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At least 19 recordsLinked to original sources
PubMed1990

Lateral condyle fractures: missed diagnoses in pediatric elbow injuries.

Pediatric elbow injuries represent diagnostic dilemmas to all health care personnel. In particular, nondisplaced lateral condyle fractures are often missed when the child first presents for evaluation, and if left untreated, can potentially produce disastrous results. Several illustrative cases are described in order to demonstrate the diagnostic symptoms and signs, as well as the long-term complications associated with the failure to diagnose and institute early treatment. Pertinent clinical findings and elbow anatomy are also reviewed.

Child↗
PubMed2002

Elbow injuries.

The elbow is a commonly injured joint, yet physicians may be less comfortable treating injuries to the elbow compared with knee and shoulder injuries. Common injuries involving the elbow are tendinosis, instability, tendon ruptures, osteochondritis dissecans, and fractures. Tendinosis is a common overuse injury and may occur on the lateral, medial, or infrequently, the posterior side of the elbow. Injury to the medial or lateral ulnar collateral ligaments may result in instability. Repetitive trauma from overuse is the most common etiologic factor in athletes. Distal biceps and triceps tendon injuries may result in elbow disability in active individuals. Partial tears are more difficult to diagnose than complete ruptures. Osteochondritis dissecans of capitellum affects adolescents involved in overhead throwing athletics. Fractures about the elbow most commonly involve the radial head in adults, and the distal humerus in children. Athletes are prone to elbow injuries resulting from both overuse and acute trauma. Our purpose is to describe the diagnosis and treatment of these common elbow injuries in athletes of all ages.

Adolescent↗
PubMed1991

Real-time digital contrast enhancement and magnification in the assessment of acute elbow injuries.

The elbow is a common site of injury and missed fractures may lead to disability and litigation. An assessment was made of a commercially available desk-top digital contrast enhancement and magnification unit (DETECT system) in a series of 320 patients with an acute elbow injury. Five radiologists of varying experience independently viewed elbow radiographs on a conventional light-box, and subsequently using the digitizer, indicating the presence or absence of a fracture. The overall results demonstrated no difference in performance when using the unit, though small improvements in the confidence with which a definite diagnosis was made were observed. Assessment of soft tissues with the digitizer was less reliable.

Acute Disease↗
PubMed1995

Elbow injuries in athletes. A review.

Elbow injuries are becoming more common as increasing numbers of people participate in throwing and racquet sports. The understanding and treatment of elbow injuries is becoming more sophisticated in conjunction with better noninvasive and invasive diagnostic techniques. The majority of injuries to the elbow in the athlete are chronic, overuse injuries. These injuries are the result of repetitive intrinsic or extrinsic overload, or both, resulting in microrupture of soft tissue such as ligament or tendon. In children, apophyses, being the weakest link in the immature musculoskeletal system, are susceptible to stress injuries. Elbow injuries are most commonly caused by valgus stress, from throwing or axial compression, resulting in increased force absorbed by the medial elbow. With repetitive valgus stress, patients may develop chondromalacia, loose bodies in the posterior or lateral compartments, injury to the ulnar collateral ligament, myotendinous injury to the flexor-pronator muscle group, osteochondritis dissecans, or ulnar neuritis. The purpose of this paper is to (1) define the significance of elbow injuries in athletics, (2) review the anatomy and biomechanics of the elbow, and (3) discuss the prevention and treatment of elbow injuries.

Athletic Injuries↗
PubMed2004

Juvenile and adolescent elbow injuries in sports.

Elbow injuries in skeletally immature athletes continue to increase as juvenile and adolescent athletes participate in organized athletics at earlier ages and with greater intensity. Specialization in specific sports at younger ages has led to an increase in injuries related to repetitive microtrauma. As a result, the spectrum of injuries commonly seen in skeletally immature athletes has increased at a time when long-term outcomes and less invasive interventions with biologic principles are gaining greater attention. Optimal treatment of these injuries requires a knowledge of the complex developmental and radiographic anatomy, the pathophysiology and natural history, and the indications and expected outcomes for conservative and operative management.

Adolescent↗
PubMed1992

Elbow injuries in athletes.

Most elbow injuries carry an excellent prognosis for return to a given sport. Early identification of overuse injuries and joint contractures can deter bone deformities in later life. Early evaluation can deter severe complications such as that of neurovascular injury. Rehabilitation should not be considered complete until there has been maximal restoration and correction of technique and accuracy in addition to the issue of soft-tissue healing.

Athletic Injuries↗
PubMed1985

Elbow injuries in gymnastics.

The medical literature contains little about elbow injuries in gymnastics. However, 30 females with 32 elbow injuries from gymnastics were found and studied. Two had Panner's disease (osteochondritis of the humeral capitellum), and all the others had fractures or dislocations. The majority required open or closed procedures. Recommendations to help reduce elbow injuries would include the use of experienced spotters, thicker pads whenever possible, and education of gymnasts in techniques of falling. After injury has occurred immobilization of the elbow for as short a period as necessary and follow-up therapy in a sports-oriented setting are recommended.

Adolescent↗
PubMed1996

Elbow injuries to the throwing athlete.

Elbow injuries in the throwing athlete are common. Because of the tremendous medial tensile forces and lateral compressive forces borne by the elbow, there is a wide array of injuries that occur. A detailed history and physical examination are necessary for an accurate diagnosis. Many of the injuries discussed can be treated successfully with conservative measures followed by aggressive physical therapy. Prompt recognition and early treatment is mandatory. In those conditions in which conservative treatment tends to fail, the detailed surgical options have been discussed. It is important to select highly motivated patients for those procedures that require extensive rehabilitation postoperatively. The keys to success in elbow surgery are a compliant patient and a well-regimented rehabilitation program.

Athletic Injuries↗
PubMed2005

Distal radioulnar joint dislocation in association with elbow injuries.

Traumatic distal radioulnar joint (DRUJ) dislocation with or without an associated fracture is a rare injury. When coupled with a radial head fracture this is commonly known as the Essex-Lopresti injury. We report two cases of elbow dislocation with ipsilateral radial neck fractures and associated true DRUJ dislocations. This has not been previously described in the literature. In elbow injuries with wrist involvement, symptoms in the latter may be subtle. Due to inadequate examination of the affected joint, poor initial radiographic views, and general rarity of this injury, distal radioulnar joint dislocations are frequently missed. We hope our experience illustrates the need to examine thoroughly the joint above and below the injured site, and to be aware of the potential for DRUJ instability in all patients with elbow injuries.

Adult↗
PubMedDate not supplied

Acute elbow injuries in the National Football League.

We performed a retrospective review to evaluate acute medial collateral ligament injuries of the elbow in professional football players from 1991 to 1996 (5 seasons). There were 5 acute medial collateral ligament injuries in 4 players (1 player with bilateral involvement). All injuries occurred with the hand planted on the playing surface while a valgus or hyperextension force was applied to the elbow. There were 2 centers, both involved with long-snapping situations, 1 running back, and 1 quarterback. All elbows had valgus instability on physical examination. Despite this instability, all players were able to function without operative reconstruction of the medial collateral ligament. No evidence of valgus instability was seen at the time of follow-up (average, 3.4 years). Next, we reviewed all acute elbow injuries in the National Football League from the same 5-season period. Ninety-one acute elbow injuries were reviewed. Overall, there were 70 (76.9%) elbow sprains, 16 (17.6%) dislocation/subluxation patterns, 4 (4.4%) fractures, and 1 (1.1%) miscellaneous injury. Review of the acute elbow sprains revealed 39 (55.7%) hyperextension injuries, 14 (20%) medial collateral ligament injuries, 2 (2.9%) lateral collateral ligament sprains, and 15 (21.4%) nonspecific sprains. The epidemiology of the 14 medial collateral ligament injuries was studied in more detail. The 2 most common mechanisms of injury were blocking at the line of scrimmage (50%) and the application of a valgus force with the hand planted on the playing surface (29%). There were 8 linemen, 4 receivers, 1 running back, and 1 quarterback. All injuries were managed with nonoperative treatment. The average time lost was 0.64 games (range, 0 to 4). We report 19 acute medial collateral ligament injuries of the elbow in elite football players, 2 of whom are considered overhead throwing athletes, who were able to function at a competitive level without surgical repair or reconstruction, in contrast to baseball players, in whom the mechanics and demands may differ.

Adult↗
PubMed1998

Functional outcomes of "floating elbow" injuries in adult patients.

OBJECTIVES: To assess elbow function, complications, and problems of floating elbow fractures in adults receiving surgical treatment. DESIGN: Retrospective clinical review. SETTING: Level I trauma center in Kanagawa, Japan. PATIENTS: Fourteen patients with fifteen floating elbow injuries, excluding one immediate amputation, seen at the Kitasato University Hospital from January 1, 1984, to April 30, 1995. INTERVENTION: All fractures were managed surgically by various methods. In ten cases, the humeral and forearm fractures were treated simultaneously with immediate fixation. In three cases, both the humeral and forearm fractures were treated with delayed fixation on Day 1, 4, or 7. In the remaining two cases, the open forearm fracture was managed with immediate fixation and the humerus fracture with delayed fixation on Day 10 or 25. MAIN OUTCOME MEASUREMENTS: All subjects underwent standardized elbow evaluations, and results were compared with an elbow score based on a 100-point scale. The parameters evaluated were pain, motion, elbow and grip strength, and function during daily activities. Complications such as infections, nonunions, malunions, and refractures were investigated. RESULTS: Mean follow-up was forty-three months (range 13 to 112 months). At final follow-up, the mean elbow function score was 79 points, with 67 percent (ten of fifteen) of the subjects having good or excellent results. The functional outcome did not correlate with the Injury Severity Score of the individual patients, the existence of open injuries or neurovascular injuries, or the timing of surgery. There were one deep infection, two nonunions of the humerus, two nonunions of the forearm, one varus deformity of the humerus, and one forearm refracture. CONCLUSION: Based on the present data, we could not clarify the factors influencing the final functional outcome after floating elbow injury. These injuries, however, potentially have many complications, such as infection or nonunion, especially when there is associated brachial plexus injury. We consider that floating elbow injuries are severe injuries and that surgical stabilization is needed; beyond that, there are no specific forms of surgical treatment to reliably guarantee excellent results.

Activities of Daily Living↗
PubMed2005

Complex pediatric elbow injury: an uncommon case.

BACKGROUND: There is paucity of literature describing complex elbow trauma in the pediatric population. We described a case of an uncommon pediatric elbow injury comprised of lateral condyle fracture associated with posterolateral dislocation of elbow. CASE PRESENTATION: A 12-year-old boy sustained a direct elbow trauma and presented with Milch type II lateral condyle fracture associated with posterolateral dislocation of elbow. Elbow dislocation was managed by closed reduction. The elbow stability was assessed under general anaesthesia, followed by open K-wiring for the lateral condylar fracture fixation. The patient had an uneventful recovery with an excellent outcome at 39 months follow-up. CONCLUSION: Complex pediatric elbow injuries are quite unusual to encounter, the management of such fractures can be technically demanding. Concomitant elbow dislocation should be managed by closed reduction followed by open reduction and internal fixation (K-wires or cannulated screws) of the lateral condyle fracture.

Bone Wires↗
PubMedDate not supplied

[Ulnar groove syndrome following elbow injuries].

For a large scaled test 52 patients with anterior transposition of the ulnar nerve and 62 patients with elbow injuries were examined by questionnaire, physical examination and electroneurography. In conformity with existing literature 24 patients out of 52 suffering from cubital tunnel syndrome had an elbow trauma previously. To our great surprise in seven patients out of 46 with elbow injuries a cubital tunnel syndrome could be found for the first time. The cubital tunnel syndrome appears to be a frequent complication of elbow injuries. Besides the well known fractures of the medial epicondyle and pericondylar fractures leading to cubital tunnel syndrome, in our study fractures of the head of the radius and processus coronoideus were found quite often. Patients having typical anamnesis and complaints should be checked by electroneurography in order to permit a quick operation and to prevent incurable damages of the nerve. The diagnosis leading to operation of the elbow should however be made with greatest care. In case the operation is unavoidable, the ulnar nerve should be thoroughly checked and anterior transposition should be carried out.

Adult↗