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Therapeutic Implications of the Radiographic “Drop Sign” Following Elbow Dislocation

2012; Elsevier BV; Volume: 25; Issue: 3 Linguagem: Inglês

10.1016/j.jht.2012.03.003

1545-004X

Joey G. Pipicelli, Shrikant J. Chinchalkar, Ruby Grewal, Graham J.W. King,

Orthopedic Surgery and Rehabilitation

A radiographic drop sign following elbow trauma is an abnormality that is controversial with limited information describing optimal management. The consequences of this complex clinical situation includes limited motion, pain, and joint impingement, which may lead to joint stiffness and contracture formation. These authors describe the therapeutic implications of this radiographic finding and present a treatment approach in order to enhance patient outcomes.—Victoria Priganc, PhD, OTR, CHT, CLT, Practice Forum Editor A radiographic drop sign following elbow trauma is an abnormality that is controversial with limited information describing optimal management. The consequences of this complex clinical situation includes limited motion, pain, and joint impingement, which may lead to joint stiffness and contracture formation. These authors describe the therapeutic implications of this radiographic finding and present a treatment approach in order to enhance patient outcomes.—Victoria Priganc, PhD, OTR, CHT, CLT, Practice Forum Editor Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.#1.A positive elbow drop sign (as seen on a lateral x-ray) showsa.an ulnohumeral distance of approximately 2 mmb.an ulnohumeral distance of greater than 4 mmc.a radiocapitellar distance of approximately 2 mmd.a radiocapitellar distance of greater than 4 mm#2.A cardinal principal of early rehab following lateral sided elbow dislocation is VSA, an acronym fora.Virtual Stress Avoidanceb.Vertical Stress Avoidancec.Valgus Stress Avoidanced.Varus Stress Avoidance#3.A major concern with a persistent drop sign is the possibility of developinga.radial nerve impingementb.ulnar nerve impingementc.degenerative changes of the ulnotrochlear jointd.degenerative changes of the radiocapitellar joint#4.Early rehab ROM exercises following reduction of a simple dislocation should be performed with thea.arm at the side, and forearm supinated from the supine positionb.arm overhead, and forearm pronated from the supine positionc.arm overhead, and forearm pronated from the sitting positiond.arm at the side, and forearm supinated from the sitting position#5.An effective rehab program will often see a gradually reduced drop sign over timea.trueb.false When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.