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At least 433 records · Page 24Linked to original sources
PubMed1994

[Severe injuries of the elbow: emergency coverage and transient revascularization. Apropos of 13 cases over a 3-year period].

Large open elbow fractures with extensive soft-tissue loss must be treated as an emergency. Vessels and nerves are often alvulsed. One stage reconstruction is very challenging. Ischemia of the distal part of the upper extremity is limited by a synthetic arterial shunt (SAS). After debridement, the authors install the SAS, then the complex procedure can begin. The authors purpose a new four-stage classification and prognostic factors. Debridement concerns crushed, devitalised soft and osteo-articular tissues. If it appears possible to salvage the hand and forearm with necessity of complex reconstructions (vessels, nerves, osteosynthesis, soft tissues) SAS is used. SAS was used 3 times on the group of large avulsions with ischemia (5 cases); it was quickly installed between the humeral and a distal artery and allowed section of the best distal artery for revascularisation. Seven external fixation devices allowed intra operative and post operative management of the wound. The coverage of these large, complex wounds was performed by the latissimus dorsi transposition flap (2 muscular and 5 musculo-cutaneous flaps). It should be considered the flap of choice. Local flaps, which include local skin transposition, muscle transposition or vascular axis, would be contra indicated in a wide zone of injury (the base of these local flaps are damaged by high energy trauma) or when distal ischemia is present because of arterial axis sacrifice. The dorsal decubitus position, the specific dissection of neurovascular pedicle proximally as far as the axillary artery, the muscular and cutaneous design can be used to cover anterior, posterior, internal and external parts of the elbow. Restoration of elbow function uses an innervated latissimus dorsi muscle (3 cases). If only coverage is wanted, this flap has significant advantages over local flaps and free transfer procedures when the recipient vessels are within the area of injury. Between the donor site and the recipient site, the muscular part of the latissimus dorsi flap is placed in an arm counterincision. It ensures closure of the elbow joint. Early progressive range of movement exercises can be performed.

Anastomosis, Surgical↗
PubMed1995

Dislocation of the elbow complicated by arterial injury. Reconstructive strategy and functional outcome.

Four cases of arterial injury complicating posterior dislocation of the elbow are described. All of these patients were treated by emergent revascularization; reconstruction of the soft-tissue constraints of the elbow joint was performed by using osseous suture anchors. Despite prompt treatment of the vascular injury and successful restoration of elbow articulation and stability, all of the patients had residual functional disability. The previous literature has not discussed the functional results of these reconstructions. This report underscores the severity of these injuries, details our reconstructive strategy, and analyzes the functional outcome of these badly traumatized extremities.

Adult↗
PubMed1977

Ulnar nerve instability: ulnar nerve injury due to elbow flexion.

The term "ulnar nerve instability" describes the chronic conditions of subluxation and relocation of the ulnar nerve at the elbow with flexion and extension of the elbow, respectively. This condition is more common than generally thought. Recurrent subluxation of the nerve at the elbow results in a tractional and frictional neuritis. The nerve is vulnerable to trauma in its subluxed position, lying superficially on the medial humeral epicondyle. In certain cases of ulnar nerve instability associated with a tight overlying band bridging the heads of origin of the flexor carpi ulnaris, nerve injury can occur with flexion of the elbow. Thus, internal as well as external compressive factors as a cause of ulnar nerve neuropathy must be considered. Described is an elbow flexion test helpful in the diagnosis and prognosis of cases of ulnar nerve instability associated with the tight overlying band.

Adolescent↗
PubMed1995

Gunshot wounds to the elbow.

Gunshot wound injuries to the elbow are rare. This article presents the experience of the King/Drew Medical Center. Classification and management of these injuries are emphasized. An algorithm is presented.

Adult↗
PubMed2001

Importance of positioning and technical factors in anatomic localization of sporting injuries in scintigraphic imaging.

Sports medicine is becoming increasingly important as more people take up exercise for health and well-being. It is adding to the spectrum of acute and chronic injuries that have traditionally been seen in elite or professional athletes. Because of its high sensitivity and lesion contrast, bone scintigraphy has traditionally played a key role in the detection of such injuries. This role has been reduced in recent times by the increased use of magnetic resonance imaging (MRI), which has functional capability, high-contrast resolution, and high-spatial resolution. Bone scintigraphy has the capability of detecting early cortical ligament avulsion and enthesopathic disease before the onset of edema or changes in bone marrow that are detected by MRI. If this capability is added to more precise anatomic localization of lesions, we may see a resurgence in its use in sports medicine. A number of techniques are presented in this article, encompassing positioning, special views, and tomographic reconstructions, that can significantly improve the accuracy of localization of scintigraphic abnormalities with reference to anatomic models or sources of cross-sectional anatomy.

Ankle Injuries↗
PubMedDate not supplied

Kinetics of baseball pitching with implications about injury mechanisms.

Elbow and shoulder kinetics for 26 highly skilled, healthy adult pitchers were calculated using high-speed motion analysis. Two critical instants were 1) shortly before the arm reached maximum external rotation, when 67 N-m of shoulder internal rotation torque and 64 N-m of elbow varus torque were generated, and 2) shortly after ball release, when 1090 N of shoulder compressive force was produced. Inability to generate sufficient elbow varus torque may result in medial tension, lateral compression, or posteromedial impingement injury. At the glenohumeral joint, compressive force, joint laxity, and 380 N of anterior force during arm cocking can lead to anterior glenoid labral tear. Rapid internal rotation in combination with these forces can produce a grinding injury factor on the labrum. After ball release, 400 N of posterior force, 1090 N of compressive force, and 97 N-m of horizontal abduction torque are generated at the shoulder; contribution of rotator cuff muscles in generating these loads may result in cuff tensile failure. Horizontal adduction, internal rotation, and superior translation of the abducted humerus may cause subacromial impingement. Tension in the biceps tendon, due to muscle contraction for both elbow flexion torque and shoulder compressive force, may tear the anterosuperior labrum.

Acceleration↗
PubMedDate not supplied

Lateral compression injuries in the pediatric elbow: Panner's disease and osteochondritis dissecans of the capitellum.

Lateral compression injuries of the elbow typically occur in throwing athletes and gymnasts. In the preadolescent and adolescent patient, these injuries predominantly include Panner's disease and osteochondritis dissecans. Panner's disease, an osteochondrosis of the capitellum, is a rare disorder that usually affects the dominant extremity in individuals younger than age 10 years. Symptomatic management of Panner's disease consisting of reduction of stressful activities of the elbow is usually sufficient to allow resolution. Although a prolonged period is required for healing, most patients demonstrate excellent long-term results. Osteochondritis dissecans of the capitellum typically occurs in adolescents and is associated with loose body formation. Panner's disease and osteochondritis dissecans likely represent a continuum of disordered endochondral ossification with presentation and prognosis dependent primarily on age at onset.

Adolescent↗
PubMed1996

MR imaging of sports injuries in the adult elbow: a tailored approach.

With an understanding of the normal anatomy of the elbow and a pertinent clinical history, MR imaging of the elbow need not be a source of fear and confusion for the MR radiologist. Because positioning and scan planning are not as straightforward as they are with other joints such as the knee or shoulder, these processes can be time-consuming. The position in which the patient is optimally scanned is inherently uncomfortable. In a busy MR center with rigorous time constraints, these factors and patient fatigue can limit the time available to acquire images. Thus, a tailored approach to designing a scanning protocol for the elbow is warranted. The preceding discussion attempts to address a streamlined approach to MR imaging of the more common pathologic processes occurring around the elbow. The sequences we have described may require some modification on different imaging systems to take into account variations in field strength and to account for disparity in hardware and software parameters of different vendors. In combination with the information provided in the clinical history, the guidelines we provide should serve as a general template upon which the practicing radiologist can base his or her approach to MR imaging of the elbow.

Adult↗
PubMed2001

Nerve injuries of the elbow, wrist, and hand in athletes.

Upper extremity compression neuropathies are fairly rare in athletes. Initially, most can be managed conservatively. These conditions can follow direct contusion of the tissues that overlay these peripheral nerves or can result from vigorous, repetitive, athletic activity leading to tissue swelling and ischemia with nerve compression symptoms. A complete history and physical examination, including a neurologic examination, should be paramount when treating athletes with upper extremity injuries. Early diagnosis and treatment with conservative measures such as splinting, rest, activity modification, and medications can afford the athlete an earlier return to sports. Surgery can be employed when conservative treatment fails and a specific diagnosis has been ascertained.

Athletic Injuries↗
PubMed1996

Handedness as a predictor of increased risk of knee, elbow, or shoulder injury, fractures and broken bones.

Several recent studies suggest that left-handers have higher susceptibility to accidental injury. Two studies investigated the suggested link between sinistrality and accidental injury by assessing the prevalence of joint problems, bone breaks, and fractures, which may be the sequelae of such mishaps. Study 1 used retrospective responses on medical history checklists completed by 1064 males on active duty with the United States Air Force. It found that left-handers were at significantly higher risk for knee problems (RR = 2.74), elbow and shoulder problems (RR = 3.03), and also swollen and painful joints (RR = 1.87), although there was no difference in the incidence of broken bones. Study 2 used an expanded handedness scale and retrospective reports of both bone breaks and fractures in a predominantly university sample of 1716 (975 women, 741 men) with median age of 20 years, and demonstrated that non-right-handers were at greater risk for bone breaks and fractures (RR = 1.24). As joint problems, as well as bone breaks and fractures, are often the aftermath of accidents that result in falls or collisions with unyielding objects, the fact that left-handers are more likely to suffer from these problems is consistent with the suggestion that sinistrals are more susceptible to accident-related injuries.

Journal Article↗
PubMed1989

Diagnostic imaging of upper extremity trauma.

The radiologic evaluation of upper extremity trauma relies primarily on standard as well as optional radiographic projections. Certain injuries are more fully evaluated with fluoroscopy, arthrography, ultrasound, computed tomography, or magnetic resonance imaging. The imaging approach to upper extremity trauma is presented, with emphasis on subtle or commonly overlooked lesions. The indications for evaluation by fluoroscopy, arthrography, and advanced imaging modalities are discussed.

Arm Injuries↗
PubMed1979

Turnbuckle orthotic correction of elbow-flexion contractures after acute injuries.

Fifteen patients with acute flexion contractures of the elbow after injuries or operations were treated with a turnbuckle splint. Satisfactory correction was achieved in twelve patients. An average reduction in deformity of about 37 degrees was recorded after an average treatment period of twenty weeks. The treatment was unsuccessful in three patients with severe intra-articular damage because the splint caused excessive discomfort. The average improvement in the arc of motion of the elbow was approximately 43 degrees.

Adolescent↗
PubMed1993

Rehabilitation of the elbow in the throwing athlete.

Rehabilitation following an injury to the elbow joint complex is common in physical therapy practice. The unique anatomical considerations of the elbow joint provide a significant challenge to the therapist in rehabilitating elbow injuries. The purpose of this paper is to describe the rehabilitation process for various elbow pathologies and provide a rationale for their treatment. The rehabilitation process for the injured elbow presented in this paper will emphasize phases that are progressive, sequential, and based on clinical and scientific research.

Athletic Injuries↗
PubMed1987

Brachial artery injuries associated with posterior elbow dislocation.

Posterior elbow dislocation is rarely associated with brachial arterial injury, occurring in two of 23 patients. A cool pulseless hypesthetic arm associated with swelling at the elbow after a history of a fall on an outstretched arm indicates arterial injury associated with posterior elbow dislocation. Concomitant neurologic and bone injury may occur as well. Arterial repair and stabilization of the elbow is the treatment of choice and should result in a functional extremity.

Adult↗
PubMed2005

The role of sonography in detecting radial head subluxation in a child.

Injuries around the elbow joint in children can be difficult to diagnose on the basis of findings on physical examination and radiographs. We present the case of a 4-year-old girl with a probable subluxation of the radial head, based on the findings on physical examination and radiographs. Radiography raised the possibility of a radial head subluxation. Sonography demonstrated displacement of the cartilaginous head of the radius away from the capitellum in the affected elbow. The child underwent corrective surgery. During fluoroscopy, results of an ulnar stress test were positive for lateral ligament tears. The patient's arm was put in a cast for 6 weeks. At 1-year follow-up, the patient had full range of motion of the elbow without pain. We present the findings of sonographic studies used to confirm the diagnosis.

Accidental Falls↗