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Elbow instability

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https://www.readbyqxmd.com/read/27904726/the-influence-of-arthroscopic-remplissage-for-engaging-hill-sachs-lesions-combined-with-bankart-repair-on-redislocation-and-shoulder-function-compared-with-bankart-repair-alone
#1
Sang-Hun Ko, Jae-Ryong Cha, Chae-Chil Lee, Il-Yeong Hwang, Chang-Gyu Choe, Min-Seok Kim
BACKGROUND: Recurrence of glenohumeral dislocation after arthroscopic Bankart repair can be associated with a large osseous defect in the posterosuperior part of the humeral head. Our hypothesis is that remplissage is more effective to prevent recurrence of glenohumeral instability without a severe motion deficit. METHODS: Engaging Hill-Sachs lesions were observed in 48 of 737 patients (6.5%). Twenty-four patients underwent arthroscopic Bankart repair combined with remplissage (group I) and the other 24 patients underwent arthroscopic Bankart repair alone (group II)...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27900709/double-locking-precontoured-plating-system-for-malunited-fractures-of-the-distal-end-of-humerus
#2
L Tarallo, R Mugnai, M Rocchi, C Rovesta, F Catani
BACKGROUND: Distal humeral malunions are uncommon injuries, often associated with limited elbow motion, pain, instability, weakness, and sometimes ulnar neuritis. The complex anatomy of the elbow joint makes this condition one of the most complex elbow injuries to treat. MATERIALS AND METHODS: Four patients were treated by the same surgeon between 2011 and 2013 using a double-locking precontoured plating system for malunited intra-articular or extra-articular fractures of the distal end of the humerus...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27900701/elbow-instability-are-we-able-to-classify-it-review-of-the-literature-and-proposal-of-an-all-inclusive-classification-system
#3
REVIEW
A Marinelli, E Guerra, R Rotini
BACKGROUND: In the recent years, considerable improvements have come in biomechanical knowledge about the role of elbow stabilizers. In particular, the complex interactions among the different stabilizers when injured at the same time have been better understood. Anyway, uncertainties about both nomenclature and classification still exist in the definition of the different patterns of instability. MATERIAL AND METHODS: The authors examine the literature of the last 130 years about elbow instability classification, analyzing the intuitions and the value of each of them...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27900307/arthroscopic-fixation-of-coronoid-process-fractures-through-coronoid-tunnelling-and-capsular-plication
#4
Paolo Arrigoni, Riccardo D'Ambrosi, Davide Cucchi, Simone Nicoletti, Enrico Guerra
PURPOSE: the purpose of this study is to describe a new arthroscopic technique for reduction and fixation of coronoid process fractures (CPFs) and report clinical and functional results in 4 patients after a 24-month follow-up. METHODS: four patients underwent arthroscopic reduction and fixation of isolated CPFs (acute or non-unions, type I or type II according to the Regan-Morrey classification) performed using a new technique based on coronoid tunnelling and capsular plication...
July 2016: Joints
https://www.readbyqxmd.com/read/27886840/elbow-dislocations-in-contact-sports
#5
REVIEW
Mark S Morris, Kagan Ozer
Elbow dislocations are more common in athletes than in the general population. Simple elbow dislocations should be managed with early range of motion and early return to sport, even with high-level contact athletes. Patients with instability on examination or with complex elbow dislocations may require surgical intervention. Overall, the outcomes after simple elbow dislocations are excellent and athletes should be able to return to play without significant limitations.
February 2017: Hand Clinics
https://www.readbyqxmd.com/read/27876488/arthroscopic-subscapularis-augmentation-of-bankart-repair-in-chronic-anterior-shoulder-instability-with-bone-loss-less-than-25-and-capsular-deficiency-clinical-multicenter-study
#6
Marco Maiotti, Carlo Massoni, Raffaele Russo, Steffen Schroter, Antonio Zanini, Diana Bianchedi
PURPOSE: To assess the short-term outcomes of the arthroscopic subscapularis augmentation (ASA) technique, consisting of a tenodesis of the upper third of the subscapularis tendon and a Bankart repair, and its effect on shoulder external rotation. METHODS: Patients selected for this study were involved in contact sports, with a history of traumatic recurrent shoulder dislocations and a minimum of 2-year follow-up. Inclusion criteria were patients with glenoid bone loss (GBL) ranging from 5% to 25%, anterior capsular deficiency, and Hill-Sachs lesion who underwent ASA technique...
November 19, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27872125/results-of-arthroscopic-bankart-repair-for-anterior-inferior-shoulder-instability-at-13-year-follow-up
#7
Mohamed Aboalata, Johannes E Plath, Gernot Seppel, Julia Juretzko, Stephan Vogt, Andreas B Imhoff
BACKGROUND: Anterior-inferior shoulder instability is a common injury in young patients, particularly those practicing overhead-throwing sports. Long-term results after open procedures are well studied and evaluated. However, the long-term results after arthroscopic repair and risk factors of recurrence require further assessment. HYPOTHESIS: Arthroscopic Bankart repair results are comparable with those of open repair as described in the literature. STUDY DESIGN: Case series; Level of evidence, 4...
November 21, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27825706/avulsion-fracture-of-the-supinator-crest-as-an-indication-for-a-sustained-posterolateral-sub-luxation-of-the-elbow-a-case-report-anatomical-evaluation-and-review-of-the-literature
#8
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...
November 4, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27824796/the-use-of-a-transolecranon-pin-in-the-treatment-of-pediatric-flexion-type-supracondylar-humerus-fractures
#9
Brandon M Green, Joseph D Stone, Robert W Bruce, Nicholas D Fletcher
BACKGROUND: Flexion-type supracondylar humerus fractures are much more uncommon than their extension-type counterparts. Instability in elbow flexion renders traditional closed techniques inadequate and often results in the need for open reduction. We present a simple technique for closed reduction using a transolecranon pin for temporary stability. METHODS: A retrospective review of 9 patients treated with a transolecranon pin technique for a flexion-type supracondylar humerus fracture was performed...
November 7, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27822697/annular-ligament-reconstruction-with-the-superficial-head-of-the-brachialis-surgical-technique-and-biomechanical-evaluation
#10
Michael Hackl, Kilian Wegmann, Christian Ries, Sebastian Lappen, Martin Scaal, Lars Peter Müller
PURPOSE: The purpose of this study was to perform biomechanical testing of annular ligament (AL) reconstruction using the superficial head of the brachialis tendon (SHBT) as a distally based tendon graft. We hypothesized that posterior translation of the radial head following AL reconstruction with an SHBT graft does not significantly differ from intact specimens. METHODS: Six fresh-frozen elbow specimens were used. The stability of the radial head against posterior translation forces (30 N) was evaluated in 0°, 45°, 90° and 120° of elbow flexion...
November 7, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27814945/reconstruction-of-medial-collateral-ligament-defects-with-a-flexor-pronator-fascia-patch-in-complete-open-release-of-stiff-elbows
#11
Shuai Chen, Hede Yan, Wei Wang, Mei Zhang, Kevin A Hildebrand, Cun-Yi Fan
BACKGROUND: Because medial elbow stability is essential for stiff elbow release, surgical techniques have been reported for reconstructing medial elbow stability. However, medial collateral ligament (MCL) defects, caused by inevitable detachment and resection performed for complete release, make the reconstruction more challenging. To our knowledge, no study has evaluated the outcomes after using a flexor-pronator fascia patch in medial elbow reconstruction for open release of stiff elbows...
November 2, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27811520/shoulder-and-elbow-injuries-in-the-adolescent-athlete
#12
Mia Smucny, Joel Kolmodin, Paul Saluan
With the recent increase in youth sports participation and single-sport youth athletes over the past 30 years, there has been an increase in the number of acute and overuse sports injuries in this population. This review focuses on overuse and traumatic injuries of the shoulder and elbow in young athletes. In particular we discuss little league shoulder, glenohumeral internal rotation deficit, glenohumeral instability, superior labrum anterior posterior lesions, Little League elbow, Panner disease, osteochondritis dissecans of the capitellum, posteromedial elbow impingement, and posterolateral rotatory instability of the elbow...
December 2016: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/27791975/wide-decompression-may-render-the-ulnar-nerve-unstable-a-cadaveric-study
#13
Andrew P Hurvitz, Brian T Fitzgerald, Leo T Kroonen
The purpose of this study was to evaluate for ulnar nerve instability following incrementally widened in situ decompression. A standard release of the ulnar nerve was performed in 16 cadaveric elbows, extending from 7cm distal to the medial epicondyle, and then released proximally for a total of 10 cm in 2-cm increments. Eight of the 16 elbows (50%) displayed subluxation of the ulnar nerve following complete in situ decompression. The rate of subluxation was found to increase with increasing length of proximal decompression...
2016: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/27751721/coronoid-reconstruction-with-an-osteochondral-radial-head-graft
#14
Enrico Bellato, Roberto Rotini, Alessandro Marinelli, Enrico Guerra, Shawn W O'Driscoll
BACKGROUND: Chronic coronoid deficiency can occur subsequent to coronoid fracture malunion/nonunion or to coronoid hypoplasia or dysplasia resulting from injury during development. Several surgical options have been described to treat this difficult condition, but results are equivocal. We hypothesized that a modified coronoid reconstruction using a radial head osteochondral graft could restore elbow stability and congruity and that a technique involving rigid internal fixation would promote graft union...
October 14, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27745810/effect-of-ulnar-tunnel-location-on-elbow-stability-in-double-strand-lateral-collateral-ligament-reconstruction
#15
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...
October 10, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27727060/minimum-2-year-outcomes-and-return-to-sport-following-resection-arthroplasty-for-the-treatment-of-sternoclavicular-osteoarthritis
#16
J Christoph Katthagen, Dimitri S Tahal, Travis J Menge, Marilee P Horan, Peter J Millett
HYPOTHESIS: The aim of this study was to assess the effect of open resection arthroplasty for osteoarthritis of the sternoclavicular (SC) joint on pain levels, functional outcomes, and return to sport. METHODS: Patients from a single surgeon's practice who underwent open resection arthroplasty (maximum 10-mm resection) for SC osteoarthritis or prearthritic changes between November 2006 and November 2013 were retrospectively reviewed. This was an outcomes study with prospectively collected data...
October 7, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27727059/radiocapitellar-contact-characteristics-during-prosthetic-radial-head-subluxation
#17
Dipit Sahu, James S Fitzsimmons, Andrew R Thoreson, Kai-Nan An, Shawn W O'Driscoll
BACKGROUND: Metallic radial head prostheses are often used in the management of comminuted radial head fractures and elbow instability. We hypothesized that during radiocapitellar subluxation, the contact pressure characteristics of an anatomic radial head prosthesis will more closely mimic those of the native radial head compared with a monopolar circular or a bipolar circular radial head design. MATERIALS AND METHODS: With use of 6 fresh frozen cadaver elbows, mean radiocapitellar contact pressures, contact areas, and peak pressures of the native radial head were assessed at 0, 2, 4, and 6 mm of posterior subluxation...
October 7, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27717527/association-of-traumatic-and-atraumatic-posterior-shoulder-instability-with-glenoid-retroversion-and-outcomes-after-arthroscopic-capsulolabral-repair
#18
J Christoph Katthagen, Dimitri S Tahal, Scott R Montgomery, Marilee P Horan, Peter J Millett
PURPOSE: To compare glenoid retroversion and functional outcomes between patients with traumatic onset of posterior shoulder instability (PSI) and patients with atraumatic onset of PSI. METHODS: Patients with PSI who underwent arthroscopic posterior capsulolabral anchor repair, were active in sports, and had undergone surgery a minimum of 2 years earlier were included. Traumatic onset was defined as PSI that occurred after a trauma with the shoulder in adduction, flexion, and internal rotation in patients with no history of instability...
October 4, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27709875/common-errors-in-the-management-of-pediatric-supracondylar-humerus-fractures-and-lateral-condyle-fractures
#19
Gurpal S Pannu, Craig P Eberson, Joshua M Abzug, Bernard D Horn, Donald S Bae, Martin Herman
Supracondylar humerus fractures and lateral condyle fractures are the two most common pediatric elbow fractures that require surgical intervention. Although most surgeons are familiar with supracondylar humerus fractures and lateral condyle fractures, these injuries present challenges that may lead to common errors in evaluation and management and, thus, compromise outcomes. It is well agreed upon that nondisplaced supracondylar fractures (Gartland type I) are best managed nonsurgically with cast immobilization...
February 15, 2016: Instructional Course Lectures
https://www.readbyqxmd.com/read/27692103/comminuted-fractures-of-the-radial-head-resection-or-prosthesis
#20
Yaiza Lópiz, Ana González, Carlos García-Fernández, Javier García-Coiradas, Fernando Marco
INTRODUCTION: At present, surgical treatment of comminuted radial head fractures without associated instability continues to be controversial. When anatomical reconstruction is not possible, radial head excision is performed. However, the appearance of long-term complications with this technique, along with the development of new radial head implants situates arthroplasty as a promising surgical alternative. The purpose of the present study was to compare the mid-term functional outcomes of both techniques...
September 2016: Injury
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