Sports Injuries

> Elbow Dislocation

The humerus, radius and ulnar are the bones of the elbow joint. The elbow joint is both a hinge joint and a ball and socket joint. Dislocations are categorised as partial, also known as subluxed elbow joints, or complete dislocations. Complete dislocation of the elbow is rare. Emergency procedures should be followed immediately to avoid any additional nerve or blood vessel complications which may arise.

> Elbow Injuries in the Throwing Athelete

Over arm throwing activities place high stress on the shoulder and elbow joint. Often these same activities involve repetitive high stress movements. Repetitive stresses often cause injury gradually over time. Common throwing injuries of the elbow include flexor tendinitis, Ulnar Collateral Ligament (UCL) Injury, Valgus Extension Overload (VEO), Olecranon Stress Fracture, and Ulnar Neuritis. Common surgical treatments include arthroscopy, UCL reconstruction and ulnar nerve anterior transposition.

> Ulnar Nerve Entrapment

The ulnar nerve runs from the neck, down the upper arm, through the medial aspect of the elbow, to the medial forearm, wrist and little and ring fingers of the hand. The ulnar nerve passes through a tunnel of tissue at the elbow called the Cubital Tunnel. Ulnar nerve entrapment may occur anywhere along the nerve, however, it is most common at the cubital tunnel, where it is commonly called cubital tunnel syndrome. If non-surgical treatments fail an ulnar nerve anterior transposition may help relieve symptoms.

> Nurse Maid's Elbow

Nurse maid's elbow is a common injury of early childhood. Nurse maid's elbow typically results from the arm being pulled too hard and the radial head partially dislocating, also known as radial head subluxation. The injury often occurs in children from 1-4yrs old, but may occur up to the age of 7. Reduction of the subluxation often results in relief pain and return to normal function.

> Tennis Elbow

Tennis Elbow is an overuse injury of the forearm extensors. Tennis elbow occurs at the lateral epicondyle of the humerus, which is felt as a boney bump on the outside of the elbow. Tennis elbow is a gradual onset condition involving pain. Treatment is typically conservative, but if stretching and anti-inflammation treatment is unsuccessful, surgical treatment involving debridement of unhealthy tissue and reattachment of healthy tissue is advised.

> Biceps Tendon Repair

Distal biceps tendon rupture or rupture of the biceps tendon at the elbow, are typically complete tears occurring spontaneously during an eccentric contraction of the biceps. Rupture of the tendon results in a 30%-40% loss in muscle strength with associated muscle shortening with the common term "popeye deformity".

> Recurrent and Chronic Elbow Instability

Repeated elbow dislocation results in looseness of the elbow such that it causes the joint to pop, catch, or slide out of place on an increasingly frequent basis. Elbow instability presents as posterolateral rotatory instability, valgus instability and or varus posteromedial rotatory instability. Surgery may be a solution if conservative treatments fail.


> Adult Forearm Fractures

Mid shaft radius and ulnar fractures may present as a small crack, a multi fragment break or a clean break which may be aligned or mal aligned. It is important to immobilise a fracture in a reduced state where it can heal correctly. Depending on the type of fracture, a simple plaster cast may be enough, or surgery may be required reduce, or bring back the parts of the fracture.

> Distal Humerus Fractures of Elbow

The distal humerus is the end of the upper arm at the elbow. Fractures of this bone are uncommon. XRay will confirm the fracture and immobilisation will be necessary to treat the fracture. Depending on the alignment of the fractured parts of the bone, surgery may be necessary to reduce or bring the parts back together.

> Radial Head Fractures

The most common elbow fractures are fractures of the radial head. Many elbow dislocations also involve a fracture of the radial head. Fractures can be described as Type I fractures such as small cracks, Type II fractures involving larger bony fragments, and Type III fractures involving multiple pieces of bone which cannot be put back together.


> Osteoarthritis (OA) of the Elbow

Osteoarthritis is worn or damaged cartilage of the elbow joint. Osteoarthritis occurs as a result of damage to the joint like dislocation or fracture, or by natural wearing or degeneration of the articular surface. Pain and loss of range of motion or movement are the typical symptoms of OA of the elbow. Depending on the degree of OA, conservative or surgical treatments can treat the condition. Total Elbow Joint Replacement surgery is available for advanced OA elbow cases.

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