[Fat pad sign associated with fracture of the elbow joint].
Explore the source record for details and available documents.
Elbow↗
SEARCH · Search PubMed
Results for “ELBOW JOINT”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[Measurement study of anatomical shape and size in Japanese elbow joints].
Recently, total elbow replacement has been developed for reconstruction of destructed elbow joints. However, various complications occurred in the constrained or semi-constrained types of elbow replacement, while unconstrained type such as surface replacement showed lower incidence of such complications. On the other hand, development of the elbow prosthesis needs anatomical measurement of the elbow for adaptation to the need of Japanese. Basically, prosthesis should be designed based on the anatomical and biomechanical analysis. In this study, elbow from 36 Japanese cadavers were measured in the outer contour and microradiograms of the sectioned samples. Midline axes of the humerus and ulna, and the center of both medial and lateral epicondyles are fixed as standardized lines for the study in the elbow measurement. The trochlea is situated slightly anteriorly from the midline of the humerus. Width of the trochlea is 21.4 +/- 2.6 mm on the right side and 21.1 +/- 2.8 mm on the left at the anterior margin. At the distal margin, the width is 23.5 +/- 2.8 mm on the right and 23.3 +/- 2.6 mm on the left, and at the posterior margin, 23.9 +/- 3.6 mm on the right and 23.5 +/- 2.8 mm on the left. Saggittal section of the humeral end shows almost complete circle in the articular surface of the trochlea. The diameter is 19.1 mm on the right and 19.3 mm on the left at the longitudinal axis of the humerus, 17.6 mm on the right and 17.7 mm on the left at the central groove, and 24.5 mm on the right, 22.6 mm on the left at the medial margin. Anterior angulation of the trochlea is about 12 degrees. Central line of the trochlea corresponds to the center of the flexion-extension of the elbow, but angulated by 8 degrees from the humeral axis from the anterior view, and internally rotated by 3 degrees from the center of the both epicondyles from the bottom view. In the measurement of the incisura trochlea, opening distance is 18.5 +/- 2.1 mm on the right, 18.5 +/- 2.0 mm on the left, and the depth is 11.8 mm on the right, 11.6 mm on the left at the mean. Forward angulation of the incisura is 30.8 degrees on the right and 28.3 degrees on the left. Width of the olecranon is 25.0 +/- 3.2 mm on the right, 25.0 +/- 2.9 mm on the left and the thickness is 18.6 +/- 1.6 mm on the right, 18.7 +/- 1.8 mm on the left. The central line of the olecranon is supero-laterally angulated about 7 degrees from the longitudinal axis of the ulna. This angulation and lateral opening of the central line of the trochlea seems to produce carring angle of the elbow. Measurement of the elbow size and shape is discussed for designing elbow prosthesis and some biomechanical problems are also represented.
Aged↗
[Arthrolysis in the treatment of post-traumatic joint stiffness of the knee and elbow joints].
In the treatment of posttraumatic limitation of the range of motion, arthrolysis is a proved procedure in the hand of an experienced surgeon. In this paper, indication, operative details and postoperative treatment are discussed. The results of 51 cases of arthrolysis of the knee joint and 33 cases of arthrolysis of the elbow joint carried out over a time of seven years are reported.
Ankylosis↗
[Endoprosthesis implantation in the elbow joint].
Previously used total elbow prostheses were mainly constrained hinged implants. Their early clinical results were favourable but they failed due to a high rate of loosening already a few years after implantation. The cause for the early loosening was the great forces across the elbow joint which were directly transmitted to the prosthesis-bone interface in these implants. Therefore, these implants were abandoned. Afterwards, unlinked, semiconstrained or non-constrained resurfacing devices were introduced. In these devices, the soft tissues constrain the joint and therefore absorb part of the transmitted forces. The rates of loosening were significantly improved and rarely the cause of early failure. But resurfacing implants require intact condyles and collateral ligaments. These implants can, therefore, only be used in a limited number of indications, and postoperative instabilities are known complications. The currently most frequently used device is the semiconstrained Coonrad-Morrey prosthesis. It is a floppy hinge which allows valgus-varus and rotational laxities. Therefore, a part of the forces across the elbow joint are absorbed by the soft tissues. The loosening rate is not a clinical problem any more, and is with 4% 10 years after implantation (rheumatoid arthritis) similar to that of total hip or knee replacement. Furthermore, this device is stabilised with a small anterior flange to the anterior cortex of the humeral shaft. Condyles and collateral ligaments are therefore not necessary neither for short nor for long-term stability. The Coonrad-Morrey total elbow prosthesis can therefore be used for almost every indication, such as severe destruction of the elbow joint and even in case of complete loss of the distal humerus. The long-term outcome with this prosthesis for the treatment of rheumatoid arthritis is favourable with 96% of very good and good results. Function is restored with an average flexion of 131 degrees, a mean loss of extension of 28 degrees, and an unrestricted pronation and supination. The rate of complications for patients with rheumatoid arthritis is 10%. Similarly, the results for Coonrad-Morrey total elbow replacement for posttraumatic arthrosis are favourable with 83% of satisfactory results. Most patients consider their elbow as improved compared to preoperatively, but pain relief is obtained only in three quarters of the patients. The rate of complications is high with 30%, indicating the total elbow replacement is contraindicated for strenuous labour and sports activities.
Arthritis, Rheumatoid↗
The Guildford elbow joint.
The Guildford Elbow Joint prosthesis uses a non-rigid hinge articulation combined with intra-medullary stems to replace the humero-ulnar joint. The metal-on-plastic articulating surfaces are designed to allow some subluxation and accessory movements while remaining self-centering and stable under load. The intra-medullary stems are shaped to provide a good fit in the curves shafts of the ulna and humerus and should provide good fixation without the removal of large amounts of bone. The prosthesis is fixed with acrylic cement. The design follows, where possible, the normal anatomy and function of the elbow. A correct operative technique is important, but the procedure shows no particular difficulties.
Elbow Joint↗
[Differential diagnosis of distortion of the elbow joint].
Distortion of the elbow joint often means a vague diagnosis describing a traumatized joint with no radiological changes, or it means a transient diagnosis until sophisticated examinations can demonstrate what the injury really is. In adults there are only a few injuries that cannot be shown by radiography. In children, however, radiography of the elbow joint is more difficult due to the inhomogeneity during growth. Contrary to adults, fractures misdiagnosed in radiography often result in significant reduction of joint function.
Adolescent↗
[MR tomography of the elbow joint].
MR examinations of the elbow joint of three healthy subjects and a comparison with corresponding sections of anatomical preparations show that MR tomography enables not only an excellent differentiation of muscles, tendons and of the articular capsule, but will also visualise vessels and nerve tracts. MR tomography proved superior to the conventional methods in demonstration of separate fragments and inflammatory changes in the bone on examining 11 pathological elbow joints: congenital malformation, osteochondritis dissecans, ostitis, ulnar and radial nerve lesions, completely healed radius fracture and epicondylitis of the radial and ulnar humerus. Epicondylitis could not be demonstrated by MR. Magnetic resonance tomography seems to be the only method that enables direct visualisation of the nerve paths at the elbow joint.
Elbow Joint↗
Static torque-angle relation of human elbow joint estimated with artificial neural network technique.
Static relations between elbow joint angle and torque at constant muscle activity in normal volunteers were investigated with the aid of an artificial neural network technique. A subject sat on a chair and moved his upper- and forearm in a horizontal plane at the height of his shoulder. The subject was instructed to maintain the elbow joint at a pre-determined angle. The wrist was then pulled to extend the elbow joint by the gravitational force of a weight hanging from a pulley. Integrated electromyograms (IEMGs), elbow and shoulder joint angles and elbow joint torque were measured. Then the relation among IEMGs, joint angles and torque was modeled with the aid of the artificial neural network, where IEMGs and joint angles were the inputs and torque was the output. After back propagation learning, we presented various combinations of IEMGs, shoulder and elbow joint angles to the model and estimated the elbow joint torque to obtain the torque-angle relation for constant muscle activation. The elbow joint torque increased and then decreased with extension of the elbow joint. This suggests that if the forearm is displaced from an equilibrium point, the torque angle relation would not act like a simple spring. In a view of the musculoskeletal structure of the elbow joint, the relation between the elbow joint angle and the moment arm of the elbow flexor muscles seems to have a dominant effect on the torque-angle relation.
Adult↗
Effect of elbow joint angle on the magnitude of muscle damage to the elbow flexors.
PURPOSE: It has been shown that eccentric actions at a long muscle length result in a larger decrease in force and more muscle tenderness compared with those at a short muscle length. To further investigate the effect of elbow joint angle on the development of muscle damage, this study compared two maximal eccentric exercise regimens in which the starting position of the action was different, but the range of movement was the same. METHODS: One arm of 10 male students performed 24 maximal eccentric actions of the elbow flexors at the elbow joint angle from 0.87 to 2.27 rad (50-130 degrees: S condition) and the other arm at the elbow joint angle from 1.74 to 3.14 rad (100-180 degrees: L condition). Maximal isometric force, range of motion, muscle soreness, plasma creatine kinase activity, upper arm circumference, and B-mode ultrasound pictures of the elbow flexors (US) were measured before and for 5 d postexercise in both conditions. Magnetic resonance imaging (MRI) of the transverse scans of the upper arm was taken at 4 d after exercise. RESULTS: All measures changed significantly (P < 0.01) after exercise for both conditions; however, significantly (P < 0.01) larger changes in the measures were found in the L condition compared with the S condition. MRI and US displayed that only the brachialis was damaged for the S condition but the biceps brachii was also damaged for the L condition. CONCLUSION: The greater development of muscle damage in the L condition compared with the S condition is likely to be associated with the elbow flexors muscles affected by the exercise.
Adult↗
Tuberculous synovitis of the elbow joint.
Tuberculous synovitis in the elbow joint is extremely rare in developed countries. We describe a 68-year-old man who had had a gradually enlarging mass over the volar side of the left proximal forearm near the elbow joint for 4 months. Plain roentgenograms of the diseased elbow showed early osteoarthritic change. Magnetic resonance imaging revealed diffuse synovitis with a large 8 x 8 cm extra-articular synovial cyst. Synovectomy was performed and histopathologic examination of the surgical specimen revealed granulomatous inflammation with caseation, prominent Langhan's giant cells, and sparse acid-fast bacilli. The patient had been receiving antituberculous chemotherapy for at least 8 months at the time of examination and had no recurrence of swelling or discharging sinuses during follow-up. Differential diagnoses in patients with elbow swelling should include pigmented villonodular synovitis, hemophilic arthropathy, rheumatoid arthritis, degenerative joint disease, and tuberculosis. Simple aspiration may enable earlier diagnosis, before destructive arthropathy becomes advanced.
Aged↗
Ulnar collateral ligament tears of the elbow joint.
The functions of the elbow in 13 cases of ulnar collateral ligament (U.C.L.) tears without gross intraarticular complications were retrospectively evaluated. Ten cases had been surgically repaired, and the remaining three cases were treated conservatively. Follow-up examinations were performed on all of the patients. There was a significant difference in valgus instability between operatively treated patients and conservatively treated patients (operatively treated patients averaged 5.1 degrees, while conservatively treated patients averaged 8 degrees). Two cases of conservatively treated patients complained of elbow joint pain while playing sports or working. Conversely, one of the operatively treated patients complained of numbness in the fifth finger. However, the remaining cases had no symptoms, even while playing sports or working. Valgus instability of the elbow joint results in little inconvenience in daily life, but it is disabling in patients performing heavy labor or vigorous sports.
Adolescent↗
The role of orthoses in the management of elbow joints in persons with haemophilia.
The elbow joint is extremely prone to haemarthroses, and when these occur the elbow requires support and rest. Supporting the limb with a simple collar-and-cuff sling, a triangular bandage either with or without a shoulder immobilization device will provide an analgesic effect without adding an unnecessary heavy orthosis. As the swelling subsides and the pain lessens a dynamic orthosis aids in the support and compression. When considering functional branching of the elbow joints there are a number of basic principles to be followed. One requires to consider problems of orthosis suspension, two dimensional motion and stabilization in the functional range of motion. This article provides the rationale for the special needs of persons with haemophilia who suffer from involvement of their elbow joints.
Contracture↗
Comparison of experimental and analytical torque-angle relationships of the human elbow joint complex.
The human elbow joint complex (EJC) is an intricate joint that is currently being modeled with eight musculotendon actuators for the analysis of flexion-extension and pronation-supination movements. The musculotendon length (LMT), musculotendon velocity (VMT), and muscular moment arm (MA) for each actuator have been investigated based on joint anatomy and joint angle position. Musculotendon parameters necessary for the muscle model have been collected from various sources. These parameters, along with the musculoskeletal geometry, are used in a static muscle model to compute the force and joint torque generated by each muscle. The results are plotted as torque-angle curves and compared with experimental joint torque data.
Biomechanical Phenomena↗
[Anatomic fundamentals and species-specific movements of the elbow joint and proximal radioulnar joint of domestic cats].
The elbow joint of the cat is more than a simple cylindrical joint and cannot be compared to that of the dog. The structure of the bone ends, arrangement of ligaments and the shapes of the joint surfaces, which are described individually, emphasize that the elbow joint, together with the proximal radioulnar joint, have an important role to play in feline-specific limb functions.
Animals↗
Comparison of experimental and predicted muscle activation patterns in ballistic elbow joint movements.
The human elbow joint complex (EJC) is an intricate joint which produces combinations of movements that are unique within the human body and that are involved in performing many important tasks. This paper discusses an on-going study to predict muscle force patterns in elbow flexion-extension. Four musculotendon actuators are included in this preliminary musculoskeletal model for the analysis of ballistic elbow flexion-extension movements. The key objective is to develop a computational model, guided by optimal control, to investigate the relationship among patterns of muscle excitation, individual muscle forces, and movement kinematics. Model verification is attempted using experimental data from volunteer subjects performing a ballistic elbow flexion movement.
Biomechanical Phenomena↗
[Osteochondrosis dissecans of the elbow joint].
Thirty-one elbow joints in 29 patients (28 males, only 1 female), operated on for osteochondritis dissecans, were available for follow-up after an average of 10 years. The mean age at diagnosis was 24.4 years, but 11 patients were younger than 20. In 23 out of 29 patients the right elbow was involved, including 2 cases with bilateral involvement. In 20 cases removing the free bodies was the only surgical procedure performed, but in 2 cases it was combined with resection of the radial head. At follow-up, only one-third of the patients had no complaints. Nevertheless, daily activity was not restricted for any of the cases. Degenerative arthritic changes were found in only a few cases. These results are illustrated by means of three typical cases, which are compared with six similar cases in the international literature.
Adolescent↗
Development of the human elbow joint.
Many studies have been published on the development of the human elbow joint, but authors disagree on its morphogenetic timetable. Most discrepancies center on the cavitation of the elbow joint (including the humeroradial, humeroulnar, and superior radioulnar joints), and the organization of the tunnel of the ulnar nerve. We summarize our observations on the development of the elbow joint in 49 serially sectioned human embryonic (n = 28) and fetal (n = 21) upper limbs. During week 12, ossification begins in the epiphyses of the elements comprising the elbow joint. At the end of the embryonic period, the shallow groove between the posterior aspect of the medial epicondyle and the olecranon process, begins to be visible. The elbow joint cavity appears in O'Rahilly stage 21 (51 days) at the level of the humeroulnar and humeroradial interzones. Formation of the cavity begins at the medialmost portion of the humeroradial interzone and the lateralmost portion of the humeroulnar interzone. The annular ligament begins to develop in O'Rahilly stage 21 (51 days), and the superior radioulnar joint cavity appears between this ligament and the lateral aspect of the head of the radius during O'Rahilly stage 23 (56 days). We established the morphogenetic timetable of the human elbow joint.
Cartilage, Articular↗
[Long-term results of therapy of open and closed fractures of the elbow joint].
Fractures of the elbow joint are quite rare compared with the total incidence of injuries to the extremities. However, elbow fractures often result in significant disability. Therefore in a retrospective study, we have evaluated criteria that are of prognostic value for late functional outcome. Sixty-four (10.3%) of 622 patients with closed elbow fractures and 107 (89%) of 119 patients with open elbow fractures underwent a physical examination. The mean follow-up time was 8.2 years. The functional outcome was recorded by a modified score (0-max. 15) according to Morrey. Epidemiological data from both groups revealed a greater severity and higher degree of injury in open fractures than in closed fractures. In contrast, both groups presented a comparably good functional result. The most significant factor for poor outcome (score < 5) was identified as nerve lesions. Among all nerve lesions in open fractures, 45% resulted in a functional score of < 5; in 42% of closed fractures combined with a nerve lesion a similarly poor result was also noted. A second major factor appeared to be the method of primary therapy. An external joint transfixation resulted in a score of < 5 in 32% of patients that were treated primarily by transfixation. In cases initially treated with open reduction and internal fixation, only 18.5% of open fractures and 3.1% of closed fractures presented a similar low score. According to our results the late functional outcome of elbow fractures depends less on the type of fracture than on the presence of a nerve lesion and the method of primary treatment, which should facilitate early mobilization.
Elbow Joint↗