Topics
Elbow Stiffness
Functional arc required: Flexion–extension: 30°–130° Pronation–supination: 50°–50° Stiffness is defined as ROM below the functional range
Distal Biceps Rupture
Disruption of the distal biceps tendon insertion at the radial tuberosity. Leads to loss of: Supination strength (primary) Flexion strength (secondary)
Proximal Biceps Tendon Pathology
Management of Long Head of the Biceps (LHB) and Biceps Reflection Pulley (BRP) Lesions
Management of Anterior Shoulder Instability
Throwing Athlete Injuries
Distal Triceps Rupture
• Rarest major tendon rupture — <1% of all tendon injuries; most common in males aged 30–50 • Mechanism: eccentric load on a contracting triceps (FOOSH, fall on elbow, direct blow) • Insertion at the olecranon tip — bony avulsion is the most common pattern (~75%) • Strong association with systemic risk factors: anabolic steroids, chronic renal failure, hyperparathyroidism, fluoroquinolone use • Clinical diagnosis: palpable gap at olecranon tip + weak or absent active elbow extension • Thompson squeeze test: squeeze triceps belly — elbow should extend; no extension = complete rupture • Complete rupture → surgical repair; partial rupture (<50%) → non-operative if extension is maintained • Repair within 2–3 weeks strongly recommended — chronic tears require tendon reconstruction
SHOULDER ANATOMY
Monteggia Fractures
Olecranon Fractures
Radial Head Fractures
Fractures of the radial head, most commonly resulting from a fall on an outstretched hand (FOOSH) Frequently associated with elbow instability injuries