ISSN-1059-6518

Elbow Injuries and Ankle Injuries

By Frank Hubbell, DO

Illustrations By T.B.R. Walsh

THE SITUATION:

A couple is hiking down a trail into the Grand Canyon, enjoying the day and looking forward to reaching some shade at the bottom. The trail is in good shape with the occasional rock in the middle of the trail. The female companion unfortunately stubs her toe on a rock and falls. She falls forward, downhill, with a 40# pack on her back. She instinctively reaches out with her right hand to control the fall. As her right hand impacts the ground with her arm straight, she feels an intense searing pain in her right elbow, a sharp snap, and her arm collapses. Crumbling onto the trail, she immediately rolls over and grasps her right elbow in her left hand, letting her companion know that her right elbow is in excruciating pain.

Upon examination, he finds that the elbow is very tender to palpation and is locked in position at 90 degrees of flexion. The elbow is deformed and looks like the butt of a gun, a gunstock. He also notes a decreased sensation in her fingers and no radial pulse at her wrist. Over the next half hour her right hand goes from pale to cyanotic, with pins and needles sensation in her fingers, and she is unable to move her fingers.

ELBOW FACTS:

Elbow pain is the second most common reason to see an orthopedic surgeon, the first reason being shoulder pain.

The “funny bone” is not a bone. It is actually the ulnar nerve. When you bump the nerve, you are going to have temporary pain and tingling in the forearm distal to where the nerve goes over the lateral aspect of the elbow.

“Tennis elbow” is a sprain of the lateral aspect of the elbow referred to as lateral epicondylitis.

“Golfer’s elbow” is a sprain of the medial aspect of the elbow referred to as medial epicondylitis

“Student elbow” is caused by leaning on the elbow while studying. This compresses the bursa over the olecranon of the ulna, causing it to become inflamed and swollen. This is referred to as olecranon bursitis.

THE ANATOMY OF THE ELBOW:

Bones:

There are 3 bones that make up the elbow joint.

Humerus – the upper arm

Radius – the forearm

Ulna – the forearm