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Ulnar collateral ligament

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https://www.readbyqxmd.com/read/28807347/dorsoradial-instability-of-the-thumb-metacarpophalangeal-joint-a-biomechanical-investigation
#1
Byung-Sung Kim, Alex Doermann, Michelle McGarry, Masaki Akeda, Hansel Ihn, Thay Q Lee
PURPOSE: To define the role of the dorsal capsule and associated dorsal fibrocartilage (DFC) and their interactions with the radial collateral ligament (RCL) as a thumb metacarpophalangeal (MCP) joint stabilizer. METHODS: Eight cadaveric thumbs were mounted onto a custom jig with 20 N of muscle load applied. The thumb position in space was digitized to measure ulnar-radial, pronation-supination, and volar-dorsal laxity at 0°, 30°, and 60° MCP joint flexion. Serial sectioning was performed and measurements were repeated for the intact state, proper RCL insufficiency, proper and accessory (complete) RCL insufficiency, complete RCL with 50% DFC (radial) insufficiency, and complete RCL with complete DFC insufficiency...
August 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28806094/the-relationship-of-throwing-arm-mechanics-and-elbow-varus-torque-within-subject-variation-for-professional-baseball-pitchers-across-82-000-throws
#2
Christopher L Camp, Travis G Tubbs, Glenn S Fleisig, Joshua S Dines, David M Dines, David W Altchek, Brittany Dowling
BACKGROUND: Likely due to the high level of strain exerted across the elbow during the throwing motion, elbow injuries are on the rise in baseball. To identify at-risk athletes and guide postinjury return-to-throw programs, a better understanding of the variables that influence elbow varus torque is desired. PURPOSE: To describe the within-subject relationship between elbow varus torque and arm slot and arm rotation in professional baseball pitchers. STUDY DESIGN: Descriptive laboratory study...
August 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28781974/do-major-league-baseball-team-physicians-harvest-the-semitendinosus-from-the-drive-leg-or-landing-leg-when-performing-ulnar-collateral-ligament-reconstruction-on-elite-baseball-pitchers
#3
Brandon J Erickson, Peter N Chalmers, Jeffrey R Dugas, Bernard R Bach, Gregory P Nicholson, Nikhil N Verma, Christopher S Ahmad, Anthony A Romeo
BACKGROUND: Hamstring autograft is a common graft choice when performing ulnar collateral ligament reconstruction (UCLR). PURPOSE/HYPOTHESIS: The purpose of this study was to survey Major League Baseball (MLB) team physicians and determine whether these physicians harvest the hamstring (semitendinosus or gracilis) from the drive leg (ipsilateral to surgical site) or landing leg (contralateral to surgical site) when performing UCLR on elite-level pitchers. The hypothesis was that the majority of surgeons harvest the hamstring from the drive leg when performing a UCLR...
July 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28774254/can-physical-examination-create-a-stener-lesion
#4
Manesha Lankachandra, John P Eggers, James W Bogener, Richard L Hutchison
BACKGROUND: The purpose of this study is to determine whether a Stener lesion can be created while testing stability of the ulnar collateral ligament (UCL) of the thumb. Testing was performed in a manner that reproduced clinical examination. METHODS: Six fresh frozen hand and forearm specimens underwent sequential sectioning of the accessory UCL, the proper UCL, and the ulnar sagittal band. Measurements of radial deviation of the metacarpophalangeal (MCP) joint were taken with the thumb in neutral rotation, pronation and supination, both with 0 degrees and with 30 degrees of flexion of the MCP joint...
September 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28774189/variation-in-the-rate-of-surgery-for-ulnar-collateral-ligament-injury-of-the-metacarpophalangeal-joint-of-the-thumb
#5
Nicky Stoop, Teun Teunis, David Ring, Kyle R Eberlin
BACKGROUND: The indications for repair of rupture of the ulnar collateral ligament (UCL) of the metacarpophalangeal (MP) joint of the thumb are debated. We studied factors predictive of operative treatment. METHODS: In this retrospective study, we queried the research database from 3 affiliated urban hospitals in a single city in the United States and identified 383 patients with a thumb MP UCL injury. We recorded age, sex, treating surgeon, and whether or not a magnetic resonance imaging (MRI) was ordered...
November 1, 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28738083/the-influence-of-sex-and-trauma-impact-on-the-rupture-site-of-the-ulnar-collateral-ligament-of-the-thumb
#6
Sandra Boesmueller, Wolfgang Huf, Gregor Rettl, Falko Dahm, Alexander Meznik, Gabriela Muschitz, Hugo Kitzinger, Adam Bukaty, Christian Fialka, Martin Vierhapper
PURPOSE AND HYPOTHESIS: Although sex- and gender-specific analyses have been gaining more attention during the last years they have rarely been performed in orthopaedic literature. The primary purpose of this study was to investigate whether for injuries of the UCL the specific location of the rupture is influenced by sex. A secondary study question addressed the sex-independent effect of trauma intensity on the rupture site of the UCL. METHODS: This study is a retrospective analysis of all patients with either a proximal or distal bony avulsion or with a mid-substance tear or ligament avulsion of the UCL treated surgically between 1992 and 2015 at two level-I trauma centres...
2017: PloS One
https://www.readbyqxmd.com/read/28735845/anterior-and-posterior-bands-of-the-anterior-bundle-in-the-elbow-ulnar-collateral-ligament-ultrasound-anatomy
#7
Masahito Yoshida, Hideyuki Goto, Tetsuya Takenaga, Atsushi Tsuchiya, Katsumasa Sugimoto, Volker Musahl, Freddie Fu, Takanobu Otsuka
BACKGROUND: The anterior oblique bundle (AOL) of the ulnar collateral ligament (UCL) is composed of anterior and posterior bands. This study evaluated the anatomy of the anterior and posterior bands in the AOL of the UCL for their separate visualization with ultrasound (US). METHODS: We dissected 18 cadaveric elbow joints and recorded the direction of each band from the lateral view to determine the proper position for the US transducer. To determine the proper inclination of the transducer, we measured the inclinations of each band at the proximal and distal insertions from the transverse view...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28734533/changes-in-pitching-mechanics-after-ulnar-collateral-ligament-reconstruction-in-major-league-baseball-pitchers
#8
Daniel A Portney, Jake M Lazaroff, Lucas T Buchler, Stephen M Gryzlo, Matthew D Saltzman
BACKGROUND: Medial ulnar collateral ligament (UCL) reconstruction is a common procedure performed on Major League Baseball pitchers. Variations in pitching mechanics before and after UCL reconstructive surgery are not well understood. METHODS: Publicly available pitch tracking data (PITCHf/x) were compared for all Major League Baseball pitchers who underwent UCL reconstruction between 2008 and 2013. Specific parameters analyzed were fastball percentage, release location, velocity, and movement of each pitch type...
August 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28730863/non-operative-management-of-ulnar-collateral-ligament-injuries-in-the-throwing-athlete
#9
Mia Smucny, Robert W Westermann, Matthew Winters, Mark S Schickendantz
Medial ulnar collateral ligament (UCL) injuries have become increasingly prevalent in overhead athletes. The orthopaedic literature contains a wealth of information on operative management of these injuries. However, there are few high-quality longitudinal studies on non-operative care of UCL injuries. The purpose of this review is to describe the non-operative approach to managing UCL injuries, including recommended rehabilitation strategies and predictors of successful non-operative treatment.
July 21, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28719556/inadvertent-harvest-of-the-median-nerve-instead-of-the-palmaris-longus-tendon
#10
Bruce M Leslie, A Lee Osterman, Scott W Wolfe
BACKGROUND: The palmaris longus tendon is frequently used as a tendon graft or ligament replacement. In rare instances the median nerve has been inadvertently harvested instead of the palmaris longus for use as a tendon. METHODS: Nineteen cases in which the median nerve had been mistakenly harvested instead of the palmaris longus tendon were collected from members of the American Society for Surgery of the Hand (ASSH) Listserve. Surgeons involved in the subsequent care of the subject who had had an inadvertent harvest were contacted or the chart was reviewed...
July 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28711411/efficacy-of-a-radial-based-thumb-metacarpophalangeal-stabilizing-orthosis-for-protecting-the-thumb-metacarpophalangeal-joint-ulnar-collateral-ligament
#11
Joseph A Gil, Kerry Ebert, Keri Blanchard, Avi D Goodman, Joseph J Crisco, Julia A Katarincic
STUDY DESIGN: Basic research (biomechanics). INTRODUCTION: The high degree of motion that occurs at the thumb metacarpophalangeal (MCP) joint must be taken into account when immobilizing a partially torn or repaired thumb ulnar collateral ligament. PURPOSE OF THE STUDY: To determine the efficacy of a radial-based thumb MCP-stabilizing orthosis in resisting abduction across the thumb ulnar collateral ligament. METHODS: Ten fresh cadaveric hands were mounted to a custom board...
July 12, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28666051/multimodality-approach-to-a-stener-lesion-radiographic-ultrasound-magnetic-resonance-imaging-and-surgical-correlation
#12
Jonathan Tresley, Adam D Singer, Elizabeth A Ouellette, Jason Blaichman, Paul D Clifford
The ulnar collateral ligament (UCL) of the thumb metacarpophalangeal joint is a static stabilizer that may rupture from a hyperabduction injury. Although some UCL tears may heal with immobilization, outcomes are worse for Stener lesions, in which the proximal ligament stump slips out from beneath the adductor pollicis aponeurosis and is entrapped proximal and superficial to the aponeurosis, preventing primary healing. We report the case of a patient with a Stener lesion with radiographic, ultrasound, and magnetic resonance imaging correlation, subsequently confirmed with intraoperative photographs...
May 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28655630/a-novel-anterior-approach-for-the-fixation-of-ulnar-coronoid-process-fractures
#13
Xiaohua Yang, Wenli Chang, Wei Chen, Song Liu, Yanbin Zhu, Yingze Zhang
BACKGROUND: There is no universally accepted approachto the elbow for the fixation of coronoid process fractures.This study aims to introduce a novel anterior surgicalapproach for the fixation of the ulnar coronoid fracture, with minimal surgical dissection damage and excellent visualization for reduction and internal fixation. HYPOTHESIS: The anterior approach can facilitatesatisfactory outcomesfor coronoid process fractures. MATERIAL AND METHODS: From February 2010 to July 2014, 12 patients (8 males and 4 females; range 14-62 years; mean age 31 years) with a closed fracture of the coronoid process of the ulna were included in this study...
June 24, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28637998/reinvestigation-of-the-morphological-characteristics-of-the-lateral-ulnar-collateral-ligament-in-humans
#14
Karen Tokunaga, Kotaro Sato, Goro Tajima, Jun Yan, Yoshikuni Mimata, Katsumi Tajima, Yuki Kikuchi, Minoru Doita
To clarify the cause of posterolateral rotatory instability after damage to the lateral ulnar collateral ligament (LUCL), the morphological characteristics of the LUCL were reinvestigated and three-dimensional (3D) image of the ligament was reconstructed using 35 human elbows. The results were as follows: 1) the insertion point of the LUCL on the humerus was almost at the center of the capitellum, and its width was 2.61 ± 1.02 mm. The insertion point of the LUCL on the ulna was located from the lesser sigmoid notch to the supinator crest and had a width of 9...
2017: Okajimas Folia Anatomica Japonica
https://www.readbyqxmd.com/read/28636299/-sprain-of-the-thumb-metacarpal-phalangeal-with-lesion-of-the-ulnar-collateral-ligament
#15
Thibault Poujade, Grégoire Chick
The sprain of the thumb metacarpal-phalangeal joint must be treated in an adapted way in order to avoid chronic laxity. The comparative and bilateral clinical exam is the main element that will allow to detect laxity. In the case of non laxity, a conservative treatment with a splint makes sense. In the case of laxity with Stener effect, a surgical procedure is recommended in order to reintegrate the collateral ligament. In the case of laxity without Stener effect, the choice of treatment is contentious. A US or MRI would be useful if the Stener effect could be underlying...
May 17, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28634742/outcomes-of-coronoid-first-repair-in-terrible-triad-injuries-of-the-elbow
#16
Junren Zhang, Mark Tan, Ernest Beng Kee Kwek
BACKGROUND: Clinical outcomes of terrible triad injuries (TTIs) of the elbow are historically poor. To date, it is still debatable whether the coronoid needs to be fixed and if so, how and in which sequence. METHODOLOGY: Between 2010 and 2013, 13 patients were treated surgically for acute TTIs of the elbow at a Tertiary Level 1 Trauma Centre by a single surgeon, using a standardized protocol, which included coronoid-brachialis complex fixation via pull-through trans-osseous sutures, radial head fixation or prosthetic replacement and a repair of the lateral ulnar collateral ligament...
June 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28608150/-arthroscopy-of-the-proximal-interphalangeal-joint
#17
N Borisch
OBJECTIVE: Pain reduction in the affected proximal interphalangeal joint (PIP joint) by synovectomy, loose body extraction, dorsal arthrolysis. INDICATIONS: Therapy-resistant synovitis in rheumatoid arthritis (RA), early stage primary and secondary degenerative arthritis, loose bodies, capsular contracture. CONTRAINDICATIONS: Established biomechanic changes in RA (boutonniere and swanneck deformity). Large dorsal synovial cysts. Advanced radiologic changes in degenerative arthritis...
August 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28607764/chronic-medial-instability-of-the-elbow
#18
REVIEW
Felix H Savoie, Michael O'Brien
Damage to the medial collateral ligament of the elbow from an instability episode usually heals with non-operative treatment. In some cases, residual instability may occur, leading to functional impairment.Non-operative management can be successful when bracing, taping and therapy are used to stabilise the elbow.A recent report detailing the efficacy of platelet-rich plasma in effectively treating ulnar collateral ligament (UCL) injuries in throwers has shown promise. However, there remain specific groups that should be considered for repair or reconstruction...
January 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28555250/ultrasound-biomechanical-anatomy-of-the-soft-structures-in-relation-to-the-ulnar-nerve-in-the-cubital-tunnel-of-the-elbow
#19
Paul Michelin, Grégoire Leleup, Mourad Ould-Slimane, Marie Caroline Merlet, Benjamin Dubourg, Fabrice Duparc
BACKGROUND: Chronic ulnar nerve entrapment worsened by elbow flexion is the most common injury, but rare painful conditions may also be related to ulnar nerve instability. The posterior bundle of the medial collateral ligament (pMCL) and the retinaculum, respectively form a soft floor and a ceiling for the cubital tunnel. The aim of our study was to dynamically assess these soft structures of the cubital tunnel focusing on those involved in the biomechanics of the ulnar nerve. METHODS: Forty healthy volunteers had a bilateral ultrasonography of the cubital tunnel...
May 29, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28532867/ultrasound-study-of-elbow-ulnar-collateral-ligament-changes-in-collegiate-baseball-players-a-pilot-study
#20
Johnathan Erb, Heather Sherman, Sydney Williard, Julien Bui, Aimie Kachingwe
OBJECTIVE: To assess changes in elbow ulnar collateral ligament length in college baseball pitchers over the course of a single season. DESIGN: Cohort Feasibility Study. METHODS: Diagnostic ultrasound was used to assess both the dominant and non-dominant medial elbow joint space in four pitchers and five fielders and compared to in-game pitching data. Shoulder, elbow, wrist, hip, knee, and ankle range of motion measurements were also taken...
April 2017: Journal of Bodywork and Movement Therapies
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