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https://www.readbyqxmd.com/read/29201310/a-neglected-markedly-displaced-medial-epicondyle-fracture-with-simultaneous-ulnar-nerve-palsy-in-an-adolescent
#1
Tamer Ahmed El-Sobky, John Fathy Haleem, Hossam Moussa Sakr, Ahmad Saeed Aly
Humeral medial epicondyle fractures constitute around 15% of pediatric elbow fractures. Up to 60% occur in association with elbow dislocations. Knowledge of potential imaging pitfalls when examining acute elbow fractures in children contributes significantly to accurate diagnosis. Nevertheless, management of missed pediatric medial epicondyle fractures has rarely been reported. We present an 11-year-old boy with a neglected and severely displaced medial epicondyle fracture with concurrent ulnar nerve palsy...
December 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/29201306/analysis-of-radiographic-parameters-of-the-forearm-in-traumatic-radial-head-dislocation
#2
Hui Taek Kim, Le Viet Can, Tae Young Ahn, In Hee Kim
Background: Various deformities can occur in the forearm bones when the traumatically dislocated radial head is untreated for a long period. Without correction of all deformities, reduction of the dislocated radial head is difficult to maintain, and forearm and elbow motion will deteriorate after reduction. We evaluated radiographic parameters of forearms with traumatically dislocated radial heads (and of the normal sides) to understand the resulting deformities and the effectiveness of surgical treatment...
December 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/29197943/two-stage-revision-of-infected-shoulder-arthroplasty-using-prosthesis-of-antibiotic-loaded-acrylic-cement-minimum-three-year-follow-up
#3
Sung Hyun Lee, Se Jin Kim, Seng Hwan Kook, Jeong Woo Kim
PURPOSE: This study aimed to evaluate the clinical outcomes and persistent infection rate of two-stage revision of infected shoulder arthroplasty. METHODS: We enrolled 12 patients who developed an infection after undergoing shoulder arthroplasty between January 2009 and January 2014. They underwent a two-stage revision with PROSTALAC implantation and shoulder re-implantation in the first- and second-stage surgery, respectively. The mean follow-up period was 40.88 months (range, 36-52 months)...
December 2, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29181356/a-case-of-3-month-old-neglected-elbow-dislocation-managed-by-open-reduction-and-cruciate-ligament-reconstruction-using-tendon-graft
#4
Ganesh N Pundkar, Satish B Sonar, Omkar P Kulkarni
Introduction: Old neglected posterior type of elbow dislocations is not very common and generally requires open reduction. It was usually treated with open reduction and K-wire stabilization. We did a newer method in which in addition cruciate type ligament reconstruction; we have reconstructed lateral ulnar collateral ligament (LUCL) and UCL (medial collateral ligament) using semitendinosus graft. This allowed extra stability and early mobilization of the elbow joint. Authors report 3-month-old neglected posterior type of elbow dislocation without any fracture...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29177172/outcome-of-long-standing-ulno-humeral-dislocation-managed-by-open-reduction-and-stabilization-with-v-y-plasty-our-experience
#5
Vikram Khanna, Ashish Gupta, Sanjeev Kumar
Objective: To assess the outcome of long standing ulno-humeral dislocation managed by open reduction and stabilization with V-Y plasty. Methods: This cross sectional study included 14 patients with elbow dislocation that was more than 3 months without joint ankylosis, myositis ossificans or nerve injury. The surgical management not only included open reduction of the elbow joint, but also elongation of the triceps aponeurosis, collateral ligament repair along with the stabilization of the elbow joint...
October 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/29169720/treatment-of-radial-head-fractures-and-need-for-revision-procedures-at-1%C3%A2-and%C3%A2-2%C3%A2-years
#6
Eli S Kupperman, Asher I Kupperman, Scott A Mitchell
PURPOSE: Optimal treatment strategies for radial head fractures remain a subject of debate. We examined national practice patterns in the management of radial head fractures to determine rates of surgical treatment, type of surgery employed, and the incidence of reoperation. METHODS: Between 2007 and 2011, we identified patients with radial head fractures along with their associated injuries by International Classification of Diseases, Ninth Revision codes in a national database of orthopedic insurance records...
November 21, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29169599/elbow-fractures-with-instability-evaluation-and-treatment-strategies
#7
REVIEW
Neal C Chen
The treatment goals of elbow fracture dislocations are congruent reduction of the ulnohumeral and radiocapitellar joints, stable fixation of the proximal ulna, stable fixation or arthroplasty of the radial head, and soft tissue repair. Fracture dislocations occur in patterns, and recognition of these patterns help guide surgical treatment. In patients with persistently unstable fractures after standard fixation, additional temporary joint spanning implants are useful to protect repairs.
February 2018: Hand Clinics
https://www.readbyqxmd.com/read/29158650/partial-humeral-replacement-for-peri-prosthetic-fractures-of-the-humerus
#8
Ruben Manohara, Colin R Howie
Introduction: Treating peri-prosthetic fractures of the humerus can be very challenging, especially when there is poor bone stock and in the presence of adjacent joint prostheses. We discuss the option of a partial humeral replacement as a salvage procedure for such cases with some technical comments. Methods: This paper presents a technique which utilises a custom- made cemented connector to incorporate the existing well functioning elbow or shoulder replacement with a commercially available partial humeral replacement (PHR) or to an existing prosthetic humeral stem...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29157249/biomechanical-study-of-isolated-radial-head-dislocation
#9
Naoki Hayami, Shohei Omokawa, Akio Iida, Jirachart Kraisarin, Hisao Moritomo, Pasuk Mahakkanukrauh, Takamasa Shimizu, Kenji Kawamura, Yasuhito Tanaka
BACKGROUND: Isolated radial head dislocation is a rare injury with an unclear pathomechanism, and the treatment is controversial. The purpose of the present study was to investigate the biomechanical contributions of the annular ligament, quadrate ligament, interosseous membrane, and annular ligament reconstructions to proximal radioulnar joint stability. METHODS: Five fresh frozen cadaveric upper extremities were amputated above the elbow and solidly fixed on a customized jig...
November 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29154266/rehabilitation-of-neglected-monteggia-fracture-dislocations-in-children
#10
Azad Yıldırım, Kemal Nas
PURPOSE: There are limited studies related to the rehabilitation of neglected Monteggia fracture-dislocations. This study reports the results of the rehabilitation of neglected Monteggia fractures and dislocations and the best treatment options available. MATERIAL AND METHODS: Thirteen children were rehabilitated between 2009 and 2012. A retrospective chart review was conducted to record the following: age, gender, anatomic region of fractures, time delay from symptom onset to fracture, Bado classification, Mayo Elbow Performance Index (MEPI) which includes pain, range of motion and daily life comfort, surgeries, length of hospitalization, location and pattern of fracture, length of follow-up and complications...
November 6, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/29104742/mr-neurography-in-intraosseous-median-nerve-entrapment
#11
Ankita Aggarwal, Manisha Jana, Vijay Kumar, Deep Narayan Srivastava, Kanwaljeet Garg
Intraosseous entrapment of the median nerve is an uncommon complication of elbow dislocation and fractures. The condition is seen to occur in adolescent age group with a remote history of trauma. We report two rare cases of type 2 intraosseous median nerve entrapment. Though the diagnosis of median neuropathy is made with clinical tests and neurophysiological studies, however exact site of entrapment and presurgical mapping of nerve is done accurately with MR neurography. Imaging thus plays a pivotal role in management of this condition...
October 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/29100710/functional-outcomes-following-lateral-ulnar-collateral-ligament-reconstruction-for-symptomatic-posterolateral-rotatory-instability-of-the-elbow-in-an-athletic-population
#12
Marina J Rodriguez, Nicholas A Kusnezov, John C Dunn, Brian R Waterman, Kelly G Kilcoyne
HYPOTHESIS: The purpose of this investigation was to characterize the functional and surgical outcomes following lateral ulnar collateral ligament (LUCL) reconstruction for posterolateral rotatory instability in an athletic population. METHODS: All US military service members who underwent LUCL reconstruction between 2008 and 2013 were identified. A retrospective chart review was performed, and the prospective Mayo Elbow Performance Score and QuickDASH (short version of Disabilities of the Arm, Shoulder and Hand questionnaire) score were obtained...
October 31, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29051900/previous-rotator-cuff-repair-is-associated-with-inferior-clinical-outcomes-after-reverse-total-shoulder-arthroplasty
#13
Edward J W Shields, Denise M Koueiter, Tristan Maerz, Adam Schwark, J Michael Wiater
BACKGROUND: Although recent evidence suggests that any prior shoulder surgery may cause inferior shoulder arthroplasty outcomes, there is no consensus on whether previous rotator cuff repair (RCR) is associated with inferior outcomes after reverse total shoulder arthroplasty (RTSA). PURPOSE: To retrospectively compare outcomes in patients who underwent RTSA with and without previous RCR. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Patients with prior RCR and those without previous shoulder surgery (control) who underwent RTSA for cuff tear arthropathy or irreparable cuff tear were retrospectively identified from a prospective database...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29051873/median-nerve-entrapment-after-elbow-dislocation-and-the-role-of-ultrasonography-a-case-report
#14
Vivek Dubey, Ali Saify, Ashwin Samant, Sunil Shahane
INTRODUCTION: Median nerve entrapment in the cases of posterior dislocation of elbow is a rare entity. The diagnosis is usually delayed. We describe here a case of median nerve entrapment in the posteromedial dislocation of elbow in a 10-year-old male child and the role of ultrasonography (USG) in localizing the median nerve in the elbow. The nerve release was done by osteotomy of medial epicondyle. USG thus proved to be a useful tool in the management of nerve injury. CASE REPORT: The authors present here a case of 10-year-old child with a history of dislocation of right elbow that was reduced elsewhere and the child presented to us with stiffness and restriction of movements at the elbow with the features of high median nerve injury...
May 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29049267/variation-among-pediatric-orthopaedic-surgeons-when-treating-medial-epicondyle-fractures
#15
Meghan Hughes, Karan Dua, Nathan N O'Hara, Brian K Brighton, Theodore J Ganley, William L Hennrikus, Martin J Herman, Joshua E Hyman, J Todd Lawrence, Charles T Mehlman, Kenneth J Noonan, Norman Y Otsuka, Richard M Schwend, M Wade Shrader, Brian G Smith, Paul D Sponseller, Joshua M Abzug
BACKGROUND: Medial epicondyle fractures are a common pediatric and adolescent injury accounting for 11% to 20% of elbow fractures in this population. This purpose of this study was to determine the variability among pediatric orthopaedic surgeons when treating pediatric medial epicondyle fractures. METHODS: A discrete choice experiment was conducted to determine which patient and injury attributes influence the management of medial epicondyle fractures by pediatric orthopaedic surgeons...
October 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29023265/radial-head-resection-and-hemi-interposition-arthroplasty-in-patients-with-multiple-hereditary-exostoses-description-of-a-new-surgical-technique
#16
Mark Flipsen, John S Ham, Arnard L van der Zwan, Konrad Mader
Multiple hereditary exostoses (MHE) are a rare disorder characterized by the growth of bony protrusions. Elbow involvement is found in a considerable number of patients and varies from the presence of a simple osteochondroma to severe forearm deformities and radial head dislocation. Patients encounter a variety of symptoms, for example, pain, functional impairment, and cosmetic concerns. Several types of surgical procedures, therefore, can be offered, ranging from excision of symptomatic osteochondromas to challenging reconstructions...
October 11, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28988397/risk-factors-for-development-of-severe-post-traumatic-elbow-stiffness
#17
Wei Zheng, Jiazhi Liu, Jialin Song, Cunyi Fan
PURPOSE: The purpose of this study was to compare different grades of elbow stiffness and investigate demographic, injury, and treatment factors potentially associated with the development of severe elbow stiffness. METHODS: We performed a retrospective study involving 169 patients with post-traumatic elbow stiffness between June 2014 and June 2016. Patient demographics, injury, and treatment details were reviewed. Patients were classified into three groups according to the elbow motion...
October 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28987654/high-resolution-ultrasound-in-etiological-evaluation-of-ulnar-neuropathy-at-the-elbow
#18
Mathieu Schertz, Celine Mutschler, Emmanuel Masmejean, Jonathan Silvera
OBJECTIVE: Ulnar neuropathy at the elbow (UNE) involves mechanical compression and irritation of the ulnar nerve (UN) caused by environmental and dynamic abnormalities that can however also be found in asymptomatic patients. Using high-resolution ultrasound, we aimed to assess and compare the relevance of morphological and dynamic variants of the UN and its surrounding structures (UN abnormalities) in symptomatic and asymptomatic patients. METHOD: UN abnormalities in patients with UNE were assessed using high-resolution ultrasound and compared against unaffected arms (patients or healthy volunteers)...
October 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28971244/an-uncommon-variant-of-the-essex-lopresti-injury
#19
Mohamed Ali Kedous, Ahmed Msakni, Wael Chebbi, Mourad Zaraa, Mondher Mbarek
The Essex-Lopresti injury is an extremely rare condition combining radial head or neck fracture, distal radio-ulnar joint dislocation and rupture of the interosseous membrane. However, there are rare or unusual varieties or associated injuries. We report a case of a 46-year-old woman with a posterior dislocation of the radio-humeral joint, a radial shaft fracture, and a distal radio-ulnar joint dislocation. She underwent open reduction and internal fixation of the radial shaft fracture followed by an immobilization by a long elbow splint in supination for 6 weeks...
October 2, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28969224/neglected-type-i-monteggia-fracture-dislocation-in-adult
#20
Archit Agarwal, Inder Pawar
Neglected Monteggia fracture dislocation is one of the challenging case and it becomes more of a therapeutic dilemma especially in adults. Several surgical techniques are described and in spite of this complication rate following surgery is high. This report concerns with management of three-month-old monteggia fracture dislocation in a 30-year-old male. Patient presented with complete loss of movement at elbow. Patient was managed surgically, with internal fixation of ulna and reduction of radial head with radio-capitellar Kirschner wires...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
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