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At least 271 records · Page 15Linked to original sources
PubMed2006

Evolution of the treatment options of ulnar collateral ligament injuries of the elbow.

Ulnar collateral ligament (UCL) insufficiency is potentially a career threatening, or even a career ending, injury, particularly in overhead throwing athletes. The evolution of treating modalities provides afflicted athletes with the opportunity to avoid premature retirement. There have been several clinical and basic science research efforts which have investigated the pathophysiology of UCL disruption, the biomechanics specific to overhead throwing, and the various types of treatment modalities. UCL reconstruction is currently the most commonly performed surgical treatment option. An in depth analysis of the present treatment options, both non-operative and operative, as well as their respective results and biomechanical evaluation, is lacking in the literature to date. This article provides a comprehensive current review and comparative analysis of these modalities. Over the last 30 years there has been an evolution of the original UCL reconstruction. Yet, despite the variability in modifications, such as the docking technique, interference screw fixation, and use of suture anchors, the unifying concepts of UCL reconstruction are that decreased dissection of the flexor-pronator mass and decreased handling of the ulnar nerve leads to improved outcomes.

Adolescent↗
PubMed1976

Intra-articular injuries of the elbow: pitfalls of diagnosis and treatment.

Poor results in treating fractures and dislocations about the elbow may be avoided if the surgeon is aware of the possible injuries, examines good radiographs of both elbows, and treats the injury promptly and appropriately. A displaced fracture of the lateral or medial condyle of the humerus should be suspected if there is a flake fracture of the adjoining metaphysis; open reduction and internal fixation give better results than closed reduction. A shear fracture of the capitulum humeri can only be seen on a lateral radiograph; excision of the fragment, followed by mobilization, is sufficient for a good functional result. Dislocation of the elbow in a child may avulse the medial epicondyle, which sometimes lodges in the joint; it is essential to recognize this and remove the fragment without delay to avoid early degenerative arthritis. An apparently isolated fracture of the ulna should alert the surgeon to the possibility of a dislocation of the radial head; the dislocation and the fracture must be reduced and stabilized to conserve elbow function.

Adolescent↗
PubMed2006

Influence of shoulder abduction and lateral trunk tilt on peak elbow varus torque for college baseball pitchers during simulated pitching.

Elbow varus torque is a primary factor in the risk of elbow injury during pitching. To examine the effects of shoulder abduction and lateral trunk tilt angles on elbow varus torque, we conducted simulation and regression analyses on 33 college baseball pitchers. Motion data were used for computer simulations in which two angles-shoulder abduction and lateral trunk tilt-were systematically altered. Forty-two simulated motions were generated for each pitcher, and the peak elbow varus torque for each simulated motion was calculated. A two-way analysis of variance was performed to analyze the effects of shoulder abduction and trunk tilt on elbow varus torque. Regression analyses of a simple regression model, second-order regression model, and multiple regression model were also performed. Although regression analyses did not show any significant relationship, computer simulation indicated that the peak elbow varus torque was affected by both angles, and the interaction of those angles was also significant. As trunk tilt to the contralateral side increased, the shoulder abduction angle producing the minimum peak elbow varus torque decreased. It is suggested that shoulder abduction and lateral trunk tilt may be only two of several determinants of peak elbow varus torque.

Abdomen↗
PubMed1992

Olecranon stress fractures in throwers. A report of two cases and a review of the literature.

The evaluation and treatment of elbow injuries in throwing athletics has been the topic of numerous articles. The intense and repetitive stresses placed on the elbow may, in rare instances, produce undisplaced olecranon stress fractures. Two cases are presented and the literature is reviewed to propose that the fractures can be successfully treated by conservative methods.

Adult↗
PubMed1997

[Injuries during handball. A comparative, retrospective study between regional and upper league teams].

To evaluate the injuries in Team Handball 186 male players out of 16 teams were questioned retrospectively at the end of a season. An important difference between practice and competition injuries could be found with an injury rate of 0.8 injuries per 1000 training hours and 13.5 injuries per 1000 playing hours. Injuries were predominant at the lower extremities with ankle injuries being the most frequent injury type. 2/3 of the playing injuries occurred in offense. 1/3 of these offense injuries could be attributed to a counter-attack. These injuries were generally more severe which lead us to a proposition of changing the rules of the game in foul plays in this situation. Elbow injuries in goalkeepers and shoulder injuries in throwers were specific for these types of players. Prophylactic braces were used by nearly 2/3 of the players.

Adult↗
PubMed2006

Radial head arthroplasty.

Radial head fractures are a particularly common yet challenging problem facing orthopedic surgeons today. Over the years multiple treatment modalities have been used including conservative management, open reduction and internal fixation, head excision, and radial head arthroplasty. The clinical outcome studies of metallic radial head arthroplasty systems indicate that head replacement is a reasonable option to offer patients with comminuted radial head fractures and complex elbow trauma. Overall the results for this procedure are quite encouraging and appear durable given the severity of the elbow injuries treated with radial head arthroplasty. This article discusses the history, classification, and treatments of radial head fractures. A description of the stabilizing structures of the elbow as they relate to radial head fractures also is included. Surgical considerations that relate to radial head arthroplasty are detailed and encompass arthroplasty indications, surgical technique, postoperative rehabilitation, and complications. Finally the arthroplasty outcomes literature and a review of current implant options also are discussed.

Arthroplasty↗
PubMed1999

A simulation of muscle force and internal kinematics of extensor carpi radialis brevis during backhand tennis stroke: implications for injury.

OBJECTIVE: The purpose of this work was use a computer simulation of the action of extensor carpi radialis brevis during a typical backhand tennis stroke of novice and advance players to examine a potential mechanism of injury. DESIGN: This study uses established kinematic data in conjunction with a computer model to give a time varying description of muscle force and length changes. BACKGROUND: Lateral epicondylitis or tennis elbow has been attributed to over-exertion of extensor carpi radialis brevis with novice tennis players being particularly susceptible. METHODS: We used a simple Hill-type muscle model to predict muscle force and internal kinematics based on activation and joint angle changes as inputs. Magnetic resonance images were used to determine the morphometric dimensions of extensor carpi radialis brevis which were used to scale the mechanical properties determined from in vivo contractions of flexor pollicis longus. RESULTS: The simulation indicated that the novice group generated considerably less force and the muscle was subjected to a substantial eccentric contraction as a result of racquet-ball impact. This eccentric contraction occurred with the muscle at a very long length with diminishing tension capabilities. CONCLUSION: The observed pattern of activation and joint kinematics of novice tennis players results in substantial eccentric contractions which are likely the cause of repetitive microtrauma leading to tennis elbow injuries. Adopting the technique seen in advanced players would limit the eccentric contractions and reduce the likelihood of injury. RELEVANCE: Lateral epicondylitis can be extremely problematic because of its chronic nature and relatively high incidence. This study offers one aetiology of the condition that results from improper kinematics during the tennis backhand stroke.

Biomechanical Phenomena↗
PubMed2006

Pediatric distal radius fractures and triangular fibrocartilage complex injuries.

Management of distal radius fractures is guided by the pattern and location of injury, degree of deformity, and expectations of bony remodeling based on the amount of remaining skeletal growth.Indications for surgical treatment include unstable or irreducible fractures, open fractures, floating elbow injuries, and neurovascular or soft-tissue compromise precluding cast immobilization. Patients and families should be counseled regarding the potential for post-traumatic distal radial growth arrest following physeal fractures. In these cases, epiphysiodeses, ulnar shortening osteotomies, or corrective radial osteotomies may be performed, depending on the pattern of arrest,degree of deformity, and remaining skeletal growth.TFCC tears may be the source of ulnar-sided wrist pain in children and adolescents, though symptoms and physical examination findings maybe subtle. Patients who have persistent pain and functional limitations despite activity modification and therapy are candidates for surgical treatment. Appropriate repair of peripheral TFCC tears with correction of concomitant wrist pathology restores normal wrist anatomy, alleviates pain, and allows for return to functional activities.

Arthroscopy↗
PubMed1995

Elbow fractures with carpal injuries.

We report four cases with six episodes of concurrent carpal and elbow fractures or dislocations. Few such combinations of injuries have been reported in the literature. We discuss the mechanism and management of such injuries and conclude that elbow injuries should be suspected in severe carpal injuries. Surgical treatment may be required in their management.

Adult↗
PubMed1986

The epidemiology of ice hockey injuries.

As part of the injury profylaxes in Denmark a questionnaire investigation was undertaken in 14 randomly chosen ice hockey teams--out of 266 players, 210 answered (79%). The injury incidence per player per 1000 hours was 4.7, i.e. 1.5 in training and 38.0 in match. Half of the injuries were localised to the head (28%) and lower extremities (27%), 19% to the upper extremities and 7% to the back. Of these 48% were contusions. Knee and elbow injuries were of longest duration. The necessity for increased shock absorption in helmets and barriers as well as built-in rotational and collateral stabilizers in the existing knee protectors for injury prophylaxis is stressed.

Adolescent↗
PubMedDate not supplied

Throwing injury of the elbow: assessment with gradient three-dimensional, fourier transform gradient-echo and short tau inversion recovery images.

We assessed MR findings of throwing injuries occurring in the elbow joint using three-dimensional Fourier transform (3DFT) and short tau inversion recovery (STIR) images. MR images of 63 elbows in 63 male patients aged from 10 to 32 years (mean age, 15 years 11 months) suffering from throwing injury were visually analyzed. The sequences used for the study were axial 3DFT and coronal STIR. Full-thickness tears were demonstrated in 34 elbows and undersurface tears of the ulnar collateral ligament (UCL) were demonstrated in five elbows. Thirty loose bodies were detected in 14 elbows. Cartilaginous damage due to osteochondral injury was depicted in 21 elbows. Multiplanar reformatted images using the 3DFT data set were useful for assessing torn UCLs, intraarticular loose bodies, and capitellar fragments. Full-thickness tears and undersurface tears of the UCL could be differentiated with STIR images. 3DFT and STIR sequences depict various aspects of throwing injuries occurring in the elbow.

Adolescent↗