Elbow

the elbow
Fig. 1. The elbow joint is: 1 - humerus; 2 - articular bag; 3 - lateral elbow ligament; 4 - ulna; 5 - radial bone; 6 - annular ligament radial bone; 7 - lateral radiation bunch.

Fig. 2. Elbow joint (opened); 1 - humerus; 2 - articular bag; 3-block of the humerus; 4 - articular cavity; 5 - ulna; 6 - radial bone; 7 - annular ligament radial bone; 8 - cylinder radial bone; 9 - the head of the humerus.

Elbow - the connection between the humerus and the bones of the forearm. Elbow joint is formed by three joints: 1) the shoulder, elbow-in which there is a flexion and extension; 2) shoulder-beam, where possible flexion, extension and rotation of the beam; 3) the proximal ray-elbow in which the rotation takes place beam, pronation and supination. In General elbow functions as a spiral: it is possible movements around the front axle bending and straightening. All three joint, forming elbow, enclosed in one common joint bag (Fig. 1 and 2). The joint cavity has front and rear cameras, connected among themselves by narrow slits. In the places of contact of tendons of muscles of shoulder to elbow are mucous bags.
The blood supply of the elbow joint is due to the eight anastomosis between arteries, departing from the shoulder, radial and ulnar artery. Lymph, flowing from the elbow joint region, concentrated in reservoirs along the shoulder artery to the lymph nodes axillary hollows. Innerviruetsya elbow joint to the median, radial, ulnar and musculo-cutaneous nerves. The area of the elbow joint is divided into front (flexion) and rear (extensor surfaces. In the subcutaneous layer on the front surface are saphenous vein, the lateral and medial nerves of the skin of the forearm and the median Vienna elbow. In the internal Department of the cubital fossa about tendon biceps muscle under the aponeurosis are brachial artery, vein, and the median nerve.
Malformations of the elbow joint is rare. These include expressed congenital curvature of the elbow, characterized by the deviation of the forearm with respect to arm outwards, additional bone elbow joint, which can be accepted in trauma for bone fragment. It is extremely rare congenital ankylosis and contractures of the elbow joint.

Congenital curvature of the elbow (cubitus valgus) is characterized by the deviation of the forearm with respect to arm outwards. Small (7 - 10 degrees) deviation of the forearm outwards is physiological. More pronounced curvature already belong to the pathological. Additional bone elbow joint (patella cubiti, s. sesamum cubiti) is rare (matters when the examination after the injury). It is independently developed Apophis olecranon, which could be mistaken for a bone fragment.
The damage. The elbow joint injuries occur frequently, may be accompanied by bleeding in the surrounding soft tissue, mucous bags and less in the joint cavity, be complicated by inflammation, which can lead to arthritis, ankylosis, contracture. When ulnar nerve injury experiencing a sharp pain radiating to the fourth and fifth fingers. Extension in the elbow joint occur when excessive its extension (during a game of tennis, exercise with weights and other)can be accompanied by a rupture of a capsule, hemarthrosis (see Arthritis). Treatment for bruises and sprains: fixing soft bandage, rest, ice, sometimes plaster immobilization Longuet on average physiological position of the elbow joint in 3 - 5 days; then heat treatments and physiotherapy. For large hemarthrosis arthrocentesis by sucking blood.
Open injury of the elbow joint in peacetime occur most often at work, and gunshot wounds in time of war (by frequency occupy the third place among other injuries of joints).
Wounds can be different: blind, end-to-end, non-invasive (with soft tissue injury), penetration (damage to a joint bags), with minor damage to bones or extensive damage to soft tissue and bone crushing. In the latter case, the wound is funnel-shaped, filled with crushed by muscles, bone fragments, blood clots, sometimes by foreign objects and pieces of clothing.
First aid with wound: abundant lubrication circumference of the wound with iodine, aseptic bandage with tamponade wounds in order to stop the bleeding, weakened harness on his shoulder, immobilization of the bus, the introduction of sera and morphine.
On the advanced stages of evacuation is debridement with excision of non-viable tissues stop bleeding, remove bone fragments deprived of periosteum, blood clots, foreign bodies, scraps of clothing. Transfusion of blood, local and intramuscular use of antibiotics. Plaster bandage with window to monitor the wound.
Complications injury of the elbow joint is: shock (see), hemorrhage (see), osteomyelitis, fistulas, contracture (see), ankylosis (see). Treatment of surgical and medical gymnastics.
The dislocations in the elbow joint happen when you fall on an outstretched peretasoval in the elbow joint hand. In overwhelming majority of cases observed back sprains of the two bones of the forearm (see Dislocations).
The dislocation of the radial head bone can be combined with a broken elbow bones along the upper and middle third - fracture of Montage. Symptoms: local tenderness, swelling, no pronation and supination of the forearm. Radiograph confirms the diagnosis. First aid - immobilization of the joint band of the type kerchiefs. Treatment: reposition elbow bone fragments and the reduction of radial head bone is usually performed by the doctor. If bloodless way cannot do this, perform surgery elbow bone osteosynthesis and the reduction of radial head bones.
The fractures of the bones of the elbow joint include: 1) fractures of the lower end of the arm, both condyles, Razmyslov, T-shaped and U-shaped fractures metaphysis shoulder, broken capitate exaltation and outside namesake; 2) fractures epiphysis forearm bones, olecranon, coronal ridge of the head and neck radiation bones. On the mechanism of occurrence of these fractures are divided into extensor and flexor. Symptoms: rapidly increasing swelling of the elbow joint, local tenderness, impaired mobility in the joint, bleeding in the joint cavity (hemarthrosis). Diagnosis of fracture and his views are based on the data of x-ray studies. Treatment is usually conservative. If successful reposition of fragments (performed by a physician) put a plaster cast on different dates depending on the type of fracture. At impossibility of matching bone fragments perform operative treatment. At the turn of the olecranon discrepancies of fragments treatment is always operational. To restore the function of extremities after seam fracture implement active and passive exercises, physiotherapeutic treatment (mud treatment etc).
The disease. Inflammation of the elbow joint, specific and non-specific,see Arthritis, Tuberculosis of bones and joints.
Bursitis elbow joint (inflammation of mucous handbags) usually arise in connection with the trauma in labour processes. Occur acutely and chronically (see Bursitis). Treatment: acute bursitis - immobilization of the joint, the compression bandage, antibiotics intramuscularly; with festering - cut. Chronic bursitis, often relapsing,- the delete operation of the mucous bag.
Agrosteomela ("tennis elbow") - traumatic and professional epicondylitis (inflammation of namesake shoulder), occurs due to overload the elbow during work and sports. Characterized by the appearance of acute pains in the field of Razmyslov shoulder when movement in the joint. Treatment: rest, immobilization plaster Longuet, novocaine blockade, thermal treatments, massage.


Elbow joint (subtalar cubiti) connection between the bones of the shoulder and arm. Topographic area of the elbow joint is called the elbow (cubitus). Elbow is a complex joint, formed of three bones, consists of three joints: 1) preselective (between the shoulder block and block the cut-elbow bones), in which the flexion and extension; 2) placebokonoha (between the pit head of the radial bone head and shoulder), where possible flexion, extension and rotation of the beam; 3) proximal luceluceluce (between articular head circumference ray and radiation tenderloin elbow bones). In this joint happen rotating beam, pronation and supination. Joint - cylindrical. In General elbow functions as a spiral (art. cochlearis). It is possible movements around the front of PCB: bending and straightening. On the sides capsules HP are collateral ligament (ligg. collateralia ulnare et radiale). Deep beams latest move in a circular link beam (lig. anulare radii), covering the head of the beam (Fig. 1-3). All three joints are enclosed in one common joint bag - capsule. In joint cavity has front and rear cameras, which shall be communicated narrow slits. With the development of purulent arthritis these gaps are closed due to swelling of the synovium that must be considered at the opening of the joint, and drain should both departments. Mucous bags elbow are under the triceps tendon at the olecranon and on the tendon and two bags on the sides of the biceps tendon.
Food HP is due to the arterial network, which is formed of eight anastomosed with each other arteries. Collateral circulation in ligation of the shoulder, elbow, or the radial artery is easily restored through the arterial network.
Lymph from all areas of the elbow joint is concentrated in reservoirs along the brachial artery, and interrupted in the lymph nodes in the armpit. Innervation HP carry out branch of the median, radial, ulnar and musculo-cutaneous nerves.

Fig. 3. The distal end of the humerus, the back surface (with the contours of the upper snap bags elbow joint); you can see the line epiphyseal cartilage: 1 - fossa olecrani; 2 - line attach the articular capsule.

Topographically, the region elbow falls into the front flexion and back extensor surfaces. In the subcutaneous layer on the front surface are headache saphenous vein and lateral cutaneous nerve of the forearm (v. cephalica, n. antebracliii lateralis), inside - the main Vienna and medial cutaneous nerve of the forearm (v. basilica, n. cutaneus antebracliii medialis) and between the median Vienna elbow (v. mediana cubiti). In the internal Department of the cubital fossa about the biceps tendon below the aponeurosis of the last (aponeurosis musculi bicipitis brachii) is the brachial artery, and 0.5-1 cm the more medially from it - the median nerve. Groove between the internal nagmyman.com upper arm and elbow process serves as a bed for the ulnar nerve.