Exam 18: The Elbow and Forearm Complex

Your patient, a 19-year-old college student, sustained a nondisplaced fracture of the distal humerus, which was managed by closed reduction and 6 weeks of immobilization in a cast.Yesterday the cast was removed and the patient is to begin exercises to improve range of motion (ROM) and strength of the elbow.Your examination reveals significant limitation of elbow flexion/extension and forearm pronation/supination as well as reduced joint play at the elbow.The patient describes her elbow as feeling "very stiff," but pain occurs only when overpressure is applied at the end of the available ranges.One of the goals in this patient's treatment plan is to increase elbow ROM.With which of the following techniques should you begin to increase ROM?

When a period of continuous immobilization of the elbow is required after trauma or surgery, the elbow often is positioned in only a moderate amount of flexion (20° to 30°) rather than 90° of flexion.This position is selected to:

You place your patient's wrist in a splint because he is experiencing an acute episode of lateral epicondylitis.Which of the following is the least appropriate intervention while the inflamed soft tissue is healing?

Which of the following is true about total elbow arthroplasty (TEA)?

Current research shows that the "survival rate" for TEA is:

Each of the following is a precaution that should be taken after TEA involving a triceps-reflecting or triceps-splitting approach except:

Using a handheld weight as the source of resistance, which of the following positions to strengthen the elbow extensors begins with the long head of the triceps brachii fully lengthened?

You are modifying a home exercise program for a patient recovering from an episode of medial epicondylitis.Although pain has subsided, there is evidence of mild limitation of motion and pain when the involved muscle-tendon unit is placed on a stretch and overpressure is applied at the end of the available ROM.To fully lengthen the muscle-tendon unit typically involved in medial epicondylitis, have the patient perform a self-stretch by using the opposite hand to:

Your goal is to increase end-range elbow flexion using joint-mobilization techniques.Which of the following techniques is appropriate?

You are educating your patient about returning to functional activities following a radial head resection with an implant.What should you tell her about returning to high-demand, high-impact activities?

Which of the following is true about myositis ossificans (heterotopic bone formation) in the elbow region?

To strengthen the elbow extensors in a closed chain, you have the patient perform push-ups, using body weight as the source of resistance.Which of the following variations of push-ups provides the greatest amount of resistance to the elbow extensors?

The most common fracture in the elbow region is a fracture of the head and neck of the radius.All of the following are true about medical management of this injury except:

Tennis elbow may involve all of the following structures except the:

A person with a long history of polyarticular rheumatoid arthritis is experiencing severe, dominant-side elbow pain that is interfering with personal grooming, light housework, and work-related responsibilities as a computer programmer.In addition to pain, physical findings include persistent synovitis despite ongoing medical management, limited elbow ROM, and complete loss of the joint space of the humeroulnar and humeroradial joints.Given these findings, this person is most likely a candidate for which of the following surgical procedures to relieve pain and improve daily function?