Principles and practice in upper extremity prostheses.
Explore the source record for details and available documents.
Amputation, Surgical↗
SEARCH · Search PubMed
Results for “Elbow Prosthesis”
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.
Advances in orthopaedic surgery.
Explore the source record for details and available documents.
Acrylic Resins↗
Total joint arthroplasty: principles and guidelines for postoperative physiatric management.
Postoperative physiatric treatment is an integral part of the replacement of hips, knees, ankles, shoulders, elbows, wrists, and digital joints. Neuromuscular substitution patterns and incoordination usually prevail after joint replacement because of the usual long-term expectation and experience of pain, limitation of motion, fatigue, weakness, and the unavoidable operative trauma. The goals of postoperative physiatric treatment, in line with those of joint replacement surgery, are relief of pain and reestablishment of comfortable, normal neuromuscular functions and their reasonable, safe application in appropriate activities of daily living and of locomotion. By close collaboration between the Department of Orthopedic Surgery and that of Physical Medicine and Rehabilitation, certain principles and detailed protocols of postoperative management have been developed over the last 10 years. These are described in some detail for each of the joint replacements. Optimal results can be achieved only through meticulous attention to physical and psychosocial details, with close cooperation and communication among the involved services and persons.
Ankle Joint↗
[Proceedings: Fractures of the radius head--replacement using the Vitallium endoprosthesis].
Explore the source record for details and available documents.
Adolescent↗
[Endoprosthesis of the elbow joint].
Explore the source record for details and available documents.
Adult↗
Nonconstrained total elbow arthroplasty.
Twenty-eight nonconstrained capitellocondylar elbow offhroplasties were performed in 23 patients. The clinical criteria were intractable pain in a joint with radiologic destruction from rheumatoid arthritis. Patients were examined at an average of 35 months postsurgery with the Ewald scoring system. Results were satisfactory in 24 elbows (86%) and unsatisfactory in four (14%). Pain relief and functional improvement were dramatic. The average arc of motion increased from 88 degrees preoperation to 101 degrees postoperation. There was an average 33 degrees residual flexion contracture. There was one failure from loosening, but no radiographic or clinical loosening was detected in the remaining patients. Postoperative dislocation was the most frequent complication, occurring in four cases. One dislocation required revision while three stabilized following four weeks of immobilization. There were two remote infections occurring two and five years postoperation. Although complications are frequent, this is a predictably successful procedure in properly selected patients.
Adult↗
Total elbow arthroplasty: a clinical review of 30 cases employing the Mayo and AHSC prostheses.
Chronic synovitis of the elbow in rheumatoid arthritics that has not responded to four to six months of optimal nonoperative management should be treated by synovectomy even in the absence of significant intra-articular X-ray changes. When intra-articular damage is significant, an arthroplasty will not only relieve the pain, but may also provide a satisfactory range of motion. It is necessary to consider all the possible complications and the fact that technically, total elbow arthroplasty is a difficult operation to perform. Because of the potential for loosening, one might consider using an unconstrained device in the patient with adequate bone structure, reserving the semiconstrained devices for elbows with disintegrated bone tissues. The constrained prostheses should be used only for the most severely disorganized and unstable elbows.
Adult↗
Total elbow replacement.
Thirty-one patients who underwent thirty-six total elbow replacements between 1974 and 1977 were followed for a minimum of two years with an average of 3.7 years. A scoring system was used to quantitate results. Patients with rheumatoid arthritis and functional disability primarily related to pain benefited most from the operation. Patients with post-traumatic arthritis and disability secondary to loss of motion benefited least. The over-all complication rate was 53 per cent and the reoperation rate was 22 percent. However, only one-fourth of the complications adversely affected the final outcome. Total elbow replacement can give good results in carefully selected patients.
Adolescent↗
Revision of failed total elbow arthroplasty.
We reviewed 25 patients with rheumatoid arthritis who had failure of 26 primary total elbow arthroplasties causing pain and loss of function. Most revision cases required special custom implants to treat varying bone loss and soft-tissue disruption. Assessment showed satisfactory functional results in the patients treated by revision at a mean follow-up period of 35 months. Our review suggests that revision surgery produces short- to medium-term painfree function, and is the treatment of choice for a failed total elbow arthroplasty in the absence of infection.
Adult↗
Inflammatory arthritis after failure of silicone rubber replacement of the radial head.
The management of radial head fractures complicated by ligamentous disruption remains a matter of controversy. The use of a silicone radial head implant to provide temporary stability is thought to help to protect the ligaments during healing. The reported complications of long-term implantation of a silicone replacement include fracture, dislocation, synovitis, lymphadenitis and subchondral resorption. We now report one case in which an inflammatory process resulted in generalised cartilage degeneration. This has not previously been noted.
Arthritis↗
[The signification of total elbow replacement in the treatment of rheumatoid arthritis].
The purpose of this paper is to emphasis the signification of total elbow replacement in the treatment of rheumatoid arthritis. Total elbow replacement were performed in twenty elbows in fourteen patients who had rheumatoid arthritis from 1982 to 1990. The follow-up period ranged from 2 to 9 years. Pain relief was complete in twelve patients. Preoperation flexion averaged 119 degrees, increasing to 127 degrees. Preoperation extension averaged -34 degrees, increasing to -24 degrees postoperation. There were no infection and fracture postoperatively. Radiolucent lines were seen in four humeral components, in one ulnar component. Proximal subsidence of the humeral component were found in two elbows. Posterior dislocation occurred in three elbows. In two cases, reduction was successful by three weeks immobilization in a plaster cast with the elbow in the flexion position. Transient ulnar nerve palsy was evident in two elbows. Revision surgeries were performed in two cases, which occurred dislocation and progressive subsidence. Multiple replacements of major joints were performed in ten patients. Two joints were replaced in two patients, three joints were replaced in six patients, four joints were replaced in two patients. Four total elbow replacements were performed accompanied with other joints replacement in the same anesthesia. We recommended two joint replacements in the same anesthesia in patient with good general condition. All patients had functional improvements after total elbow replacement, especially reaching of the arm. Four patients improved the walking by being able to use stich after total elbow replacement.
Activities of Daily Living↗
Orthopaedic surgery in hemophilia. 20 Years' experience in Sweden.
At the International Hemophilia Center, Malmö, Sweden, which serves a large proportion of the Swedish hemophilia population, 98 orthopaedic surgical procedures were performed from 1970 to 1989 in 66 patients ranging in age from 6 to 71 years. The most common procedures were knee synovectomy, elbow synovectomy in combination with resection of the radial head, and total hip replacement. Comparing the 2 decades of the period, 3 differences were observed: a decreasing need of surgery, an increasing average age of the patients, and a change in the kinds of operations performed. Knee synovectomy and achillotenotomy were most frequent during the 1970s, whereas elbow synovectomy with resection of the radial head and total hip replacement were most frequent during the 1980s. Owing to the availability of regular factor replacement therapy as practiced at the Malmö Center, the situation of patients with hemophilia has improved dramatically during the last 2 decades. In the authors' opinion, it is now possible to avoid hemophilic arthropathy almost completely by giving effective continuous prophylaxis from an early age. In all likelihood, this is the explanation of the changing picture of orthopaedic surgery in patients with hemophilia today.
Adolescent↗
[Arthroplasty of the elbow].
Elbow arthroplasty is still one of the less frequently performed joint replacement procedures. It is technically demanding, and numerous complications are possible. It is therefore indicated mainly in severely handicapped patients in whom all other alternatives have been attempted. A review of the literature relating to arthroplasties monitored over follow-up periods of more than 5 years shows that the results are now quite acceptable. They are far better than those seen following most resection arthroplasties. The results achieved with our GSB III prosthesis are compared with those obtained with other prosthetic devices in current use. It appears that in a large proportion of cases our prosthesis allows a good range of painfree motion, which we attribute in part to the operative approach used. The complication rate appears to be relatively low.
Adult↗
Results of total elbow arthroplasty after excision of the radial head and synovectomy in patients who had rheumatoid arthritis.
We compared the results of twenty-three consecutive capitellocondylar total elbow arthroplasties in twenty-three patients in whom an excision of the radial head and synovectomy for rheumatoid arthritis had failed with those of twenty-three non-consecutive primary capitellocondylar total elbow arthroplasties in twenty-three patients who had rheumatoid arthritis. The two groups were matched for age, gender, duration of follow-up, side of the operation, type of prosthesis, and operative approach. The average duration of follow-up was four years (range, two to fourteen years). At the most recent follow-up examination, use of a 100-point rating system demonstrated an improvement from an average preoperative score of 21 points (range, 12 to 42 points) to an average postoperative score of 87 points (range, 17 to 97 points) for the group in whom an excision of the radial head and synovectomy had failed. The group that had primary arthroplasty demonstrated an improvement from an average preoperative score of 22 points (range, 7 to 42 points) to an average postoperative score of 94 points (range, 85 to 100 points). The group that had primary arthroplasty had a significantly greater improvement in terms of relief of pain (p < 0.05), functional status (p < 0.01), and the elbow-rating score (p < 0.03) than the other group. Four patients who had had failure of an excision of the radial head and synovectomy and none of those who had primary arthroplasty needed an additional operative procedure. Six of the patients who had had a failed excision and synovectomy and none of the patients who had primary arthroplasty had instability of the elbow components. We concluded that, although excision of the radial head and synovectomy is a conservative and effective method of treating a painful rheumatoid elbow, conversion to a capitellocondylar total elbow arthroplasty is more difficult after such an operation and the results at a minimum of two years are inferior to those for primary capitellocondylar total elbow arthroplasty.
Adult↗
Constrained total scapula reconstruction after resection of a high-grade sarcoma.
Patients with high-grade sarcomas arising from the scapula or periscapular soft tissues traditionally have been treated with either a total scapulectomy or a wide, en bloc, extraarticular scapular resection, termed the Tikhoff-Linberg resection. The major challenge after such resections is to restore shoulder girdle stability while preserving a functional hand and elbow. The current authors describe three patients who had an extraarticular, total scapula resection (modified Tikhoff-Linberg) for a high-grade sarcoma. Each patient had reconstruction with a constrained (rotator cuff-substituting) total scapula prosthesis in an effort to optimally restore the normal muscle force couples of both glenohumeral and scapulothoracic mechanisms. At latest followup, the Musculoskeletal Tumor Society functional score was 24 to 27 of 30 (80%-90%). All patients had a stable, painless shoulder and functional hand and elbow. Forward flexion and abduction ranged from 25 degrees to 40 degrees. Glenohumeral rotation (internal rotation, T6; external rotation -10 degrees) below shoulder level, shoulder extension, and adduction were preserved. Protraction, retraction, elevation, and abduction of the scapula were restored and contributed to shoulder motion and upper extremity stabilization. There were no complications. Total scapula reconstruction with a constrained total scapula prosthesis is a safe and reliable method for reconstructing the shoulder girdle after resection of select high-grade sarcomas. The authors emphasize the clinical indications, prosthetic design, surgical technique, and early functional results.
Adolescent↗
Computer-Aided Design and Computer-Aided Manufacture (CAD-CAM) applications in cosmetic below-elbow prostheses.
Computer-Aided Design and Computer-Aided Manufacture (CAD/CAM) techniques, though often technologically associated with engineering and applied sciences, has opened new horizons in the medical field. In CAD, a product is first geometrically modelled in three dimensions in a computer and it can be viewed and examined from any direction. This model can then be used for many downstream applications such as manufacturing and analysis. In CAM, numerically controlled machining processes are used for cutting out a prosthetic device of the hand for prosthesis. The paper aims at establishing the basis of using CAD/CAM techniques in prostheses in particular, a review of our present work done in the area of below-elbow prostheses using CAD/CAM. A laser scanning device has been used to capture the geometry of human hands. The algorithm used in processing the images is discussed. The processed 3D data file is then interfaced with a CAD modeller where reconstruction, mirroring, scaling, etc., can be performed. The resultant CAD model is then passed on to CAM, which concentrates purely on producing a "positive core" mould for moulding the prosthetic device.
Algorithms↗
Transection of the brachial artery after closed posterior elbow dislocation.
Although elbow dislocations are common orthopaedic lesions, vascular complications remain rare. We report the cases of three patients who presented with a rupture of the brachial artery after closed posterior dislocation, which is even more uncommon. Arteriograms were performed in all cases because of the persistent absence of pulses at the wrist after emergency reduction. In each patient, the treatment consisted of the insertion of reversed end-to-end saphenous bridges. None of them presented mid-term vascular complications (mean follow-up, 17 months). Brachial artery disruption can result from closed posterior elbow dislocation and responds well to vascular repair.
Adult↗
Results of the Souter-Strathclyde total elbow arthroplasty in patients with rheumatoid arthritis. A preliminary report.
The results of 19 consecutive Souter-Strathclyde total elbow arthroplasties (Zimmer, London) in 17 patients with a mean follow-up time of 41 months are reported. Pain relief was achieved in all cases, with 13 elbows becoming entirely pain-free. The mean range of flexion increased 24 degrees and extension improved 8 degrees, with upper limb function greatly improved. The complication rate was 32%, including three nerve palsies, of which two resolved completely, and three early postoperative dislocations. There were two cases of prosthetic loosening, one following revision surgery for a traumatic humeral fracture in the early postoperative period. The authors consider the overall functional results with the Souter-Strathclyde prosthesis to be satisfactory in this group of patients.
Adult↗