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At least 829 records · Page 46Linked to original sources
PubMed1997

Pedicled latissimus dorsi transfer for immediate soft-tissue coverage and elbow flexion.

This case report describes a new method of unipolar transfer of the latissimus dorsi for restoration of elbow flexion. The advantages of the technique are that it has superior resting tension compared to other unipolar transfers and provides more extensive soft-tissue coverage at the elbow than other unipolar or bipolar transfers. The disadvantage is that it does not restore the supinator function of the biceps. The technique is felt suitable for traumatic defects requiring extensive soft-tissue coverage as well as restoration of an active elbow flexor.

Adolescent↗
PubMedDate not supplied

Hyperextension of the elbow joint: pathoanatomy and kinematics of ligament injuries.

According to an epidemiologic study (Scand J Med Sci 1996/ 6: 297-302) the mechanism of "handball goalie's elbow" may be forced hyperextension. The pathomechanics of hyperextension were studied in nine macroscopically normal male cadaver elbow joints. The mean age of the donors was 43.2 years (range 25 to 61 years). Kinematic tests were performed with an experimental three-dimensional kinematic loading apparatus. Hyperextension loads induced joint laxity during flexion of less than 50 degrees. The kinematic changes were significant in joint flexion during forced valgus and external and internal axial rotation, but were not significant in flexion during forced varus. No instability was found with flexion beyond 90 degrees. The hyperextension loads produced four lesions: (1) anterior capsule rupture; (2) L-shaped rupture of the pronator/flexor origin with elongation of the anterior part of the medial collateral ligament; (3) occasional incomplete rupture of the lateral collateral ligament; and (4) small fragments of cartilage near the posterior edge of the ulna in one of the specimens. One or more of these lesions may be responsible for the symptoms in "handball goalie's elbow."

Adult↗
PubMed1982

Fractures and dislocations about the elbow in the head-injured adult.

Of 548 head-injured adults, 16 sustained injuries about the elbow (3%). Sixteen of 18 patients (89%) developed heterotopic ossification (HO). All elbows which had been dislocated developed new bone in the substance or adjacent to the medial or lateral collateral ligaments, or both. Some dislocations also developed significant HO in all planes. Final motion correlated with the amount of HO in the joint. Supracondylar fractures generally developed a moderate amount of anterior or posterior HO, or both. Motion was moderately compromised. Posteriorly located HO developed in olecranon fractures. Range of motion was generally functional. Ectopic bone developed in dislocations of the radial head in the area of the annular ligament, and resulted in mild to moderate loss of motion. Spasticity was not necessarily associated with the development of HO. Two tardy ulnar palsies were noticed and associated with HO in the medial collateral ligament.

Adolescent↗
PubMed1984

Traumatic recurrent posterior dislocation of the radial head. A case report.

Traumatic recurrent isolated posterior dislocation of the radial head occurred in a 56-year-old woman. The differential diagnosis included congenital dislocation, neurovascular disorders, tumors of the forearm, and Monteggia-type fracture-dislocation. The etiology of the injury is obscure. The treatment of choice depends on the age of the patient and the status of the elbow. The characteristics distinguishing this case from others previously presented in the literature include the recurrence, posterior displacement, and age of the patient.

Elbow Joint↗
PubMed1982

The scapular free flap.

A purely cutaneous free flap overlying the infraspinous region of the scapula has been used successfully in three cases. It is of intermediate thickness, predominantly hairless and is based on the cutaneous branch of the circumflex scapular artery. Te dissection of the flap is easy, quick and safe, resulting in a minimal pedicle length of 3 cm but this can be lengthened significantly by the inclusion of the more proximal vessels. The vessel diameter and its distribution make revascularization predictable. In this vessels. The vessel diameter and its distribution make revascularization predictable. In this series, the longest flap used was 24 cm and the widest was 12 cm, the width being limited by the ability to achieve primary closure. The only donor site disability is related to a tight linear transverse scar. These is no functional limitation nor distortion of the axillary contours. This contrasts with the thicker and widely used latissimus dorsi free flap. The scapular flap should replace the latissimus dorsi flap where the size of the defect to be covered is within the critical dimensions of this flap. The scapular flap can be combined with the latissimus dorsi flap for larger areas of skin cover, or the two flaps can be separated still based on their common vascular pedicle to cover two areas with diverging axes.

Adult↗
PubMed1998

Stress fractures of the upper limb.

Stress fractures are commonly found in the lower limb, but also occur in the upper limb, and are particularly associated with upper limb-dominated sports such as tennis and swimming and those involving throwing activities. Stress fractures of the clavicle and scapula are rare but have been reported, whereas those of the humerus are more frequent and have been described mainly in adolescent baseball pitchers. Olecranon stress fractures occur in throwers and gymnasts. Stress fractures of the ulna and radius have also been reported in a number of different upper limb-dominated sports. In all cases, these fractures heal with conservative management. The physician should consider stress fracture as a possible diagnosis in cases of upper limb pain of bony origin where the pain is associated with overuse.

Arm Injuries↗
PubMed1997

Complications when using the cannulated 3.5 mm screw system.

Five patients with breakage of instrumentation when using the cannulated 3.5 mm screw system for fracture fixation are reported. Four 1.25 mm guide wires were sheared off by the cannulated drill and one 3.5 mm cannulated tap sleeve fractured. This article presents potential dangers when using the cannulated 3.5 mm screw system for general fracture care.

Adolescent↗
PubMed2006

Irreducible radial neck fracture in a child.

Pediatric radial neck fractures are relatively common injuries resulting from a fall onto an outstretched arm. However, radial neck fractures with medial displacement of the shaft are difficult and fortunately rare injuries, having only been described twice in the literature. This case report describes the presentation and treatment of a pediatric elbow fracture where the radial shaft displaced medial to the coronoid process and pierced the joint capsule, requiring open reduction with internal fixation.

Child↗
PubMed2002

[Corrective interventions after elbow para-articular fractures in childhood].

Besides supracondylar fracture of the humerus there are several injuries of the elbow joint, which may lead to major disability. In this study 5 cases of corrective procedures are described after elbow fractures. Initially the lesions were overlooked. These were a fracture of the radial condyle, producing a pseudarthrosis, three cases of Monteggia fractures with persisting dislocation of the radial head in young children and a periarticular calcification issuing from an avulsion of the radial epicondyle and the radial capsule in a 13-year-old. All children had marked functional limitation of the elbow joint. The primarily overlooked fractures were corrected early. Various osteosynthesis procedures including movement and distraction extend fixator were employed. Overall, in all patients an almost complete movement of the joint at existing stability could be achieved. Transcondylar and Monteggia fractures should not be overlooked at the initial diagnosis as secondary operations for correction always have a less favorable outcome than the primary one. For the management of ankylosis of the elbow a movement extend fixator after distraction is a useful additional management.

Adolescent↗
PubMed2001

Identification of static and dynamic components of reflex sensitivity in spastic elbow flexors using a muscle activation model.

Static and dynamic components of the stretch reflex were studied in elbow flexors of 13 hemiparetic brain-injured individuals. Constant-velocity joint rotations were applied to the elbow, and the resulting stretch reflex torque and electromyographic responses were recorded in the biceps brachii and brachioradialis muscles. Ten elbow extension velocities between 6 and 150 deg s(-1) were applied in random order. The resulting reflex torque response was plotted as a function of elbow angle and fitted with a mathematical model designed to depict elbow flexor activation. We found that four of the six model parameters were essentially independent of test velocity. Conversely, 73% (19/26) of cases involving the other two model parameters were dependent on velocity of joint extension (p<0.05). We conclude from these results that four of the model parameters reflect the static reflex response while the two remaining velocity-dependent parameters reflect the dynamic reflex response. To describe overall velocity dependence of stretch reflexes in spastic elbow muscles, the two dynamic reflex parameters were fitted to a fractional exponential function of velocity, similar to a model previously used to describe spindle firing rate in the cat hindlimb. We found that the mean velocity exponent of the dynamic reflex parameters was 0.24 + 0.17 (s.d.) (N = 13), a value similar to that for muscle spindle velocity sensitivity in reduced animal preparations. We conclude that both static and dynamic reflex sensitivities can be measured by examining different aspects of the torque/angle relation associated with the reflex response to a large-amplitude ramp stretch of the elbow.

Adult↗
PubMed2004

Arthroscopic management of elbow trauma.

The arthroscope can assist in effectively treating traumatic injuries about the elbow, including some intra-articular fractures. Proper selection of patients is important to ensure effective treatment, but when used judiciously, arthroscopic-assisted debridement and fracture fixation is effective. The arthroscope is a valuable tool in the diagnosis and management of acute intra-articular fractures and in dealing with the sequelae that sometimes cause problems after healing has occurred. It allows for effective fracture treatment without the extensive soft tissue disruption that would be otherwise necessary for exposure. The authors certainly cannot advocate arthroscopic treatment of all intra-articular elbow fractures, but in specific circumstances, the arthroscope cannot only assist but also improve treatment of these sometimes difficult and often challenging injuries. The arthroscope is also useful in the identification of varus, valgus, and posterolateral rotatory instability, particularly when these instabilities are less obvious on clinical examination.

Arthroscopy↗