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Lateral collateral ligament elbow

Brian C Lau, Nirav K Pandya
BACKGROUND: There are excellent data supporting recommendations to prevent elbow injuries (osteochondritis dissecans [OCD] and ulnar collateral ligament [UCL] injuries), such as pitch count and pitch type in baseball, but anatomic risk factors have not been thoroughly examined. This study aimed to evaluate radiographic measurements in adolescents with elbow OCD lesions or UCL injuries and controls. METHODS: We retrospectively identified adolescent patients between 2011 and 2016 with isolated capitellum OCD, UCL tear, or normal elbows based on magnetic resonance imaging...
January 10, 2017: Journal of Shoulder and Elbow Surgery
Christopher Fenelon, Muhammed M Zafar, Gerard Anthony Sheridan, Stephen Kearns
Posterolateral dislocation of the elbow is an injury commonly treated in the emergency department by closed reduction. Very rarely it can be irreducible and require open reduction. Only four cases of irreducible posterolateral elbow dislocation have been described in the literature over the past 50 years. We report the case of a 20-year-old man who sustained such an injury. Open reduction was performed and revealed the radial head protruding or 'buttonholing' through the lateral collateral ligament complex...
December 30, 2016: BMJ Case Reports
Y Li, Y J Cha, T Li, M Q Gong, X Y Jiang
OBJECTIVE: To treat the coronal shear fracture of the distal humeral during open reduction and internal fixation by anterolateral approach and lateral approach, and to analyze the advantage and disadvantage of each approach. METHODS: From September 2006 to July 2014, 10 patients with coronal fracture of the distal humeral were analyzed, who were all treated with Open Reduction and Internal Fixation (ORIF), 5 with anterolateral approach (group A) and 5 with lateral approach (group B)...
December 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Ranita H K Manocha, Jonathan R Kusins, James A Johnson, Graham J W King
BACKGROUND: Elbow lateral collateral ligament (LCL) injury may arise after trauma or lateral surgical approaches. The optimal method of rehabilitating the LCL-insufficient elbow is unclear. Therapists often prescribe active motion exercises with the forearm pronated. Recently, overhead exercises have become popular as they may enable gravity to compress the elbow joint, improving stability, although this has not been proved biomechanically. This investigation aimed to quantify the effects of several variables used in LCL injury rehabilitation on elbow stability...
November 22, 2016: Journal of Shoulder and Elbow Surgery
D Broekhuis, J H J M Bessems, J W Colaris
The treatment of elbow injuries can be challenging because of the complexity of both anatomy and pathology. We present a rare traumatic avulsion fracture of the supinator crest of the ulna in a 37-year-old patient. Conservative treatment in a long arm cast for four weeks led to satisfactory results. Reproduction of the fracture on a cadaveric elbow clarified that the avulsed fragment holds the insertion of the lateral ulnar collateral ligament (LUCL). The mechanism of trauma that causes this fracture is a posterolateral (sub) luxation of the elbow, which usually causes the LUCL to rupture, but in rare cases the insertion of this ligament can be avulsed...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Taku Hatta, Shingo Nobuta, Toshitake Aizawa, Koichi Sasajima, Soichi Nakajima, Masahito Honda, Gosuke Oki, Yoshiaki Yamanaka, Eiji Itoi
The aim of our study is to evaluate the clinical and radiologic outcomes in patients with terrible triad injury, who underwent surgical treatment with or without the medial collateral ligament (MCL) repair. Fourteen patients who underwent surgery with a minimum of 12-month follow-up (mean, 17 months) were reviewed. Based on the systematic treatment protocol, radial head fracture, lateral collateral ligament, and coracoid fracture were treated. Subsequently, torn MCL was repaired in 7 patients, whereas in the remaining 7 patients, the MCL was not treated...
September 19, 2016: Orthopedic Reviews
H Mike Kim, Colin R Andrews, Evan P Roush, Gregory I Pace, Gregory S Lewis
BACKGROUND: Double-strand lateral ulnar collateral ligament (LUCL) reconstruction is an effective treatment for posterolateral rotatory instability (PLRI) of the elbow, but anatomic landmarks for ulnar tunnel placement are often difficult to identify intraoperatively, which potentially can result in a nonanatomic LUCL reconstruction. This study investigated the effect of ulnar tunnel location on joint stability in double-strand LUCL reconstruction. METHODS: PLRI was artificially created in 7 cadaveric elbows, and double-strand LUCL reconstruction was performed...
March 2017: Journal of Shoulder and Elbow Surgery
K Gharanizadeh, F N Mazhar, N Molavy, A Bagherifard, H Shariatzadeh
This study reports the clinical presentations, intra -operative findings, type of the treatments, outcome of the treatment and specially associated injuries in patients with the avulsion of the distal end of the triceps brachii (TB) tendon. We studied 6 patients with rupture or avulsion of the distal end of the TB tendon. The medical records, imaging files, clinical outcomes at the final follow up visit were reviewed. The clinical outcomes were assessed by Mayo Elbow Score at the final follow-up visit. All patients were male, 4 of them having injury in the left hand as the non-dominant hand...
August 2016: Acta Orthopaedica Belgica
M Hackl, T Leschinger, L P Müller, K Wegmann
BACKGROUND: Chronic ligamentous instability of the elbow is an important pathology as it is accompanied with pronounced dysfunction. Moreover, it represents an established risk factor for the development of osteoarthritis. Posterolateral rotatory instability (PLRI) caused by insufficiency of the lateral collateral ligament (LCL) is the most common type of chronic elbow instability and is usually a sequel of traumatic elbow dislocation. Chronic overload can lead to insufficiency of the ulnar collateral ligament (UCL) with subsequent valgus instability, especially in overhead athletes...
October 2016: Der Orthopäde
M Hackl, T Leschinger, C Ries, W F Neiss, L P Müller, K Wegmann
BACKGROUND: Chronic posterolateral rotatory instability (PLRI) of the elbow is the result of an insufficiency of the lateral collateral ligament (LCL). Lateral ulnar collateral ligament (LUCL) reconstruction represents a well-established treatment method for PLRI. However, recurrent instability remains a problem. OBJECTIVES: The goal of this in-vitro study was to evaluate the posterolateral rotatory stability of the intact elbow, after sectioning of the LCL and after LUCL reconstruction with a triceps tendon autograft and double BicepsButton(TM) fixation...
October 2016: Der Orthopäde
Jeong Woo Kim, Young Yi, Tae Kyun Kim, Hong Je Kang, Jong Yun Kim, Jong Myoung Lee, Kyu Hwan Bae, Min Su Joo
BACKGROUND: Lateral ulnar collateral ligament injury following unstable elbow dislocation can induce posterolateral rotatory instability that requires surgery. The aim of this study was to determine the effectiveness of arthroscopic repair of the lateral collateral ligament (LCL) complex in an unstable elbow joint. METHODS: The study group consisted of 13 patients who experienced posterolateral rotatory instability after an unstable elbow dislocation with an injury to the lateral ulnar collateral ligament...
August 3, 2016: Journal of Bone and Joint Surgery. American Volume
Femke M A P Claessen, Amir R Kachooei, Gregory P Kolovich, Geert A Buijze, Luke S Oh, Michel P J van den Bekerom, Job N Doornberg
PURPOSE: In this anatomical cadaver study, the distance between major nerves and ligaments at risk for injury and portal sites created by trainees was measured. Trainees, inexperienced in elbow arthroscopy, have received a didactic lecture and cadaver instruction prior to portal placement. The incidence of iatrogenic injury from novice portal placement was also determined. METHODS: Anterolateral, direct lateral, and anteromedial arthroscopic portals were created in ten cadavers by ten inexperienced trainees in elbow arthroscopy...
June 28, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Christopher L Camp, Shawn W O'Driscoll, Michael K Wempe, Jay Smith
BACKGROUND: Although clinical tests can detect posterolateral rotatory instability (PLRI) of the elbow, the ability of ultrasound to evaluate PLRI has not been assessed. OBJECTIVE: To determine whether increasing stages of posterolateral rotatory subluxation of the elbow could be assessed accurately with a sonographic posterolateral rotatory stress test. DESIGN: Cadaveric study. SETTING: Laboratory. PATIENTS: Ten, unpaired, cadaveric upper limbs...
June 16, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
C J Bodaan, C B Riley, E Engeli
The objectives of this study were to evaluate the likelihood of successful arthrocentesis of the equine elbow joint using the caudolateral approach and to determine if the deep branch of the radial nerve (DBRN) varies in its proximity to the site of centesis. Methylene blue (MB) was injected into 71 elbow joint specimens immediately caudal to the lateral collateral ligament using a 3.8-cm needle advanced to its hub. The elbow joints were dissected, staining of the synovial structures assessed and the proximity of DBRN to the site of centesis evaluated...
August 13, 2016: Veterinary Record
Aashay L Kekatpure, Iman Widya Aminata, In-Ho Jeon, In-Hyeok Rhyou, Hyun-Joo Lee, Jae-Myeung Chun
BACKGROUND: Ligamentous injury associated with isolated coronoid fracture had been sparingly reported. Concealed or unclear fractures and ligamentous or articular cartilage lesions are promptly acknowledged by magnetic resonance imaging (MRI) but cannot be entirely pictured in regular radiological assessments. In isolated coronoid fracture, the fragment size is very small and due to the complex anatomy surrounding the coronoid radiographic imaging may not be sufficient. The purpose of this study was to evaluate the incidence of combined osteochondral and ligamentous injuries by magnetic resonance imaging (MRI) in 24 patients with an isolated coronoid fracture...
May 2016: Indian Journal of Orthopaedics
Dave R Shukla, Elan Golan, Philip Nasser, Maya Culbertson, Michael Hausman
BACKGROUND: There has been a renewed interest in the pathomechanics of elbow dislocation, with recent literature having suggested that the medial ulnar collateral ligament is more often disrupted in dislocations than the lateral ligamentous complex. The purpose of this serial sectioning study was to determine the influence of the posterior bundle of the medial ulnar collateral ligament (pMUCL) as a stabilizer against elbow dislocation. METHODS: An elbow dislocation was simulated in 5 cadaveric elbows by mechanically applying an external rotation moment and valgus force...
November 2016: Journal of Shoulder and Elbow Surgery
You Zhang, Shiqing Liu, Hongbin Zhou, Xiaorong Qin, Xiangwei Zhang
OBJECTIVE: To investigate the feasibility of modified classification of terrible triad of the elbow and the effectiveness of treatment strategy which was chosen by modified classification results. METHODS: Between March 2007 and November 2013, 12 cases of terrible triad of the elbow were treated by operation. There were 5 males and 7 females with an average age of 37.2 years (range, 26-74 years). The mechanism of injury was falling from height in 8 cases and traffic accident in 4 cases...
March 2016: Chinese Journal of Reparative and Reconstructive Surgery
M Hackl, M Bercher, K Wegmann, L P Müller, J Dargel
INTRODUCTION: The aim of this study was to analyze the functional anatomy of the lateral collateral ligament complex (LCLC) and the surrounding forearm extensors. MATERIALS AND METHODS: Using 81 human cadaveric upper extremities, the anatomy of the forearm extensors-especially the anconeus, supinator and extensor carpi ulnaris (ECU)-was analyzed. After removal of aforementioned extensors the functional anatomy of the LCLC was analyzed. The origin of the LCLC was evaluated for isometry...
July 2016: Archives of Orthopaedic and Trauma Surgery
Catherine J Fedorka, Luke S Oh
Posterolateral rotatory instability of the elbow is often caused by a complex injury to the lateral ulnar collateral ligament complex. This often leads to chronic mechanical symptoms of instability and pain. Surgical repair or reconstruction of the ligament is often required to stabilize the radiocapitellar joint. Multiple techniques have been described in the literature for repair or reconstruction of the lateral ligamentous complex with overall good clinical outcomes.
June 2016: Current Reviews in Musculoskeletal Medicine
Mehmet Hakan Özsoy, Metin Işık, Abdurrahman Sakaoğulları, Hacı Mustafa Özdemir, Mehmet Yücel, Veysel Ercan Dincel
OBJECTIVE: The purpose of this study was to evaluate the results of a new reconstruction with anconeus interposition arthroplasty in acute multiligamentous elbow injuries with irreparable radial head fractures. METHODS: Five patients (3 males, 2 females) with a mean age of 42.6 years who underwent reconstruction with anconeus arhtroplasty were evaluated. With lateral approach, lateral capsuloligamentous structures were repaired, the radial head was excised, and anconeus interposition arthroplasty was performed...
2016: Acta Orthopaedica et Traumatologica Turcica
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