Module 9 : Humeral Shaft and Elbow

The VariAx Elbow Locking Plates offer how many degrees of variable angle locking?

+/- 15 degrees

The VariAx Elbow locking plates offer how many degrees of variable angle locking?

+/- 15°

What are the 4 sizes of the extended collar stem component in the UNI elbow set?

1,2,3,4

What are the 4 sizes of the standar collar stem components in the UNI elbow set?

1,2,3,4

The joint distraction mechanism ranges from ___ to ___ mm

1-10mm

What are the 3 elbow plate fixation techniques?

1. 2 plates at 90 degrees if cortical contact 2. 2 plates at 180 degrees if no cortical contact 3. Pre-contoured anatomic plates or 3.5 recon plate

What are the 3 criteria for "Terrible Triad of the Elbow?"

1. Elbow dislocation 2. FX of Coronoid 3. Fx of radial head

For elbow fx's, what makes for a successful fixation?

1. parallel plates are placed that permit a total of four to six long screws in the distal fragments from one side across to the other. 2. Screws interdigitate 3. plates are precontoured particularly on the lateral side 4. intra-op contouring if necessary 5. locking if necessary

The T____ screwdriver is used for the VariAx elbow screws

10

What is a common plating error, physicians make?

2 posterior plates only

What are the 3 sizes of the radial head components in the UNI elbow set?

2, 3, 4

What is the size of the standard collar stem component in the UNI elbow set?

2.0 mm

What screw size(s) does the VariAx Elbow locking plate system use?

2.7mm & 3.5mm

Plates hould be long enough to get ______ above the fracture

3-4

What are your screw options in VariAx elbow? - Shaft and head diameter?

3.5 and 2.7 shaft locking and non locking 5mm torx for both

What is the complication rate (maluinons/nonunions caused by inadequate fracture fixation)?

35%

What size mm pins are utilized in DJD II?

3mm + 4mm

How many degrees do the medial and lateral condyles angulate anteriorly?

40°

The VariAx Elbow Locking Plate system offers how many plate options for both the distal humerus and olecranon (not including left/right options)?

5 distal humerus and 1 olecranon

What grade titanium is the VariAx plate? Inserts? Screws?

5, 2, 5

____% of the coronoid must be present for the ulno-humeral joint to have normal function

50%

What is the length of the stem for the rHead extended stem?

50mm

The plates should be sufficiently strong to avoid breakage for ___ months (avoid 1/3 tubular plates)

6

What is the size of the extended collar stem component in the UNI elbow set?

6.0 mm

What is the collar height of rHead Extended stem?

6mm.

The plates should be at _____ to each other, or facing each other at _____ (if there is no cortical contact)

90°; 180°

The triceps muscle is part of the elbow ______. A.Extensors B. Flexors

A

What are the AO/OTA classifications for olecranon fractures? (A, B, C)

A = extraarticular B = Articular (radius or ulna) C = Articular (both radius and ulna)

What are the distal humerus fracture classifications? (Type A, B, C)

A = extraarticular B = Partial articular C = Complete articular

The bones of the elbow include: (Check all that apply) A. Radius B. Olecranon C. Ulna D. All of the above

A and C

What Stryker products are available for Elbow fractures?

Asnis III cannulated screws Twinfix Cannulated Compression Screw Profyle Hand VariAx Hand VariAx Elbow Locking Plate System Dynamic Joint Distractor II Solar Total Elbow Solar Radial Head

A distal humeral fracture consisting of the medial epicondyle and part of the trochlea broken from an otherwise intact distal humerus is called a.... A. Type A fracture B. Type B fracture C. Type C fracture

B

Which T2 humeral nail has 6mm of active internal compression capabilities? A. T2 Proximal Humeral Nail B. T2 Standard Humeral Nail C. Both

B

In VariAx Elbow, what are the colors and the sizes of the drill they represent?

Black - 2.7 (2.0 drill) Yellow - 3.5 (2.6 drill)

Which Hoffman II system components does the Stryker DJD II mostly use? A. Hoffman II Hybrid B. Hoffman II Micro C. Hoffman II Compact D. Hoffman II Standard MRI

C.

What are the 2 main landmarks of the ulna?

Coronoid Process, Olecranon

The VariAx Elbow Locking Plate system offers how many plate options for both the distal humerus and olecranon (not including L/R options)? A. 6 distal humerus and 2 olecranon B. 4 distal humerus and 1 olecranon C. 5 distal humerus and 2 olecranon D. 5 distal humerus and 1 olecranon

D

Which are the two most common distal humerus plating fixation techniques? A. 180 degree plating & Rafting plating B. Tension band plating & 90 degree plating C. Volar plating & Rafting plating D 180 degree plating & 90 degree plating

D

What 3 bones that make up the elbow joint? Be specific with location.

Distal Humerus, Proximal Radius, Proximal Ulna

What are the 5 main landmarks of the distal humerus?

Epicondyles, trochlea, capitullum, olecranon fossa, coronoid fossa

A common complication (up to 18%) of distal third humeral shaft fractures is palsy of the ulnar nerve. True or False?

False

A common complication (up to 18%) of distal third humeral shaft fractures is palsy of the ulnar nerve? T or F?

False

On average, the humeral head is 30 degrees anteverted relative to the shaft of the humerus. True or False?

False

The UNI-Elbow implant is cement - optional. T or F?

False

The Uni-Elbow is FDA cleared for use without a radial head prosthesis. T or F?

False

Which Hoffman II system components does the Stryker Dynamic joint Distractor II (DJD II) mostly use?

Hoffman II compact

The radial nerver is at risk with this spiral fracture of the distal third of the humerus. This fracture is also known as a _____fracture.

Holstein-Lewis

Typically the 4 mm pins are for what bone in what DJD II?

Humerus

What are the 3 types of Coronoid fractures? (I,II, III)

I - tip of coronoid II - middle III - most distal of coronoid

What are your length options for the VariA elbow - Olecranon plate?

Length 4, 6, 8 holes

What is the classification for radial head fractures? Explain I, II, III

Mason classification. I - nondisplaced II - displaced III - displaced and severely comminuted

Besides AO/OTA, what are the 2 other classifications for an olecranon fracture?

Mayo (type 1=undisplaced, type 2 = displaced, type 3 = accompanying lesions-instability Schatzker (transverse, oblique, comminuted)

What are your length options for the VariAx elbow - Extended medial plate? L/R specific?

No - 4, 6, 8 holes

What are your length options for the VariAx elbow - medial plate? L/R specific?

No - 4, 6, 8, holes

What are the 2 targeted proximal static locking options (configurations) for the T2 Standard Humeral Nail?

Oblique & Transverse

What are your 6 options for VariAx elbow plates?

Olecranon plate, lateral plate, posterior lateral plate, posterior medial plate, extended medial plate, medial plate

Where is the site of most elbow dislocations?

Posterolateral (90%)

What are your 4 options for radial head and neck fixation when you are dealing with a radial head fracture?

Screw Placement - lag screw, headless compression buttress plate prothesis (TEA) external fixation

What is the ONLY system the radio capitellum implant is indicated for use with?

Stryker rHead

An Olecranon Osteotomy is commonly done to gain exposure to the distal humeral articular surface, when performing an ORIF of an AO/OTA 13-C3. True or False?

True

An olecranon osteotomy is commonly done to gain exposure to the distal humeral articular surface, when performing an ORIF of an AO/OTA 13-C3. T or F?

True

Any deviation in the angle when inserted axis pin will cause misalignment of center of rotation. True or False?

True

The Stryker DJD II can beused for medial or lateral frames on the elbow. True or False?

True

The Stryker Dynamic Joint Distractor II (DJD II) can be used for medial or lateral frames on the elbow? T or F?

True

The capitellum replacements come in left and right specific options. T or F?

True

The majority of humeral shaft fractures are treated conservatively. True or False?

True

The rHead extended stem can be used in primary and revision surgeries. T or F?

True

The radial head articulates with the capitellum. T or F?

True

The radial head articulates with the capitellum. True or False?

True

When using the radio capitellum implant, what is the ONLY material approved as an articulating surface against the UNI-elbow?

UHMWPE

The trochlea articulates with the _______.

Ulna

Typically the 3 mm pins are for what bone in DJD II?

Ulna

Is the Olecranon plate L/R specific?

Yes

Is the lateral plate in VariAx elbow L/R spcific?

Yes

What are your length options for the VariAx elbow - lateral plate? L/R specific?

Yes - 4, 6, 8 holes

What are your length options for the VariAx elbow - posterior lateral plate? L/R specific?

Yes - 4, 6, 8 holes

What are your length options for the VariAx elbow - Posterior medial plate? L/R specific?

Yes - 4, 6, 8, holes

The ligaments on either side of the elbow are known as the _____.

collaterals

What type of joint is the elbow and how many axes does it have?

hinge joint. Single axis of rotation

What are the 3 DJD II specific instruments needed?

humeral guide, 3mm & 4mm pin insertion guides, hoffman II compact wrench

A distal humerus fracture, that is intraarticular bicolumn fracture, comminution very common, most common distal humeral fracture...

intercondylar fracture

A distal humerus fracture, that is intraarticular, single column (unicondylar med or lat), oblique fracture into trochlea, uncommon fracture

isolated condylar fracture

There should be one plate on the ______ and one plate on the ______ column

medial; lateral

What are your 2 options for olecranon fracture treatments?

nondisplaced = non operative; splint - Early ROM displaced = ORIF

What are the 2 main landmarks of the radius?

radial head, neck

If there is an olecranon osteotomy, what are the 2 ways to put it back together?

screw and tension band k-wires and tension band

A distal humerus fracture, where the fracture is extraarticular and above the olecranon fossa....

supracondylar fracture

A distal humerus fracture, where the fracture is extraarticular, through the olecranon fossa, fracture line traverse both condyles (growth plate), and is most common in young children....

transcondylar fracture

What landmark does the ulna rotate/articulate on?

trochlea

What landmark is described as a spool? If this landmark is disrupted in any way, rotation is thrown off.

trochlea