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Elbow instability

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https://www.readbyqxmd.com/read/28435584/intra-articular-entrapment-of-medial-epicondyle-fracture-fragment-in-elbow-joint-dislocation-causing-ulnar-neuropraxia-a-case-report
#1
J Syed, A R Zamri, S Jamaluddin, J K Ruben, M Gopindran
Traumatic elbow dislocations in children are rare but most of them are complex dislocations, and in such dislocations, medial humerus epicondyle fractureis the most common associated injury. Fracture incarceration in the elbow joint occurs in 5-18% of medial humerus epicondyle fractures but ulnar neuropraxia is very rare. Open reduction internal fixation is indicated in medial humerus epicondyle fracture with fracture incarceration, ulnar neuropraxia, marked instability or open fracture. Operative treatment options include fragment excision and sutures, closed or open reduction and Kirschner wire fixation, open reduction and suture fixation, open reduction and smooth pin fixation, and open reduction and screw fixation...
March 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28435560/humeral-supracondylar-fractures-in-children-a-novel-technique-of-lateral-external-fixation-and-kirschner-wiring
#2
R Y Kow, A R Zamri, J K Ruben, S Jamaluddin, M T Mohd-Nazir
Introduction: Supracondylar fracture of the humerus is the most common fracture around the elbow in children. Pinning with Kirschner wires (K-wires) after open or closed reduction is generally accepted as the primary treatment modality. However, it comes with the risk of persistent instability and if the K-wire is not inserted properly, it may cause displacement and varus deformity. We present our two-year experience with a new technique of lateral external fixation and K-wiring of the humeral supracondylar fracture...
July 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28412106/radial-notch-labralization-for-proximal-radioulnar-joint-dysplasia
#3
Enrico Bellato, Shawn W O'Driscoll
BACKGROUND: Chronic posterior subluxation or dislocation of the radial head is uncommon and difficult to treat. To restore radiocapitellar alignment, procedures such as deepening of the notch using a high-speed burr have been described, but they can result in cartilage damage. We hypothesized that a radial notch labralization using soft tissue could improve radiocapitellar tracking without violating the joint surface. METHODS: A radial notch labralization was performed in 3 patients with chronic posterior subluxation of the radial head and developmental dysplasia of the radial notch in the setting of complex recurrent instability of the elbow...
April 12, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28405226/assessment-and-decision-making-in-the-unstable-elbow-management-of-simple-dislocations
#4
Roger P van Riet
Simple elbow dislocations are usually treated conservatively. Radiographs are negative in simple dislocations. Results are generally good, although a small percentage of patients may develop chronic instability. Ligamentous repair can be indicated in high demand patients or if the elbow remains unstable following a closed reduction. Chronic instability is classified per their direction. Surgery is often indicated in the chronically unstable elbow.
April 2017: Shoulder & Elbow
https://www.readbyqxmd.com/read/28359694/long-term-clinical-results-in-patients-treated-for-recurrent-posterolateral-elbow-joint-instability-using-an-ipsilateral-triceps-tendon-graft
#5
Christian Kastenskov, Jeppe Vejlgaard Rasmussen, Janne Ovesen, Bo Sanderhoff Olsen
BACKGROUND: The aim was to report the long-term functional and radiologic outcomes in patients treated for recurrent posterolateral elbow joint instability using an ipsilateral triceps tendon graft. METHODS: We included 18 patients previously treated for posterolateral elbow joint instability and evaluated for clinical results in 2003. Fifteen patients were examined with a mean follow-up period of 19 years (range, 17-22 years). We performed the clinical follow-up with clinical examination of stability, range of motion, pain score on a visual analog scale, Mayo Elbow Performance Score, and Danish version of Oxford Elbow Score...
March 27, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28341879/intra-articular-findings-in-symptomatic-minor-instability-of-the-lateral-elbow-smile
#6
Paolo Arrigoni, Davide Cucchi, Riccardo D'Ambrosi, Usman Butt, Marc R Safran, Patrick Denard, Pietro Randelli
PURPOSE: Lateral epicondylitis is generally considered an extra-articular condition. The role of minor instability in the aetiology of lateral elbow pain has rarely been considered. The aim of this study was to evaluate the correlation of lateral ligamentous laxity with aspects of intra-articular lateral elbow pathology and investigate the role of minor instability in lateral elbow pain. METHODS: Thirty-five consecutive patients aged between 20 and 60 years with recalcitrant lateral epicondylitis who had failed conservative therapy and had no previous trauma or overt instability, were included...
March 24, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28337591/arthroscopic-r-lcl-plication-for-symptomatic-minor-instability-of-the-lateral-elbow-smile
#7
Paolo Arrigoni, Davide Cucchi, Riccardo D'Ambrosi, Alessandra Menon, Alberto Aliprandi, Pietro Randelli
PURPOSE: Minor instability has been proposed as a possible aetiology of lateral elbow pain. This study presents the results of the arthroscopic plication of the radial component of the lateral collateral ligament (R-LCL) to reduce minor instability of the lateral elbow. METHODS: Twenty-seven patients with recalcitrant lateral epicondylitis who had failed conservative therapy and who had no previous trauma or overt instability, were included. R-LCL plication was performed in the presence of at least one sign of lateral ligamentous patholaxity and one intra-articular abnormal finding...
March 23, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28333542/critical-value-of-anterior-glenoid-bone-loss-that-leads-to-recurrent-glenohumeral-instability-after-arthroscopic-bankart-repair
#8
Sang-Jin Shin, Rag Gyu Kim, Yoon Sang Jeon, Tae Hun Kwon
BACKGROUND: Generally, a glenoid bone loss greater than 20% to 25% is considered critical for poor surgical outcomes after a soft tissue repair. However, recent studies have suggested that the critical value should be lower. PURPOSE: To determine the critical value of anterior glenoid bone loss that led to surgical failure in patients with anterior shoulder instability. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: The study included 169 patients with anterior glenoid erosion...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28314869/-operative-treatment-of-terrible-triad-injury-of-the-elbow-open-reduction-and-internal-fixation
#9
R Babst, C Schraner, F J P Beeres
AIM OF SURGERY: Reconstruction of the most important ligamentous and osseus structures of the elbow after terrible triad injury via the radial head to the lateral collateral ligament complex (LCL) and if necessary beginning at the coronoid process. The aim is a stable concentrically guided elbow with early functional follow-up treatment. The approach depends on the intraoperatively tested stability. INDICATIONS: Osteoligamentous terrible triad injury pattern with or without subluxation position following reduction and temporary immobilization...
March 17, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28277259/comparison-of-reverse-total-shoulder-arthroplasty-outcomes-with-and-without-subscapularis-repair
#10
Richard J Friedman, Pierre-Henri Flurin, Thomas W Wright, Joseph D Zuckerman, Christopher P Roche
BACKGROUND: Repair of the subscapularis with reverse total shoulder arthroplasty (rTSA) is controversial. The purpose of this study is to quantify rTSA outcomes in patients with and without subscapularis repair to determine if there is any impact on clinical outcomes. METHODS: Three hundred forty patients received rTSA and had the subscapularis repaired, whereas 251 patients received rTSA and did not have the subscapularis repaired. The patients were scored preoperatively and at latest follow-up using the Simple Shoulder Test; University of California, Los Angeles; American Shoulder and Elbow Surgeons; Constant; and Shoulder Pain and Disability Index metrics...
October 27, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28258868/rates-of-complications-and-secondary-surgeries-after-in%C3%A2-situ-cubital-tunnel-release-compared-with-ulnar-nerve-transposition-a-retrospective-review
#11
Dafang Zhang, Brandon E Earp, Philip Blazar
PURPOSE: The purpose of this study was to contrast the rate and types of complications and secondary surgeries for in situ cubital tunnel release and ulnar nerve transposition. METHODS: A retrospective cohort study was performed by query of hospital billing records for all patients who underwent cubital tunnel surgery from August 2008 to July 2013, yielding 421 patients. Exclusion criteria were acute trauma, revision surgery, neoplasm, age younger than 18 years, incomplete records, and postoperative follow-up less than 3 months...
April 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28258327/latarjet-procedure-using-subscapularis-split-approach-offers-better-rotational-endurance-than-partial-tenotomy-for-anterior-shoulder-instability
#12
Ali Ersen, Fevzi Birisik, Hakan Ozben, Ata Can Atalar, Turker Sahinkaya, Aksel Seyahi, Mehmet Demirhan
PURPOSE: Latarjet, which is a coracoid bone block procedure, is an effective treatment for anterior shoulder instability with glenoid bone loss. During this reconstructive procedure the subscapularis may be tenotomized or be split to expose the glenoid neck. The aim of this study was to assess the effect of subscapularis management on functional outcomes and internal and external rotation durability and strength. Hypothesis is that the subscapularis split approach will result in better functional results and superior internal rotation strength and endurance...
March 3, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28249855/physical-examination-of-the-elbow-what-is-the-evidence-a-systematic-literature-review
#13
REVIEW
Elisa L Zwerus, Matthijs P Somford, François Maissan, Jelle Heisen, Denise Eygendaal, Michel Pj van den Bekerom
OBJECTIVE: Primary to provide an overview of diagnostic accuracy for clinical tests for common elbow (sport) injuries, secondary accompanied by reproducible instructions to perform these tests. DESIGN: A systematic literature review according to the PRISMA statement. DATA SOURCES: A comprehensive literature search was performed in MEDLINE via PubMed and EMBASE. ELIGIBILITY CRITERIA: We included studies reporting diagnostic accuracy and a description on the performance for elbow tests, targeting the following conditions: distal biceps rupture, triceps rupture, posteromedial impingement, medial collateral ligament (MCL) insufficiency, posterolateral rotatory instability (PLRI), lateral epicondylitis and medial epicondylitis...
March 1, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28209448/management-of-post-traumatic-elbow-instability-after-failed-radial-head-excision-a-case-report
#14
Georgios Touloupakis, Emmanouil Theodorakis, Fabio Favetti, Massimiliano Nannerini
Radial head excision has always been a safe commonly used surgical procedure with a satisfactory clinical outcome for isolated comminuted radial head fractures. However, diagnosis of elbow instability is still very challenging and often underestimated in routine orthopaedic evaluation. We present the case of a 21-years old female treated with excision after radial head fracture, resulting in elbow instability. The patient underwent revision surgery after four weeks. We believe that ligament reconstruction without radial head substitution is a safe alternative choice for Mason III radial head fractures accompanied by complex ligament lesions...
February 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28205469/valgus-instability-of-the-elbow-due-to-medial-epicondyle-nonunion-treatment-by-fragment-excision-and-medial-collateral-ligament-reconstruction
#15
Yasunori Kaneshiro, Noriaki Hidaka, Koichi Yano, Makoto Fukuda, Hideki Sakanaka
BACKGROUND: The medial epicondyle nonunion becomes symptomatic valgus instability with medial elbow pain and joint instability due to dysfunction of the medial collateral ligament (MCL), thus requiring surgical treatment. The purpose of the present study is to report the clinical result of the fragment excision and ligament reconstruction by free tendon graft in the treatment of symptomatic medial epicondyle nonunion. METHODS: A retrospective study of five consecutive patients was performed...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28191366/radiological-and-functional-outcome-of-displaced-colles-fracture-managed-with-closed-reduction-and-percutaneous-pinning-a-prospective-study
#16
Sagar Panthi, Kishor Khatri, Krishna Kharel, Subin Byanjankar, Jay R Sharma, Rahul Shrestha, Raju Vaishya, Amit Kumar Agarwal, Vipul Vijay
BACKGROUND: Displaced Colles' fractures are treated by manipulation and below elbow cast application. Malunion is a common complication, resulting in pain, mid-carpal instability, and post-traumatic arthritis. Fracture stabilization by percutaneous pinning is a simple, minimally invasive technique that helps prevent displacement of the fracture, thereby minimizing complications. This study aims to assess the amount of collapse after closed manipulation and percutaneous pinning with Kirschner wires (K-wires) and its correlation with the functional outcome of the wrist after union...
January 6, 2017: Curēus
https://www.readbyqxmd.com/read/28185992/lasso-plate-an-original-implant-for-fixation-of-type%C3%A2-i-and%C3%A2-ii-regan-morrey-coronoid-fractures
#17
P Wang, Y Zhuang, Z Li, W Wei, Y Fu, X Wei, K Zhang
INTRODUCTION: Coronoid fractures are notoriously difficult to manage particularly when there is a small fragment. We report a retrospective analysis of our experience with consecutive type I and II Regan-Morrey coronoid fractures using a lasso plate. HYPOTHESIS: Type I and II Regan-Morrey coronoid fractures can be effectively managed using a lasso plate. METHODS: From October 2011 and December 2013, 25 patients (21 males and 4 females, mean age 40...
May 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28168131/radiological-and-functional-outcome-of-medial-epicondyle-fracture-treated-surgically-in-children-and-adolescents-a-retrospective-study
#18
Sagar Panthi, Kishor Khatri, Krishna Kharel, Raju Vaishya, Amit Kumar Agarwal, Vipul Vijay
PURPOSE: Fractures of the medial humeral epicondyle represent approximately 10% of all pediatric elbow fractures. Surgically treated pediatric fractures of the medial humeral epicondyle were analyzed retrospectively for their epidemiological, clinical, radiological and surgical parameters. The evaluation includes the Mayo elbow performance score (MEPS). METHODS: Twenty-five surgically treated fractures of the medial humeral epicondyle were analyzed...
January 4, 2017: Curēus
https://www.readbyqxmd.com/read/28164052/treatment-of-stiff-elbow-in-young-patients-with-interpositional-arthroplasty-for-mobility-case-series
#19
R Sivakumar, V SomaSheker, Prahalad Kumar Shingi, T Vinoth, M Chidambaram
INTRODUCTION: The elbow is a complex joint involving many articulations and complex biomechanics come into play. Elbow motion is crucial to upper limb movement that loss of 50% of elbow function equals to loss of 80% of upper extremity global function. Restoring movement and stability is challenging to the surgeon while treating a stiff elbow. Unlike other arthroplasties of hip and knee, total elbow arthroplasty (TEA) may not be a primary treatment. Interpositional arthroplasty (IPA) can be considered a viable option in posttraumatic arthritis of elbow in young patients...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28160902/elbow-instability-anatomy-biomechanics-diagnostic-maneuvers-and-testing
#20
REVIEW
Lauren E Karbach, John Elfar
The elbow comprises a complex of bony and ligamentous stabilizers that provide both primary and secondary constraints to elbow instability. Through trauma and overuse, classic instability patterns arise by loss of these important stabilizers. The diagnosis of elbow instability can made using specific examination maneuvers and testing to diagnose the clinical pattern. This article reviews the elbow's unique anatomy and biomechanical characteristics and these are applied when reviewing the maneuvers and testing used to diagnose elbow instability...
February 2017: Journal of Hand Surgery
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