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Elbow instability

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
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
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
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
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
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
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
R Obuchowicz, M Bonczar
Lateral elbow pain is often attributed to degenerative or posttraumatic impairment of the common extensor tendon. Ultrasonography assesses the soft tissue structures of the lateral elbow, allowing the differentiation between various underlying processes, including angiofibroblastic degeneration, hyaline degeneration, and inflammation, and exclusion of other possible causes of pain such as posterior interosseous and lateral antebrachial nerve compression. Furthermore, the real-time imaging nature of ultrasonography enables the detection of impingement of the lateral synovial fold, degenerative changes in the elbow recess, and elbow posterolateral instability during dynamic maneuvers...
May 2016: Ultrasound Int Open
A Lenich, A B Imhoff, S Siebenlist
BACKGROUND: In young patients, post-traumatic osteoarthritis of the elbow is a rare condition. Whereas clinical manifestations often differ from radiological findings, pain and stiffness are variably combined in symptomatic forms. In deciding whether to perform surgery, the patient's age, activity level, and symptoms, as well as the location and severity of the osteoarthritis have to be taken into account. Elbow joint instability has to be identified to stop the post-traumatic osteoarthritic progress...
October 2016: Der Orthopäde
Behnam Behnoush, Nasim Tavakoli, Elham Bazmi, Fariborz Nateghi Fard, Mohammad Hossein Pourgharib Shahi, Arash Okazi, Tahmineh Mokhtari
BACKGROUND: Universal goniometer (UG) is commonly used as a standard method to evaluate range of motion (ROM) as part of joint motions. It has some restrictions, such as involvement of both hands of the physician, leads to instability of hands and error. Nowadays smartphones usage has been increasing due to its easy application. OBJECTIVES: The study was designed to compare the smartphone inclinometer-based app and UG in evaluation of ROM of elbow. MATERIALS AND METHODS: The maximum ROM of elbow in position of flexion and pronation and supination of forearm were examined in 60 healthy volunteers with UG and smartphone...
June 2016: Asian Journal of Sports Medicine
L P Müller, K Wegmann
No abstract text is available yet for this article.
October 2016: Der Orthopäde
K Schmidt-Horlohé, S Buschbeck, D Wincheringer, M Weißenberger, R Hoffmann
Radial head fractures are common injuries in elbow trauma. Non-displaced fractures are best treated conservatively. Simple but displaced fractures require anatomic reduction and fixation, typically using screws. The treatment course for complex fractures with multiple fragments is still being debated, as results are less predictable. Radial head resection is not advised if concomitant injuries of the coronoid process or the collateral ligaments with instability are present. Favorable outcomes following open reduction and fixation using plates were reported recently...
October 2016: Der Orthopäde
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
J Geßmann, M Königshausen, T A Schildhauer, D Seybold
The high stability of the elbow joint is provided by the congruent articular surfaces in combination with soft tissue stabilizers. The main osseous contributor of elbow stability is the coronoid, which is therefore referred to as a primary stabilizer. The radial head as a secondary stabilizer together with the medial collateral ligament assures valgus stability and together with the coronoid it assures posterolateral stability. Insufficiency of the osseous stabilizers may lead to difficulties in the treatment of chronic dislocation and complex instability...
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
Joideep Phadnis, Gregory I Bain
BACKGROUND: Failure of total elbow arthroplasty is more common than after other major joint arthroplasties and is often a result of aseptic loosening, peri-prosthetic infection, fracture and instability. Infection can be a devastating complication, yet there are no established guidelines for the pre-operative diagnosis of total elbow peri-prosthetic infection. This is because pre-operative clinical, radiographic and biochemical tests are often unreliable. METHODS: Using three case examples, a standardized protocol for the clinical and arthroscopic assessment of the painful total elbow arthroplasty is described...
January 2016: Shoulder & Elbow
Mandeep S Virk, Richard L Manzo, Mark Cote, James K Ware, Augustus D Mazzocca, Carl W Nissen, Kevin P Shea, Robert A Arciero
BACKGROUND: The results of open and arthroscopic instability repairs have been shown to be equivalent in recent literature. PURPOSE: To compare the time to recurrence (TTR) of instability and disease-specific outcome measures in patients undergoing open and arthroscopic Bankart repair. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Patients with recurrent traumatic anterior shoulder instability and a Bankart lesion on diagnostic arthroscopy underwent either open Bankart repair (OB) or arthroscopic Bankart and suture capsulorrhaphy (ABSC) using suture anchors...
June 2016: Orthopaedic Journal of Sports Medicine
Prospero Bigazzi, Marco Biondi, Massimo Ceruso
Radiocapitellar prosthetic arthroplasty is a fascinating new option in the treatment of complex lesions of the elbow. The device has been developed in order to treat primitive and post-traumatic radiocapitellar degenerative arthritis, while preserving the ulnohumeral joint of the elbow. Compared to a radial head resection, it avoids valgus and axial instability of the elbow and forearm preventing ulnohumeral degeneration. Seven patients have been reviewed with a mean of follow-up of 40 months. Two of them presented with an acute trauma and five of them with a post-traumatic degenerative arthritis involving the radial compartment of the elbow...
August 20, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
M Brett Raynor, Marilee P Horan, Joshua A Greenspoon, J Christoph Katthagen, Peter J Millett
BACKGROUND: Outcomes after arthroscopic pancapsular capsulorrhaphy (APC) with suture anchors for multidirectional instability (MDI) of the shoulder are not widely reported. PURPOSE: To compare intraoperative findings and midterm outcomes of APC with suture anchors for MDI between female and male athletes and between a classic, atraumatic onset versus clinical onset of MDI after a traumatic event. STUDY DESIGN: Cohort study; Level of evidence, 3...
August 19, 2016: American Journal of Sports Medicine
Keiichiro Oura, Oka Kunihiro, Kiyoshi Okada, Hiroyuki Tanaka, Tsuyoshi Murase
INTRODUCTION: Intra-articular malunion after fractures of the distal humerus can cause pain, stiffness and, consequently, osteoarthritis in the long run. Although corrective osteotomy for intra-articular malunion has been reported, it is still technically challenging and needs careful preoperative evaluation and planning. Here, we present two cases of corrective osteotomy assisted by preoperative three-dimensional (3-D) computer simulation. MATERIALS AND METHODS: We present two cases of malunited intra-articular fracture of the distal humerus, which was treated by corrective osteotomy with the aid of 3-D computer simulation...
November 2016: Archives of Orthopaedic and Trauma Surgery
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