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At least 19 recordsLinked to original sources
PubMed1987

Accuracy of voluntary movements at the thumb and elbow joints.

Subjects made simultaneously movements from a common rest position and attempted to align corresponding joints (elbow joints, or distal joints of thumb), on opposite sides of the body. When misalignments were expressed in angular terms, variability of performance within and between subjects was greater for thumb than for elbow joints. When the misalignments were expressed in terms of linear misalignment at the end of the moved lever arms, variability of performance within and between subjects was less for thumb than elbow joints. However, when the misalignments were expressed in terms of mean proportional changes in the lengths of fascicles in muscles operating at the joints, variabilities of performances at both joints were similar. In another test, subjects made small unloaded movements at either the elbow joint or the distal thumb joint to guide a cursor along a narrow path. When the movement task was made similar for the elbow and thumb joints in terms of either the angular excursion required, or the required linear excursion of the moved lever tip, accuracy of performances at the two joints varied greatly. Only when the tasks were similar in terms of the mean proportional changes of length in fascicles of muscles operating at the joints, were performances at the two joints of similar accuracy. The results suggest that proportional change in muscle fascicle length is a significant variable for the CNS in proprioception and the control of voluntary movement.

Adult↗
PubMed1991

Reconstruction of shifting elbow joint compliant characteristics during fast and slow movements.

The purpose of this study was to experimentally investigate the applicability of the equilibrium-point hypothesis to the dynamics of single-joint movements. Subjects were trained to perform relatively slow (movement time 600-1000 ms) or fast (movement time 200-300 ms) single-joint elbow flexion movements against a constant extending torque bias. They were instructed to reproduce the same time pattern of central motor command for a series of movements when the external torque could slowly and unpredictably increase, decrease, or remain constant. For fast movements, the total muscle torque was calculated as a sum of external and inertial components. Analysis of the data allowed reconstruction of the elbow joint compliant characteristics at different times during execution of the learned motor command. "Virtual" trajectories of the movements, representing time-varying changes in a central control parameter, were reconstructed and compared with the "actual" trajectories. For slow movements, the actual trajectories lagged behind the virtual ones. There were no consistent changes in the joint stiffness during slow movements. Similar analysis of experiments without voluntary movements demonstrated a lack of changes in the central parameters, supporting the assumption that the subjects were able to keep the same central motor command in spite of externally imposed unexpected torque perturbations. For the fast movements, the virtual trajectories were N-shaped, and the joint stiffness demonstrated a considerable increase near the middle of the movement. These findings contradict an hypothesis of monotonic joint compliant characteristic translation at a nearly constant rate during such movements.

Adult↗
PubMed1984

Carrying angle of the human elbow joint.

Previous elbow kinematic studies have created some controversy because of conflicting and contradictory results. The lack of consistent results may be traced to the limitations and definitions of the specific measurement techniques, as well as individual variations in the specimens. To resolve this issue, a rigorous theoretical analysis of elbow kinematics was performed based on available anatomic and geometric data of the skeleton with consideration of anthropometric variations. Three definitions have been adopted previously for the measurement of the carrying angle of the elbow joint. The relationships of these three definitions of the carrying angle as a function of the elbow joint flexion angle were evaluated. Clinically, the dynamic change of carrying angle may have little practical significance. However, the variation is reflected in differences in design criteria of the resurfacing and semiconstrained elbow replacement implants.

Anthropometry↗
PubMed1979

Functional anatomy of the elbow joint and three-dimensional quantitative motion analysis of the elbow joint.

This work consists of two parts. Part One is a three-dimensional study of the passive motion of the elbow joint and revealed that the elbow joint was not a true hinge joint. Part Two is a three-dimensional quantitative motion analysis which was undertaken to compare shoulder and trunk motion in normal subjects with those with contracted elbows. This analysis revealed that shoulder rotation, shoulder abduction, trunk flexion and trunk rotation compensates for a contracted elbow.

Elbow Joint↗
PubMed1986

[Elbow joint].

The elbow joint is a key joint for positioning of the hand. Four operations have to be considered for the rheumatoid elbow: removal of rheumatoid nodules and bursectomy, resection of the radial head, synovectomy, and arthroplasty. Synovectomy and arthroplasty are carefully analyzed, both from the point of view of recent international literature as well as personal experience. Synovectomy of the elbow is highly effective even when performed relatively late (stage 3 according to Larsen-Dahle-Eek) insofar as pain relief and swelling are concerned. In long-term disease, deterioration as assessed by radiology can usually not be prevented, but clinical improvement may be the reason for the relatively rare indication for arthroplasty. According to recent literature, the results of elbow arthroplasty vary greatly. Fully constrained hinges should no longer be used, and no decision has been made so far on whether semiconstrained or nonconstrained surface replacement is preferred. We use the semiconstrained GSB Mark II prosthesis, which has provided results in nearly 50 cases that rank among the best reported from the point of view of pain relief, improvement of ROM, and low complication rate. Use of our so-called transtricipital approach to the elbow has proved particularly valuable, especially with regard to lack of extension and muscle strength.

Arthritis, Rheumatoid↗
PubMed2003

Effect of humeral osteotomy on joint surface contact in canine elbow joints.

OBJECTIVE: To determine the effect of sliding and wedge osteotomies of the humerus on the joint surface contact areas in anatomically normal elbow joints of dogs. SAMPLE POPULATION: Left thoracic limbs from 5 skeletally mature mixed-breed canine cadavers. PROCEDURE: Joint casting was performed by placement of colored polymethylmethacrylate in the elbow joint cavity followed by loading in a materials testing system at physiologic angle and load. Joint casting was performed in unaltered specimens, after 10 degrees medial opening wedge osteotomy, and after lateral sliding osteotomy of the proximal portion of the humerus. Computer-aided analysis of photographs of proximal radial and ulnar articular surfaces after each casting procedure was performed. RESULTS: The lateral sliding humeral osteotomy and 10 degrees medial opening wedge osteotomy significantly altered joint surface contact regions of the canine elbow joint. Osteotomies resulted in a reduction in the size of the radial, ulnar, and combined radioulnar contact areas. Both osteotomies also resulted in craniolateral migration of the radial contact area and craniomedial recession of the ulnar contact area. Although the reduction in ulnar contact area with these treatments is consistent with our hypotheses, the reduction in radial contact area was not anticipated. CONCLUSIONS AND CLINICAL RELEVANCE: Humeral osteotomies alter joint surface contact areas of the canine elbow joint in vitro. Humeral osteotomies may decrease contact areas on the diseased region of the joint in dogs with elbow dysplasia; however, the overall decrease in joint surface contact area suggests that these procedures may induce focal increases in pressure that may cause iatrogenic cartilage damage when applied in vivo.

Animals↗
PubMed1996

Determining consistency of elbow joint threshold angle in elbow flexor muscles with spastic hypertonia.

BACKGROUND AND PURPOSE: Threshold angle, the point in passive range of motion where a muscle response or torque change is elicited, may be a potentially valid measure of hypertonus. Because the relationship of initial muscle length to threshold angle has not been addressed previously, this preliminary study examined whether starting elbow joint position and speed of stretch to elbow flexor muscles affect threshold angle. SUBJECTS: Five subjects with stroke-induced hypertonia of the elbow flexor muscles participated. METHODS: Two starting angles and two designated stretch speeds were applied randomly by a torque motor at each of three testing sessions. RESULTS: Starting angle, subject, and session affected threshold angle. A 90-degree starting angle at a stretch speed of approximately 1.0 radian/s produced the most consistent threshold angles between sessions within subjects, and threshold angle was relatively consistent for some subjects, irrespective of speed. CONCLUSION AND DISCUSSION: If future research indicates that these data can be generalized, the use of threshold angle as a consistent measure of hypertonia will require comparison within individuals, use of a consistent starting angle, and a movement condition of a 90-degree starting angle and an approximate movement speed of 1.0 radian/s across sessions.

Adult↗
PubMedDate not supplied

Kinematics of the lateral ligamentous constraints of the elbow joint.

Thirty osteoligamentous elbow joint specimens were included in a study of the lateral collateral ligament complex (LCLC). The morphologic characteristics of the LCLC were examined, and then three-dimensional kinematic measurements were undertaken after selective ligament dissections were performed. Isolated sectioning of the annular ligament (AL) or the lateral ulnar collateral ligament (LUCL) induced only minor laxity to the elbow joint with a maximum of 2.2 degrees and 4.4 degrees during forced varus and external rotation (supination), respectively. Transsection of the lateral collateral ligament (LCL) caused a maximal laxity of 15.4 degrees and 22.8 degrees during forced varus and external rotation (supination), respectively. Combined ligament dissections showed that total transection of the LCLC at the ulnar or the humeral insertion was important for joint laxity. Total transection of the LCLC at the humeral or the ulnar insertion induced a maximal laxity of 24.5 degrees and 37 degrees during forced varus and external rotation (supination), respectively. This study suggests the AL and the LUCL are of minor importance as constraints when cut separately, whereas the LCL is a significant preventer of elbow joint laxity. The LCLC was observed to be a complex structure of ligamentous fibers rather than discreet bands. The LCLC forms a ligamentous constraint between the lateral humeral epicondyle and the ulna, stabilizing the elbow joint and forming a base for radial head stability and rotation.

Aged↗
PubMed2001

Radiographic joint space in rheumatoid elbow joints. A 15-year prospective follow-up study in 74 patients.

OBJECTIVE: To evaluate radiographically the humeroulnar (HU) and humeroradial (HR) joint spaces in patients with long-term rheumatoid arthritis (RA). METHODS: An inception cohort of 74 patients with RA were followed for 15 yr. At the end-point, 148 elbows were radiographed by a standard method. The HU and HR joint spaces were examined from the anteroposterior radiographs by measuring the shortest tangential distance in the middle of the joints. Destruction of the elbow joints, assessed with the Larsen method on a scale of 0-5, was studied in relation to the joint-space measurements. RESULTS: Mean (s.d.) HU joint space (n=148) in RA patients was 2.5 (1.1) mm, range 0-4 mm [2.9 (0.8) mm in men and 2.4 (1.1) mm in women]. Mean (s.d.) HR joint space (n=140) was 2.3 (0.9) mm, range 0-4 mm [2.5 (0.8) mm in men and 2.3 (1.0) mm in women]. HU and HR spaces of the affected joints (Larsen grades 2-5) [1.9 (s.d. 1.1) and 1.8 (0.9) mm respectively] were notably narrower than those of the unaffected (Larsen grades 0-1) joints [3.1 (0.7) and 2.9 (0.6) mm]. All the joints graded as Larsen 4 or 5 (n=13) had a value of 0 mm for both joint spaces. Both the HU and the HR joint-space narrowing was associated with increasing destruction (Larsen grading) of the joint. [r= -0.69 (95% CI -0.77 to -0.60) and r= -0.70 (-0.78 to -0.60)]. The monotonic narrowing was significantly increasing from unaffected (Larsen 0, 1), slightly (2), moderately (3) to severely (4, 5) affected joints (P<0.001). A step in this process occurred between Larsen grades 3 and 4, when the mean joint space diminished from 1.4 and 1.5 respectively to 0 mm. CONCLUSIONS: Joint-space narrowing is a frequent consequence of rheumatoid affection of the elbow joint. HR joint space decreases together with HU joint space; however, the HR joint space is already slightly narrower at the start. The narrowing is a rather late phenomenon, occurring only after erosive destruction. This should be borne in mind when using the Larsen method to evaluate changes in the elbow joint.

Adolescent↗
PubMed2003

[Joint-preserving procedures for the rheumatoid elbow joint. Medium-term results].

The follow-up of 42 patients with 50 symptomatic elbow joints [average age at operation: 66.1 years (46-79 years)] with rheumatoid arthritis at an average of 6.8 years (SD: 3.5 years) after joint-preserving open operation is presented in this study. Synovectomy was mandatory. Open synovectomy with facultative additional soft tissue techniques (AS) was performed on 17 elbows, while in 33 elbows joint surface remodeling (SR)-radial head excision included-was performed. There was only a slight progression in the overall Larsen staging from 3.70 to 4.02 in the operated joints, while the non-operated joints were nearly unchanged (3.43 vs 3.56). Especially in the SR group a nearly significant ( p=0.06) increase of 31.0 degrees for the total elbow ROM as a sum of extension/ flexion and pronation/supination could be detected, while the AS group slightly decreased with -1.1 degrees. Both groups gained a comparable average Morrey score result (AS 77.6 points vs SR 75.6 points). Poor results were not noticed at all. A mild collateral instability was seen in 40% of the AS and in 20% of the SR cases, respectively. Moderate instability was found in 10% in the AS vs 5% in the SR group. Both groups showed an excellent benefit in terms of pain relief, function, and satisfaction according to the patients' self-assessment on a visual analog scale.Joint-preserving operations on the rheumatoid elbow proved to be safe and efficient methods on a medium term even at late stages. Especially joint surface remodeling guarantees a noticeable increase for the elbow ROM without provoking marked collateral instability. The patients' expectations for pain relief and functionality can be fulfilled completely with these methods.

Aged↗
PubMed1983

[Measurement study of anatomical shape and size in Japanese elbow joints].

Recently, total elbow replacement has been developed for reconstruction of destructed elbow joints. However, various complications occurred in the constrained or semi-constrained types of elbow replacement, while unconstrained type such as surface replacement showed lower incidence of such complications. On the other hand, development of the elbow prosthesis needs anatomical measurement of the elbow for adaptation to the need of Japanese. Basically, prosthesis should be designed based on the anatomical and biomechanical analysis. In this study, elbow from 36 Japanese cadavers were measured in the outer contour and microradiograms of the sectioned samples. Midline axes of the humerus and ulna, and the center of both medial and lateral epicondyles are fixed as standardized lines for the study in the elbow measurement. The trochlea is situated slightly anteriorly from the midline of the humerus. Width of the trochlea is 21.4 +/- 2.6 mm on the right side and 21.1 +/- 2.8 mm on the left at the anterior margin. At the distal margin, the width is 23.5 +/- 2.8 mm on the right and 23.3 +/- 2.6 mm on the left, and at the posterior margin, 23.9 +/- 3.6 mm on the right and 23.5 +/- 2.8 mm on the left. Saggittal section of the humeral end shows almost complete circle in the articular surface of the trochlea. The diameter is 19.1 mm on the right and 19.3 mm on the left at the longitudinal axis of the humerus, 17.6 mm on the right and 17.7 mm on the left at the central groove, and 24.5 mm on the right, 22.6 mm on the left at the medial margin. Anterior angulation of the trochlea is about 12 degrees. Central line of the trochlea corresponds to the center of the flexion-extension of the elbow, but angulated by 8 degrees from the humeral axis from the anterior view, and internally rotated by 3 degrees from the center of the both epicondyles from the bottom view. In the measurement of the incisura trochlea, opening distance is 18.5 +/- 2.1 mm on the right, 18.5 +/- 2.0 mm on the left, and the depth is 11.8 mm on the right, 11.6 mm on the left at the mean. Forward angulation of the incisura is 30.8 degrees on the right and 28.3 degrees on the left. Width of the olecranon is 25.0 +/- 3.2 mm on the right, 25.0 +/- 2.9 mm on the left and the thickness is 18.6 +/- 1.6 mm on the right, 18.7 +/- 1.8 mm on the left. The central line of the olecranon is supero-laterally angulated about 7 degrees from the longitudinal axis of the ulna. This angulation and lateral opening of the central line of the trochlea seems to produce carring angle of the elbow. Measurement of the elbow size and shape is discussed for designing elbow prosthesis and some biomechanical problems are also represented.

Aged↗
PubMed1987

[Arthrolysis in the treatment of post-traumatic joint stiffness of the knee and elbow joints].

In the treatment of posttraumatic limitation of the range of motion, arthrolysis is a proved procedure in the hand of an experienced surgeon. In this paper, indication, operative details and postoperative treatment are discussed. The results of 51 cases of arthrolysis of the knee joint and 33 cases of arthrolysis of the elbow joint carried out over a time of seven years are reported.

Ankylosis↗
PubMed2002

[Endoprosthesis implantation in the elbow joint].

Previously used total elbow prostheses were mainly constrained hinged implants. Their early clinical results were favourable but they failed due to a high rate of loosening already a few years after implantation. The cause for the early loosening was the great forces across the elbow joint which were directly transmitted to the prosthesis-bone interface in these implants. Therefore, these implants were abandoned. Afterwards, unlinked, semiconstrained or non-constrained resurfacing devices were introduced. In these devices, the soft tissues constrain the joint and therefore absorb part of the transmitted forces. The rates of loosening were significantly improved and rarely the cause of early failure. But resurfacing implants require intact condyles and collateral ligaments. These implants can, therefore, only be used in a limited number of indications, and postoperative instabilities are known complications. The currently most frequently used device is the semiconstrained Coonrad-Morrey prosthesis. It is a floppy hinge which allows valgus-varus and rotational laxities. Therefore, a part of the forces across the elbow joint are absorbed by the soft tissues. The loosening rate is not a clinical problem any more, and is with 4% 10 years after implantation (rheumatoid arthritis) similar to that of total hip or knee replacement. Furthermore, this device is stabilised with a small anterior flange to the anterior cortex of the humeral shaft. Condyles and collateral ligaments are therefore not necessary neither for short nor for long-term stability. The Coonrad-Morrey total elbow prosthesis can therefore be used for almost every indication, such as severe destruction of the elbow joint and even in case of complete loss of the distal humerus. The long-term outcome with this prosthesis for the treatment of rheumatoid arthritis is favourable with 96% of very good and good results. Function is restored with an average flexion of 131 degrees, a mean loss of extension of 28 degrees, and an unrestricted pronation and supination. The rate of complications for patients with rheumatoid arthritis is 10%. Similarly, the results for Coonrad-Morrey total elbow replacement for posttraumatic arthrosis are favourable with 83% of satisfactory results. Most patients consider their elbow as improved compared to preoperatively, but pain relief is obtained only in three quarters of the patients. The rate of complications is high with 30%, indicating the total elbow replacement is contraindicated for strenuous labour and sports activities.

Arthritis, Rheumatoid↗