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At least 73 records · Page 4Linked to original sources
PubMed1998

Hyperextension trauma to the elbow joint induced through the distal ulna or the distal radius: pathoanatomy and kinematics. An experimental study of the ligament injuries.

Loads applied to the forearm result in hyperextension of the elbow. The pathomechanics of hyperextension trauma with load applied to the distal radius and ulna were studied in 10 macroscopically normal cadaver elbow joint specimens to reveal patterns of injury with radial traction (n = 5) compared to ulnar traction (n = 5). The mean age of the donors was 60.8 years (range 33-74). Kinematic testing was performed in an experimental 3D-kinematic loading apparatus. The extension range of motion increased by 20.9 degrees +/- 2.9 degrees after joint loading. Hyperextension loads induced joint laxity during flexion of less than 60 degrees. In both groups, the changes were significant in joint flexion during forced valgus and external rotation, but were not significant in flexion during forced varus and internal rotation. In both groups, the same four lesions were produced: 1) Anterior capsule rupture, 2) L-formed rupture of the origin of the pronator muscle with elongation of the anterior bundle of the medial collateral ligament, 3) partial rupture of the lateral collateral ligament and 4) small cartilage damage to the posterior or anteromedial edge of the ulna. In conclusion, hyperextension trauma to the elbow joint induced through the distal ulna or the distal radius produced the same pattern of injury as reported in hyperextension of the elbow with traction to the forearm when free rotation of the radius relative to the ulna was allowed.

Adult↗
PubMed2003

Prediction of childhood pulmonary function using ulna length.

Pulmonary function is important in neuromuscular weakness. In children, height determines normal values. Height measurement is unreliable when neuromuscular weakness or spinal deformity is present. The aim of this study was to accurately predict pulmonary function from a limb segment measurement that is precise and reproducible. Normal males (n = 1,144) and females (n = 1,199), 5.3 to 19.6 years old, were recruited from Melbourne schools. Height, weight, ulna, forearm, tibia, and lower leg lengths were measured using a Harpenden stadiometer and calipers, and electronic scales. Three maximal expiratory maneuvers were performed. Limb measurements were highly reproducible. Linear regression on log-transformed FEV1 and FVC was used to develop prediction equations from limb measurements and age. In males FEV1 = exp (0.071 x U + 0.046 x A - 1.269), r2 = 0.86; FVC = exp (0.77 x U + 0.041 x A - 1.285), r2 = 0.86 and in females FEV1 = exp (0.072 x U + 0.041 x A - 1.272), r2 = 0.84; FVC = exp (0.078 x U + 0.037 x A - 1.315), r2 = 0.83 (U refers to ulna length and A refers to age). Precision is similar to equations using height. Ulna measurement is accessible in wheelchair-bound children. Using ulna length to predict pulmonary function should facilitate respiratory assessment in children whose height is difficult to measure.

Adolescent↗
PubMedDate not supplied

Stress injury of the proximal ulna in professional baseball players.

BACKGROUND: To date, stress injury of the proximal ulna has been infrequently reported as a cause of elbow pain in the throwing athlete. PURPOSE: We describe a syndrome of osseous stress injury of the proximal ulna in the professional throwing athlete. STUDY DESIGN: Retrospective review. METHODS: We evaluated the clinical, radiographic, and magnetic resonance imaging findings of seven professional baseball players with osseous stress injury of the proximal ulna. RESULTS: Plain radiographs of the involved elbows failed to demonstrate any significant findings. All of the clinically significant lesions were detected with magnetic resonance imaging. In addition, magnetic resonance imaging was found to be of value in following the course of healing of the injuries. All of the lesions originated on the posteromedial aspect of the proximal ulna. The ulnar collateral ligament was intact in all seven athletes. One athlete had two occurrences of this injury. Six of the seven athletes returned to their previous level of play after a nonoperative course of treatment. CONCLUSIONS: We believe that this injury should be considered in the differential diagnosis of elbow pain in the throwing athlete. Magnetic resonance imaging is the diagnostic test of choice when this injury is suspected.

Adolescent↗
PubMed1982

Congenital pseudarthrosis of the ulna due to neurofibromatosis.

Two cases of congenital pseudarthrosis of the ulna due to neurofibromatosis are reported. Similar radiographic changes in the ulna were found, with distortion of the capitulum and part of the trochlea and bowing of the radius. In one patient the head of the radius was dislocated and in the other it dislocated readily during pronation. A possible mechanism to explain the findings was suggested. On the basis of these and a review of the literature it is recommended that the main aim of treatment should be maintenance of the normal relative lengths of the radius and ulna by early excision of the pseudarthrosis to remove the restraining effect of the abnormal ulna. This will allow normal development of the lower end of the humerus and radius and prevent dislocation of the radial head.

Adult↗
PubMed2001

Osteofibrous dysplasia of the ulna.

Osteofibrous dysplasia is a rare condition usually ffecting the tibiae and fibulae of males in the first two decades of life. Involvement at the ulna has also been reported in some cases. We describe an extensive, rapidly progressive lesion of the ulna in a three-year-old girl. The progression of the disease accelerated after a local marginal removal, and required extensive resection of the ulna with reconstruction using a fibular autograft. The particular features of this case are the change in the aggressive nature of the condition, which has not been previously reported. We believe that this is only the second recorded case of histologically proven involvement of the ulna.

Bone Transplantation↗
PubMed1997

En bloc resection of tumors of the distal end of the ulna.

The operative treatment of malignant tumors and aggressive benign tumors involving the distal end of the ulna often necessitates en bloc resection. The oncological and functional results for eight patients in whom a neoplasm involving the distal end of the ulna had been treated with en bloc resection without reconstruction of the osseous defect were reviewed retrospectively at a mean of seventy-nine months (range, twenty-three to 271 months). Four patients had a giant-cell tumor; two, a low-grade osteogenic sarcoma; one, a hemangioendothelioma; and one, a soft-tissue epithelioid sarcoma with osseous involvement. The amount of bone that was removed from the distal end of the ulna ranged from 3.1 to 9.0 centimeters. In the four patients who had a malignant tumor, a minimum of 7.5 centimeters was removed in order to achieve an adequate wide margin proximally. In the patients who had a benign tumor, a maximum of 6.6 centimeters was resected. Extraperiosteal resection was performed in three of the patients who had a malignant tumor and in one of the patients who had an aggressive giant-cell tumor. Subperiosteal resection was performed in the three patients who had a benign tumor and in one patient who had a parosteal osteogenic sarcoma. None of the patients had local or systemic evidence of recurrence of the tumor. The functional result was excellent for six patients and good for two. Grip strength was reduced by a mean of 15 per cent compared with the strength on the contralateral side, and this reduction did not appear to be related directly to the amount of bone that had been resected. The findings of this study support the concept that routine reconstruction of the osseous defect is not necessary after en bloc resection of a neoplasm of the distal end of the ulna.

Adult↗
PubMed1989

Bone strength of the radius and ulna in the non-human primate.

The technique and measurement of the bone strength of the radius and ulna in the non-human primate are presented. The aim of this study was to find a relationship between the mechanical strength of an intact radius and ulna forearm and its collateral isolated radius and isolated ulna which would be of assistance in the studies on mechanical bone strength and bone healing. The findings include: (1) bone strength is significantly influenced by factors such as age, sex, and body weight; (2) wide variation in normal bone-tissue strength exists among similar individuals; (3) there are differences in bone strength in the same individual if contralateral sides are compared; (4) growing bones are very elastic and are able to bend to an angle of up to 90 degrees before a fracture occurs; (5) soft tissue structures (such as muscle, interosseous membrane, and tendons) do not contribute to the strength of a diaphysis in low velocity injuries; and (6) the midshaft area of the radius is approximately 10% stronger than that of the ulna in the adult.

Aging↗
PubMed2004

[Adaptive remodeling of bone--change of radius shape after resection of ulna in dog].

Bone changes its shape adaptively according to the mechanical environment, suggesting a close relationship between the bone remodeling and the stress induced in bones. We measured the geometries of the canine radius after partial resection of the ulna with X-ray CT and microscopic study with fluorescent labeling. The experimental animals were six beagle dogs aged three months. The midshaft of their right ulna was partially resected. The experimental period of them was 6, 12 and 24 weeks. Sectional images of their antebrachium were taken every 2 or 4 weeks with X-ray CT. The bone was labeled with Calcein and Xylenol Orange each week. From CT observation, significant bone growth was observed at cranial-lateral, caudal-medial side and resected ulnar side at 6 weeks after surgery. At 12 weeks, the thickness of cortical bone was increased. At 24 weeks, the cross-section changed to an oval or round shape. From confocal laser microscope observation, significant new bone formation was identified under the periosteum at the cranial-lateral and resected ulnar side from 2 weeks after surgery. On the control side, lamellar bone formation took place in an orderly manner, whereas on the experimental side, there was a large quantity of rapid woven bone formation filling the cavities of the resected ulna, followed by the lamellar bone formation. The bone formations took place to compensate for the mechanical functions of the lost ulna, suggesting the adaptive nature of bone remodeling.

Adaptation, Physiological↗
PubMed1975

Compression-plate fixation in acute diaphyseal fractures of the radius and ulna.

At the Campbell Clinic and City of Memphis Hospital from 1960 to 1970, 244 patients (216 with closed and twenty-eight with open fractures) had 330 acute diaphyseal fractures of the radius and ulna which were treated with ASIF compression plates and followed for from four months to nine years. One hundred and twelve patients had fractures of both bones of the forearm; fifty, single fractures of the ulna; and eighty-two, single fractures of the radius. In all, 193 fractures of the radius and 137 fractures of the ulna were treated by compression plating. Sixty-three patients (25.9 per cent) with severely comminuted fractures also had iliac-bone grafts. The over-all rate of union for the radius was 97.9 per cent and for the ulna, 96.3 per cent. ASIF compression plates, therefore, provided a successful method for obtaining union and restoring optimum function after acute diaphyseal fractures of the forearm.

Acute Disease↗
PubMed1975

[Biomechanical investigations on the parry fracture of the ulna (author's transl)].

108 ulnae from the cadavers of 50 men and 6 women were fractured in four positions with a tension testing machine with electronic measurement of force. Stress-strain-diagrams were registered, and the values of breaking load, breaking energy, breaking stress and ultimate deflection were correlated to the areas of cross sections of compacta and medulla. Breaking load and breaking energy decrease distally: medium breaking load in the upper portion of the ulna about 320 kp, in the lower portion about 100 kp; breaking energy in the upper portion about 65 kpcm, in the lower about 20 kpcm. Breaking stress is greatest in the middle portion of the ulna (19 kp/mm-2 in contrast to 11-14 kp/mm-2 near the joints). With increasing age the cross sections of the medulla increase significantly, but breaking load, breaking energy, breaking stress and area of cross section of the compacta decrease significantly. Ulnae from females are less resistant than those from males. Intact periosteum rises resistance to breaking and ultimate deflection. Experimental data agree with clinical observations.

Adult↗
PubMed2001

[Complex fractures of the proximal end of the radius and ulna in adults: a retrospective study of 38 cases].

PURPOSE OF THE STUDY: Complex lesions of the proximal end of the radius and ulna are uncommon and generally associate a fracture of the proximal ulna and a dislocation of the radial head, which also may be fractured. We assessed the effect of the type of fracture and treatment on functional outcome and complications. MATERIAL AND METHODS: Thirty-eight adults (25 men and 13 women) were treated for complex fractures of the proximal end of the radius and ulna. For 25 of them, mean follow-up was 2.4 years. For the ulna, there was an epiphyseal fracture in 10 cases, a metaphyseal-epiphyseal fracture in 16 and a diaphyseal fracture in 12. The coronoid process was fractured in 20 cases and the proximal radius in 19. There was an anterior displacement in 24 cases. There were 9 open fractures and 13 patients had another injury of the upper limb. Functional outcome was assessed with a 100 point scale using subjective (pain) and objective (active motion, muscle force, stability) criteria. RESULTS: For the 25 fractures with more than 1 year follow-up, outcome was very good in 8, good in 6, fair in 8 and poor in 3. The pain and muscle force scores followed a similar pattern. Motion appeared as the determining factor for good outcome. Seven early revisions (2 for deep infections, 2 for disassembly of the fixation system, 3 for insufficient fixation) were required among the 38 patients. Among the late complications, there were 3 nonunions, 5 misalignments, and 4 proximal radio-ulnar synostoses. Six elbows required revision to restore motion. DISCUSSION: Certain characteristics of the fractures were predictive of poor outcome: skin opening, association with a lesion of the homolateral upper limb, mirror lesion of the lateral condyle, metaphyseal-epiphyseal fractures, communitive fractures, presence of a fracture of the radial head or the coronoid process. CONCLUSION: Complex proximal fractures of both bones of the forearm threaten the functional prognosis of the upper limb due to the risk of stiffness. Successful treatment depends on three factors: stable anatomic reconstruction of the ulnar articulation, and reconstruction of the lateral column and the coronoid process, necessary for a stable elbow. In addition, early mobilization, possible with a stable osteosynthesis, is indispensable for recovering useful joint movement.

Adolescent↗
PubMed1991

Excision of the distal ulna in rheumatoid arthritis.

Resection of the ulna is an effective operation in the treatment of rheumatoid disorders of the distal radioulnar joint. Tenosynovectomies of the overlying extensor tendons and synovectomy of the joint are integral parts of the procedure. Following resection, the ulna usually remains in alignment with the radius, although some dorsal displacement is common. Restoring stability to the ulna as well as reconstructing a new sheath for the extensor carpi ulnaris can be accomplished in most cases by using the extensor retinaculum. In those cases where the retinaculum has been destroyed by the disease process or when the distal ulna is severely displaced, stability can be restored using the extensor carpi ulnaris for a tenodesis.

Arthritis, Rheumatoid↗
PubMed1990

[Normal radiologic anatomic variants and X-ray findings of hypervitaminosis D of the ulna, radius and carpal bones in children].

The forearm and wrist radiographs in 400 children with age ranging from 2 months to 2 1/2 years were analyzed. Comparatively, x-ray films and their correlated macrosections of the wrist of 14 children's cadavers about the same age were studied. Alternate lines of increased, decreased, and increased density at the distal metaphysis of the ulna and radius were accountable. All these are normal variants of the development of the ulna and radius of infants. A series of abnormal x-ray signs were demonstrated in children administered over 100,000 IU of vitamin D every month on the average. These signs are blurred cortical bone with linear periosteal reaction, disorganization of the cortical bone, osteoporosis, cortical thickening and sclerosis of the ulna and radius, dense and thick calcified ring of ossification nuclei of the carpale, and dense metaphyseal band of the ulna and radius. The more vitamin D was administered, the more frequently abnormal x-ray signs occurred. These signs coincide with the results of radiopathologic and microangiographic correlations of hypervitaminosis D in animals, an experiment we had made before. The x-ray findings of hypervitaminosis D are very complicated. Only based on a series of x-ray signs rather than a single dense metaphyseal band could a radiologic diagnosis of hypervitaminosis D be made.

Bone and Bones↗
PubMed1976

Management of massive defects in radius and ulna following wringer injury. A case report.

An unusual case of wringer injury in a 29-month-old child demonstrates extensive loss of the diaphysis of both the radius and ulna. Reconstruction consisted of cortico-cancellous autogenous tibial bone grafting of the radius and ulna in two stages. Follow-up of 24 years showed remodeling and good alignment of the entire radius and ulna, culminating in a good functional and cosmetic result. Extensive soft tissue damage and decreased blood supply result in bone necrosis. There is no reason to bone graft the radius and ulna at the same time.

Accidents, Home↗
PubMedDate not supplied

The proximal ulna: An anatomic study with relevance to olecranon osteotomy and fracture fixation.

The purpose of this study was to define the proximal ulna anatomy with respect to olecranon osteotomy and fracture fixation. Thirty-nine cadaver elbows were dissected. The mean ulnar length (triceps insertion to ulnar styloid) was 26.0 cm (range, 27.1-29.0 cm). The mean distance from the triceps insertion to the ulna's varus angulation point was 7.6 cm (range, 6.5-9.0 cm). The distance ratio from the triceps insertion to the proximal ulnar angle to the overall ulna length was consistent, averaging 0.29 (range, 0.23-0.33). The mean diameter of the medullary canal at the ulnar angulation point could accommodate a 7.0- or 7.3-mm intramedullary screw. The mean width of the olecranon bare area (lacking articular cartilage) was 0.53 cm (range, 0.13-0.97 cm), and the mean distance from the triceps insertion to the corresponding area of the bare spot on the dorsal cortex was 2.1 cm (range, 1.4-2.5 cm).

Cadaver↗
PubMed1999

Morphological and taxonomic affinities of the Olduvai ulna (OH 36).

The OH 36 ulna derives from Upper Bed II in the Olduvai Gorge, and is dated to circa 1.1-1.2 Myr. Multivariate analyses incorporating data from samples of modern humans, common and pygmy chimpanzees, gorillas, orangutans, and two other early hominin ulnae, Omo L40-19 and KNM-BK 66, suggest that OH 36 belonged to an individual with powerful forearms consistent with a locomotor repertoire that included arboreal locomotion. However, there is no compelling evidence that it made regular use of its forelimbs as supports when travelling on the ground. When compared with levels of intra- and intertaxon size and shape variation in the comparative sample (humans, chimpanzees, gorillas), the differences between OH 36, KNM-BK 66, and Omo L40-19 are compatible with OH 36 differing from the other two fossil hominin ulnae to the extent that modern humans differ from modern great apes. KNM-BK 66 and Omo L40-19 differ from each other in overall size and shape only to the degree that would be expected within any of the individual modern comparative samples. Based on these analyses, there is no evidence to support the hypothesis that OH 36 and Omo L40-19 belong to the same species of fossil hominin, or to two species that shared a similar forelimb locomotor repertoire. We suggest that OH 36 has the greater claim to be assigned to Paranthropus boisei, and we recommend that for the time being the latter be referred to the tribe Hominini gen. et sp. indet. The surprising result of these analyses is the overall size and shape similarity between Omo L40-19 and KNM-BK 66, two fossils that are separated in time by more than 1.5 million years, and which have traditionally been assumed to represent hominin species with quite different locomotor patterns.

Animals↗
PubMed2003

A distinctive type of metaphyseal chondrodysplasia with characteristic thickening of the distal ulna and radius: possible metaphyseal chondrodysplasia-Rosenberg.

We report an 8-year-old boy with a distinctive form of metaphyseal chondrodysplasia (MCD). He presented with moderate disproportionate short stature and bony swelling of his wrists, knees, and ankles. There were severe metaphyseal abnormalities with a honeycomb appearance affecting the distal tibiae and fibulae, proximal tibiae, distal femurs, distal ulnae and radii, and both hands. His thoracolumbar spine was normal. Radiological examination of the mother's forearms revealed widening of the distal radii and short ulnae with hypoplastic distal ends. Rosenberg and Löhr [1986: Eur J Pediatr 145:40-45] reported a four-generational kindred in which affected members had thickening of the wrist proximal to the styloid process of the ulna and thickening of the dorsum sellae. Although many of the radiographic features of this patient are those of MCD-Rosenberg, the skeletal features of our patient do not appear to represent any known classified forms of MCD.

Bone Diseases↗
PubMed2006

Effect of wrist and ulna head position on gliding resistance of the extensor digitorum minimi and extensor digitorum communis III tendons: a cadaver study.

While attrition from sharp bony surfaces is the most common cause of extensor digiti minimi (EDM) tendon rupture, the etiology of other cases of spontaneous EDM tendon rupture is still unknown. Friction within the compartment may play a role, especially with ulna dislocation. The purpose of this study was to compare gliding resistance of the EDM tendon with that of a tendon which rarely ruptures spontaneously, the extensor digitorum communis of the middle finger (EDC III) tendon, under various wrist and ulna head positions. Eight fresh frozen cadavers were used. Gliding resistance between the tendon and its sheath in each compartment was measured in five different wrist positions and three different ulna head positions. Gliding resistance of the EDM tendon (0.13 +/- 0.03 N) was significantly greater than the EDC III tendon (0.09 +/- 0.03 N) (p < 0.05). For the EDM tendon, the gliding resistance in ulnar deviation or pronation was higher than the gliding resistance in neutral, radial deviation, or supination (p < 0.05), and the gliding resistance with ulnar lengthening (over 6 mm) or dorsal ulnar dislocation (over 9 mm) was higher than in neutral ulnar head positioning. For the EDC III tendon, the gliding resistance in ulnar deviation was significantly higher than the gliding resistance in neutral, radial deviation, or supination, or dorsal dislocation with ulnar lengthening (p < 0.05). Wrist ulnar deviation, ulnar dorsal dislocation (over 9 mm), and ulnar lengthening (over 6 mm) increased the gliding resistance of the EDM tendon. In patients at risk for EDM rupture, such as those with rheumatoid arthritis or distal radioulnar joint osteoarthritis, avoiding such positions may be advantageous.

Aged↗