Orthopaedic MD

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Presentation at Orthopaedic Grand Rounds, McMaster August 2005

Menu of topics
- Adult Condylar Fractures: (surgical technique)
- capitellar and coronal shear frx
- distal humerus frx:
- lateral condyle frx:
- medial condyle frx:
- distal humeral non union:
- ulnar nerve in condylar fractures:
- Pediatric Elbow Injuries
- distal humeral physeal separation:
- lateral condyle frx, pediatric
- medial epicondyle frx of the humerus
- supracondylar frx of humerus
Wheeless' Textbook of Orthopaedics

Wheeless' Textbook of Orthopaedics
See: Injuries of the Throwing Elbow - Discussion: - OCD is a localized fragmentation of the bone and overlying cartilage of the capitellum; - it frequently progresses to loose body formation, and sometimes progresses to posttraumatic arthritis; - laxity of the MCL may accentuate the loading on the capitellum; - osteochondritis dissecans of the capitellum tends to occur in patients 10-16 years of age; - it is commonly found in young (10 yr old) baseball pitchers; - during the acceleration phase, the elbow assumes a valgus position which loads the capitellum; - it should be distinguished from Panner's Disease:

Osteochondrosis / Stress Frx of Medial Epicondyle
Wheeless' Textbook of Orthopaedics
Discussion: - a traction apophysisitis of the medial epicondyle which needs to be distinguished from avulsion frx of the medial epicondyle - the medial epicondyle is an apophysis which is connected to the MCL as well as being connected to the flexor-pronator mass; - both of these structures will stress the apophysis w/ valgus stress

Wheeless' Textbook of Orthopaedics
Discussion: - disease involving capitulum of distal humerus that produced changes similar to those observed in Legg Calve Perthes disease; - it should be distinguished from osteochondritis dissecans; - pathologic process is believed to be caused by an interferrence in blood supply to growing epiphysis, which results in resorption & eventual repair and replacement of the ossification center; - in patients under 20 years of age, capitellum is only supplied by end arteries entering posteriorly; - Panner's disease almost always occurs in the dominant elbow in boys between 5 and 12 years of age; - inciting causes: - chronic repetitive trauma, congenital and hereditary factors, embolism (fat), and endocrine disturbances;

List of topics associated with Paediatric Elbow Injuries
- Distal Humeral Physeal Separation:
- Elbow Dislocation
- Lateral Condyle Fracture
- Medial Condyle Fracture
- Medial Epicondyle Fracture
- Nursemaid's Elbow
- Olecranon Fracture
- Osteochondritis
- Osteochondrosis of Medial Epicondyle
- Radial Neck Fracture
- Supracondylar Fracture of Humerus
- Throwing Elbow Injuries Wheeless' Textbook of Orthopaedics

McMaster Grand Rounds Presentation

Wheeless' Textbook of Orthopaedics

Wheeless' Textbook of Orthopaedics

Wheeless' Textbook of Orthopaedics

Wheeless' Textbook of Orthopaedics

Wheeless' Textbook of Orthopaedics

Wheeless' Textbook of Orthopaedics

Portal Placement and related neurovascular anatomy Possible nerve injuries Tissue resection/debridement techniques Maintaining adequate visualization Arthroscopically assisted surgery Developing technical skills Comorbidities and risks