka golfer’s elbow is due to repetitive or resisted extension of the wrist.

false, flexion

Lateral/medial epicondyle fracture

typically an avulsion type injury

Supracondylar fracture

mc in kids, cubitus varus/gunstock deformity

what location of dislocation of elbow is most common?

posterior/posteriolateral/posteroinferior

what ligament is involved with nursemaid’s elbow?

annular ligament

What is the keystone of the carpals?

capitate

where is the tunnel of guyon located?

between pisiform and hook of hamate

proximal row of carpals

scaphoid, lunate, triquetrum, pisiform

distal row of carpals

trapezium, trapezoid, capitate, hamate

where does majority of wrist flexion occur?

inter carpal/midcarpal joint

where does most wrist extension occur?

radiocarpal joint

Longitudinal arch of the hand

Runs the length of the hand centering near the 3rd metacarpal and crucial for

grasping objects

Proximal transverse arch of hand

The most rigid and stable of the hand arches, formed primarily by the distal row of

carpal bones

Game-keepers thumb

sprain/tear of UCL, full rupture/avulsion fx

Brawler’s fx

4th and 5th metacarpal, high likelihood of infection

Boxer’s fx

2nd and 3rd metatarsal

Bennette (maybe?) fx

fx of 1st CMC

Colles’ fx

fracture of the distal radius with posterior displacement of the wrist and hand

Smith’s fx

falling on flexed wrist

Most commonly fx carpal bone

scaphoid

Most commonly sublimated carpal bone

lunate

De-Quervaine’s syndrome

tenosynovitis of tendon of the thumb

What pt population is carpal tunnel common?

pregnant women

Rheumatoid arthritis

swan-neck (hyperextension of the PIPs and flexion of DIPs), ulnar deviation of fingers