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At least 145 records · Page 8Linked to original sources

Noninvasive loading of the rat ulna in vivo induces a strain-related modeling response uncomplicated by trauma or periostal pressure.

Adaptive changes in bone modeling in response to noninvasive, cyclic axial loading of the rat ulna were compared with those using 4-point bending of the tibia. Twenty cycles daily of 4-point bending for 10 days were applied to rat tibiae through loading points 23 and 11 mm apart. Control bones received nonbending loads through loading points 11 mm apart. As woven bone was produced in both situations, any strain-related response was confounded by the response to direct periosteal pressure. Four-point bending is not, therefore, an ideal mode of loading for the investigation of strain-related adaptive modeling. The ulna's adaptive response to daily axial loading over 9 days was investigated in 30 rats. Groups 1-3 were loaded for 1200 cycles: Group 1 at 10 Hz and 20 N, Group 2 at 10 Hz and 15 N, and Group 3 at 20 Hz and 15 N. Groups 4 and 5 received 12,000 cycles of 20 N and 15 N at 10 Hz. Groups 1 and 4 showed a similar amount of new bone formation. Group 5 showed the same pattern of response but in reduced amount. The responses in Groups 2 and 3 were either small or absent. Strains were measured with single-element, miniature strain gauges bonded around the circumference of dissected bones. The 20 N loading induced peak strains of 3500-4500 mustrain. The width of the periosteal new bone response was proportional to the longitudinal strain at each point around the bone's circumference. It appears that when a bone is loaded in a normal strain distribution, an osteogenic response occurs when peak physiological strains are exceeded. In this situation the amount of new bone formed at each location is proportional to the local surface strain. Cycle numbers between 1200 and 12,000, and cycle frequencies between 10 and 20 Hz have no effect on the bone's adaptive response.

Animals↗

[Solitary bone cysts of the ulna (author's transl)].

The solitary bone cysts occurs most frequently in the upper humerus and femur in 75% of the cases, and it is very seldom located in the ulna, in 0.5--1.5%. This report deals with the treatment results of two children, five and six years old, suffering from solitary bone cysts of the lower end of the ulna. In one case a subtotal resection of the cyst was carried out and the defect was bridged with an autologous iliac bone graft. In the other case the patient was treated by curettage, and the defect was filled in with an autologous bone graft and cancellous bone out of the tibia. In both cases complete cure of the tumorlike lesion was obtained and no loss of function or deformity of the forearm was observed 12 and 16 years after operation. In the X-ray picture at that time there was no alteration on the length, form or structure of the bone.

Bone Cysts↗

A new hereditary bone dysplasia with characteristic bowing and thickening of the distal ulna.

An autosomal dominant hereditary bone dysplasia was observed in three members of a Sardinian family living in Germany--the father and two sons. The guiding clinical symptom is thickening of the wrist proximal to the styloid process of the ulna. The radiologically recognizable changes--non-calcified cartilaginous islands protruding like cones into the metaphysis--begin with the onset of puberty and are not always associated with pain. Varying degrees of thickening and bowing of the relatively poorly mineralized metaphyseal region, particularly of the distal ulna, occur at the end of skeletal development. Thickening of the dorsum sellae is also characteristic. Serum calcium levels remain slightly elevated throughout life. The metatarsals, metacarpals and the distal fibula are dysplastic to varying degrees. The two boys display a coxa valga. Skeletal development is retarded. A developmental disorder of the vertebral column may form part of the condition, which defied allocation to any of the acknowledged forms of skeletal disease.

Adolescent↗

Anterior interosseous nerve palsy following closed fracture of the proximal ulna. A case report and review of the literature.

Complete paralysis of the anterior interosseous nerve was seen in 32-year-old army officer 5 weeks after he sustained a minimally displaced fracture of the proximal ulna. The fracture was immobilized in an arm cast. Thirteen weeks after injury, the cast was removed following evidence of bone union. Complete recovery of the flexor pollicis longus was noted 17 weeks after the injury, while recovery of the flexor profundus to the index finger to grade four lasted 10 months. To the best of our knowledge, this is the first case reported in the English language literature in which anterior interosseous nerve palsy follows isolated fracture of the proximal ulna.

Adult↗

Stress fracture of the ulna in a professional tennis player using a double-handed backhand stroke.

Stress fractures of the ulna are uncommon injuries, but they have been reported in athletes from various sports. In tennis players stress fractures of the ulna are described exclusively in the nondominant forearm of athletes using a two-handed backhand stroke. We report such a case in a 24-year-old tennis player, with special emphasis on diagnostic imaging, accurate grading of the injury, and specific treatment recommendations.

Adult↗

Hemangioma of bone arising in the ulna: imaging findings with emphasis on MR.

An 18-year-old woman presented with left elbow joint pain. Radiographs and computed tomographic scan showed a well-defined osteolytic lesion of the left ulna associated with a honeycomb appearance on the radiographs. Magnetic resonance images showed intermediate signal intensity on T1-weighted images and mixed intermediate and high signal intensities on T2-weighted images. Only the periphery of the lesion enhanced with intravenously injected gadolinium-diethylenetriamine pentaacetic acid. The lesion was curetted to avoid pathologic fracture, and a histologic diagnosis of cavernous hemangioma of bone was made. Hemangioma involving the ulna is rare, but should be included in the differential diagnosis of a radiographic osteolytic lesion with a honeycomb appearance.

Adolescent↗

Stabilization of the ulna stump after Darrach's procedure at the wrist.

We studied the outcome of patients with chronic distal radioulnar joint symptoms who were treated with excision of the distal ulna and reconstruction using the flexor carpi ulnaris tendon. Twelve patients with 14 wrists were assessed. Ten patients were posttraumatic, and two had bilateral surgery for rheumatoid arthritis. Average age was 37 years at time of operation. Follow-up averaged 20 months (9 months to 4 years). All patients except one reported improvement in pain symptoms. Grip strength of the operated hand as measured by dynamometer readings was 67% of the strength of the normal hand with five wrists achieving an excellent result in grip strength. Eleven patients reported a subjective improvement in functional activities. An improved range of motion was obtained in all patients. We discuss the importance and basis for ligamentous reconstruction following excision of the distal ulna and review the literature for other previously described procedures.

Adult↗

Osseous lesions of the distal ulna: atypical location--unusual diagnosis. Report of three cases with similar imaging and different pathologic diagnoses.

Three cases with destructive bone lesions of the distal end of the ulna caused by different pathologic entities (Ewing's sarcoma, osteosarcoma, rheumatoid pseudotumoral synovitis) are presented, all with similar clinical and comparable x-ray and magnetic resonance imaging features. Although the distal end of the ulna may be resected without significant functional impairment, careful evaluation of treatment strategies compatible with oncologic standards is warranted.

Adult↗

Radial head dislocation with acute plastic bowing of the ulna.

Five radial head dislocations with acute plastic bowing of the ulna in patients aged 6-12 years were reviewed. Closed reduction was successful in two, and open reduction was required in three patients in whom treatment was started more than 2 weeks after injury. In one child who presented 2 months after injury, realignment by osteotomy of the ulna as well as open reduction of the radial head was necessary. Follow-up evaluations at 6-24 months revealed good clinical outcomes in all patients. Awareness of this type of radial head dislocation is important to avoid delays in diagnosis and treatment.

Accidental Falls↗

Juxtacortical osteoma of the ulna.

Acase of juxtacortical osteoma of the ulna in a 47-year-old woman is presented. She had a dense bony mass on the ulna. Radiological examinations (plain radiography, computed tomography, magnetic resonance imaging) strongly suggested a rare case of juxtacortical osteoma of a long tubular bone. The differential diagnosis included parosteal osteosarcoma, melorheostosis, osteochondroma, end-stage juxtacortical myositis ossificans, and fibrous dysplasia protuberans. The tumor was excised totally for thorough pathological examination, which revealed it to be composed of lamellar bone, suggesting that the origin was periosteal.

Biopsy, Needle↗

Ulnar impingement syndrome after Darrach procedure: treatment by advancement lengthening osteotomy of the ulna.

The Darrach procedure was the standard treatment for painful disorders of the radioulnar joint for several decades. However, recent articles have described unsatisfactory results after this procedure including dorso-palmar instability of the ulna, clicking upon rotation of the forearm, ulnar translocation of the carpus, and a painful ulnar impingement syndrome. Management of these problems following an ulnar shortening procedure requires restoration of ulnar length to provide stability to the triangular fibrocartilage complex and ulnar sling mechanism. Also, recurrent impingement must be prevented. A technique of ulnar lengthening by advancement step osteotomy in conjunction with a "matched" resection of the advanced ulna is presented. Three case reports illustrate its use.

Adult↗

Force transmission through the distal ulna: effect of ulnar variance, lunate fossa angulation, and radial and palmar tilt of the distal radius.

The relationship between the amount of force transmitted through the distal ulna and seven radiologically apparent anatomic parameters (ulnar variance, radial tilt, palmar tilt, lunate fossa angulation, carpal height, carpal ulnar distance, and ulnar head inclination) was examined in 58 fresh cadaver forearms. A positive, although very weak, relationship was found between the amount of force and the ulnar variance (r = 0.44). This suggests that a clinically more positive ulnar variant wrist will not necessarily cause more force to be transmitted to the head of the ulna than a wrist with a more negative ulnar variance, primarily because the triangular fibro-cartilage complex is thicker in arms with a more negative ulnar variance. Changes in ulnar variance of a forearm due to ulnar lengthening or radial shortening do, however, dramatically alter the force transmission. No other relationships were found between the ulnar force and the other radiologic parameters.

Analysis of Variance↗

Cross-sectional geometrical properties of distal radius and ulna in large, medium and toy breed dogs.

Fractures of the distal radius and the ulna are the third most common fractures in dogs. Toy and miniature breeds have a propensity to develop antebrachial fractures after falling or jumping. Most affect the distal third of both bones involving between 15% and 37% of the radial length. Larger dogs, instead, typically sustain hyperextension injuries to the carpus. The causative mechanisms for this fracture prevalence in toy dogs are unknown. Breed-related changes in bone geometry and/or mineral density have been suggested as possible etiologic factors. In a multifactorial study, the main etiological factors potentially responsible for determining susceptibility to fractures in toy breeds are considered. The aim of this first study is to evaluate the geometric bone features in different dog sizes. The cortical bone cross-sectional properties along the length of the right radius and the ulna of 28 dogs from three different size categories have been quantified by computerized tomographic scanning. Geometrical cross-sectional parameters were measured and normalized to radial length to allow intergroup comparisons. Discriminant analysis was used to classify the observations into different groups. Through statistical analysis of the normalized values, significant differences in cross-sectional properties of different bone sizes were found. The results suggest that, when proportionally loaded, the antibrachii of toy breed dogs are more susceptible to fracture than those of large breed dogs due to morphological differences.

Anatomy, Cross-Sectional↗

Radiographic changes after resection of the distal ulna in rheumatoid arthritis.

Progressive ulnar translocation of the carpus and problems with the ulnar stump have been reported after resection of the distal ulna in rheumatoid arthritis (RA). However this has only occasionally been quantitatively assessed. In this study 24 wrists in 21 patients with RA were followed up for an average of 100 months after resection of the distal ulna. An additional 24 wrists in 14 non-operated RA patients were followed up for 92 months. In a retrospective radiographic analysis we demonstrate similar increases in ulnar translocation and ulnar-carpal distances in both groups.

Adult↗

Centralization of ulna for infected nonunion of radius with extensive bone loss. A modified Hey-Groves procedure.

We describe a case of infected nonunion of the radius with extensive bone loss in an 11-year-old boy treated by centralization of the ulna. The technique used differs from the original Hey Groves procedure in that it preserves the distal end of the ulna with its important triangular fibrocartilage complex, thereby retaining stability and contour of the wrist joint. Our patient obtained a functionally and cosmetically satisfactory, stable forearm and wrist. We present the technique as a useful armament in the management of extensive bony defect of the radius arising from trauma or infection.

Child↗

The accuracy and reliability of linear measurements of the ulna for anthropometrical studies in dogs.

This study investigated the accuracy and reliability of measuring the distance between two surface landmarks (the point of the tuber olecrani and the proximal aspect of the stopper pad) as an indication of ulna length in the live dog. It was found that the chosen skin landmarks did correlate well with the length of the ulna bone. The reliability of such measurements was high when performed by a single person, however this fell to unacceptable levels when multiple people were used to make the measurements. It was concluded that if this technique was to be used in studies to serially record the bone length in live growing dogs, then the measurements should be taken by a single person.

Analysis of Variance↗

Stabilisation of distal ulna after excessive Darrach's procedure.

A patient is presented in whom painful instability persisted more than a year after the resection of 1 1/2 inches of the distal ulna, for a painfully subluxed distal radio-ulnar joint. The palmaris longus tendon was detached distally, passed through a drill hole in the distal radius and then wrapped and stitched, as a sling, around the distal ulna stump. Two years later the patient's symptoms were relieved.

Arthritis, Rheumatoid↗

Fractures of the radius and ulna.

Fractures of the radius and ulna are common in the dog and cat. If treated inappropriately, complications may result. These include delayed union, nonunion, malunion, and growth deformities. ESF is a versatile method of fixation for fractures of the radius and ulna. Types that are applicable range from the simple type I to the complex type III fixator. In general, the more unstable the fracture, the more rigid the assembly must be to counteract fracture forces. There are three basic phases to consider when using ESF: (1) preoperative planning, (2) application of the ESF, and (3) long-term management. A deficiency in any one of these phases can lead to complications and an unsatisfactory clinical outcome. Although ESF can be used on many types of fractures, the technique is especially well suited for open or highly comminuted fractures when internal fixation is not applicable. In these cases, close attention must be paid to the integrity of the soft tissues. In addition, cancellous bone grafts should be placed either at the time of initial repair or in a delayed fashion after adequate vascularity has been established. Staged or complete removal of the ESF should be individualized to each fracture case. In general, staged disassembly or "dynamization" can begin when the bone and fixator begin to function as a composite as determined by radiographs. Complete fixator removal should be considered when the fracture exhibits clinical and radiographic evidences of union.

Animals↗