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Elbow trauma

Mark E Morrey, Mario Hevesi
Total elbow arthroplasty (TEA) has undergone a significant evolution in indications and outcomes in the past decade. Although rheumatoid patients once had the overwhelming number of TEAs, now TEAs for the sequelae of trauma predominate. Furthermore, as obesity has mirrored the increase in the posttraumatic population, TEA complications have increased whereas the durability of implants under these loads has decreased. Solutions are urgently needed to address the complications and revision burden related to posttraumatic deformity and obesity...
July 2018: Orthopedic Clinics of North America
Tolga Onay, Seyit A Gümüştaş, Said E Baykan, Ahmet H Akgülle, Bülent Erol, Kaan S Irgit
BACKGROUND: Capitellum fractures are rare in adolescents, and information in literature is still limited. The purpose of this study was to report the mid-term and long-term functional and radiographic results of 13 surgically treated adolescent capitellum fractures in a level I trauma center. METHODS: This retrospective study included patients aged 10 to 16 years, who underwent surgery for a capitellum fracture and were followed up for at least 12 months. Fractures were classified according to the McKee modification of the Bryan and Morrey classification, and elbow arthritis was classified using the Broberg and Morrey system...
June 18, 2018: Journal of Pediatric Orthopedics
R Nietschke, K J Burkhart, B Hollinger, F I Dehlinger, A Zimmerer, M M Schneider
Background: An inadequate clinical outcome after conservatively treated radial head fractures is not uncommon. We analyzed the subjective limitations, objective complaints, and surgical procedures for radial head fractures initially treated conservatively. Patients and method: Between 2007 and 2016, 70 patients (42 men, 28 women) who suffered from fracture sequelae after conservatively treated radial head fractures were examined. Demographic (age, 41.8 years, range, 16-75 years) and clinical data (pain, range of motion, instability) were retrospectively evaluated...
2018: Obere Extremität
H J Christiaan Swellengrebel, David Saper, Paul Yi, Alexander A Weening, David Ring, Andrew Jawa
Diaphyseal fractures of the distal humerus have a high rate of union when treated with a functional brace or an above-elbow cast (AEC). This study compares alignment of the humerus and motion of the elbow after functional brace or AEC treatment. One-hundred and five consecutive patients with a closed, extra-articular fracture of the distal humeral diaphysis were identified in the orthopedic trauma databases of 3 hospitals between 2003 and 2012. Seventy-five patients with a follow-up of at least 6 months or with radiographic and clinical evidence of fracture union were included (51 treated with functional bracing and 24 treated with an AEC)...
May 2018: American Journal of Orthopedics
Janelle Cyr, Annie Liu, Danny Ghazarian, Sanjay Siddha
Epidermolysis bullosa acquisita (EBA) is a rare acquired type of mechanobullous disease affecting the dermal-epidermal junction (DEJ) of trauma prone acral surfaces. It manifests as tense vesicles, bullae, and milia and typically heals as atrophic hypo- or hyperpigmented scars. Classic noninflammatory mechanobullous EBA typically presents at a mean age of 48 years. A 21-year-old man presented with a 2-year history of nonpainful papular-vesicular lesions on his hands, knees, and toes after minor trauma to these areas...
May 2018: Journal of Cutaneous Medicine and Surgery
Alvin Chao-Yu Chen, Ying-Chao Chou, Chun-Jui Weng, Chun-Ying Cheng
BACKGROUND: The purposes of this study were to investigate the long-term outcomes of radial head replacement and to analyze the relationship between functional outcomes and periprosthetic radiolucency. METHODS: We retrospectively reviewed 32 patients who underwent unilateral radial head replacement between 2004 and 2011. Data on patient characteristics including age, gender, injury complexity, associated trauma, injury chronicity, and number of surgeries were collected and analyzed...
June 1, 2018: Journal of Orthopaedic Surgery and Research
Catherine Kilmartin, Katharine D Harper, Chirag Mehta, Joseph Thoder, Andrew Newman
Reconstructive flaps have revolutionized the ability of surgeons to restore function and cosmesis for patients. While reconstructive flaps have been used to bridge large defects due to oncologic or congenital maladies necessitating large debridements, few cases have observed salvage flaps in traumas which provide additional challenges secondary to an injury trajectory. This case report details use of an osteofasciocutaneous fibular free flap and radial head prosthesis to restore forearm function in a 64-year-old female with a comminuted fracture of the proximal radius...
2018: Case Reports in Orthopedics
Jiazhi Liu, Shuai Chen, Cunyi Fan
Objective : To observe the effectiveness of open release combined with distal radius fixation hinged external fixation for the treatment of elbow stiffness. Methods: A total of 77 patients with elbow stiffness caused by trauma were enrolled in this study between October 2014 and October 2015. The patients were divided into control group (39 cases) and observation group (38 cases) by random number table method. The patients in the observation group were treated with elbow joint opening and release combined with distal radial fixation hinged external fixation, while the control group was treated with traditional release...
February 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
John G Skedros, James S Smith, Marshall K Henrie, Ethan D Finlinson, Joel D Trachtenberg
We report the case of a 30-year-old Polynesian male with a severe gout flare of multiple joints and simultaneous acute compartment syndrome (ACS) of his right forearm and hand without trauma or other typical causes. He had a long history of gout flares, but none were known to be associated with compartment syndrome. He also had concurrent infections in his right elbow joint and olecranon bursa. A few days prior to this episode of ACS, high pain and swelling occurred in his right upper extremity after a minimal workout with light weights...
2018: Case Reports in Orthopedics
Yu-Pei Chen, Yi-Shan Lan, Wen-Long Hu, Yu-Chiang Hung
RATIONALE: Displaced olecranon fracture is a common injury following a fall or direct trauma to the elbow. There have been no reports of patients with a displaced olecranon fracture who have only received nonoperative manipulative reduction with Chinese herbs. PATIENT CONCERNS: The patient was a 64-year-old woman with a complex elbow injury that occurred in a traffic accident. The patient complained of severe, painful limitation of motion on straightening or bending...
May 2018: Medicine (Baltimore)
M Asher Schusterman, Rishi Jindal, Jignesh V Unadkat, Alexander M Spiess
In cases of significant upper extremity trauma, the thoracodorsal nerve is a reliable secondary option for the restoration of elbow flexion. In all previous descriptions, however, the entire nerve is transferred. We describe a case utilizing the lateral thoracodorsal nerve (LaT) branch for biceps reinnervation with an associated cadaver study. Transfer of the LaT branch to the biceps branch was performed on a patient who had sustained a traumatic brachial plexus injury that left him without elbow flexion. Also, 4 cadavers (8 upper extremities) were dissected to identify the bifurcation of the thoracodorsal nerve and confirm the feasibility of transferring the LaT branch to the biceps motor branch...
March 2018: Plastic and Reconstructive Surgery. Global Open
Debora Lana, Luigi Tarallo, Fabio Catani
Injuries of the triceps brachii muscle are a rare entity and mostly concern its distal tendon. These represent the least common of all muscle and tendons injuries. The most common reported causes are repeated strong physical efforts, a fall on an outstretched forearm when a sudden deceleration is put on contract triceps, or a direct trauma. High-dosed and prolonged corticosteroid therapies, repeated local steroid injections, chronic renal failure, diabetes, rheumatoid arthritis, hyperparathyroidism, and osteogenesis imperfecta are reported as systemic causes...
April 2018: Journal of Hand and Microsurgery
Efstathios Karamanos, Ilya Rakitin, Sophie Dream, Aamir Siddiqui
CONTEXT: Nerve transfer surgery is an option for repair of penetrating injuries of the upper extremity. In the right setting, it has advantages over tendon transfers and nerve grafting. OBJECTIVE: To review our experience since 2006 of nerve transfer surgery in the upper extremities. DESIGN: We included cases performed to repair penetrating trauma within three months of injury with at least three years' follow-up. MAIN OUTCOME MEASURES: Preoperative and postoperative muscle strength of the affected extremity...
April 9, 2018: Permanente Journal
Julia Tokarski, Jeffrey R Avner, Joni E Rabiner
OBJECTIVES: To determine whether point-of-care elbow ultrasound (US), with history and physical examination, can decrease radiography for patients with elbow trauma. Secondary outcomes included evaluation of pediatric emergency department (PED) length of stay (LOS) and test performance characteristics. STUDY DESIGN: This was a prospective study of patients up to age 21 years with elbow trauma necessitating radiography. After clinical examination and before radiography, pediatric emergency physicians performed elbow ultrasonography of the posterior fat pad and determined whether radiography was required...
April 19, 2018: Journal of Pediatrics
Noboru Oya, Tsuyoshi Tajika, Tsuyoshi Ichinose, Tsuyoshi Sasaki, Atsushi Yamamoto, Takuro Kuboi, Fumitaka Endo, Kenji Takagishi, Hirotaka Chikuda
BACKGROUND: The aim was to investigate the prevalence of elbow osteoarthritis (OA) in populations aged 40 years or older and to clarify the risk factors and their relationship with elbow function. METHODS: The respondents were 354 residents of a single village who underwent general medical examinations in April 2016. The mean age was 67.2 years (range, 40-93 years), and 222 respondents (62.7%) were women. Anteroposterior radiographs of the bilateral elbow joints were obtained, and the subjects were classified into 4 groups (non-OA, mild OA, moderate OA, and severe OA) according to the modified Kellgren-Lawrence scale...
June 2018: Journal of Shoulder and Elbow Surgery
Jian Yin, Zhaoyang Yin, Ge Gong, Chao Zhu, Chao Sun, Xinhui Liu
PURPOSE: This study was designed to compare the surgical outcomes of a hook plate with double-tunnel coracoclavicular (CC) ligament reconstruction by conjoined tendon transfer versus single hook plate surgery for the repair of acute type of Rockwood type III and V acromioclavicular (AC) joint dislocations. METHODS: The study cohort included 62 patients with acute (within 6 weeks after trauma) Rockwood type III and V AC joint dislocations who underwent surgery from February 2012 to September 2015...
April 19, 2018: International Journal of Surgery
Hamza M Alrabai, Martin G Gesheff, Ahmed I Hammouda, Janet D Conway
Voluntary elbow extension is essential for optimal upper limb positioning required for daily living activities, particularly above-shoulder maneuvers. The authors present a case of traumatic brachial plexus injury in which paralysis of the musculature selectively supplied by the posterior cord was based on magnetic resonance imaging and nerve conduction studies. An attempt at a radial nerve graft at another center was not effective. Ipsilateral hand function improved after multiple local tendon transfers were performed...
April 9, 2018: Journal of Hand Surgery
Altaf Hussain, Sandeep Kumar Nema, Deep Sharma, Sujiv Akkilagunta, Gopisankar Balaji
Objective: The optimal treatment for isolated fractures of ulnar shaft is debatable. The purpose of this study was to compare functional outcomes and radiological union in patients treated for isolated fractures of the ulnar shaft by open reduction and internal fixation and a long arm cast. Methods: This prospective study was conducted at level I trauma center from November 2014 to March 2016. 30 patients with isolated fractures of ulnar shaft were randomized to two groups to receive treatment by open reduction and internal fixation by plates and screws and a long arm cast...
March 2018: Journal of Clinical Orthopaedics and Trauma
Rajeev Shukla, Nikhil Jain, Utkarsh Agarwal, Tanveer Sheikh, Ravikant Jain
Objectives: This study aims to determine the various epidemiological factors responsible for orthopedic trauma cases: how do weather patterns, month, season and public working schedule influence the daily frequency of orthopedic trauma. Material and methods: This was a descriptive study performed in the Department of Orthopedics at a tertiary care centre in central India Participants: 7980 trauma cases reported in our study period. Study variables: Demographic characteristics of the cases, time, day, the month of injury and type of trauma and cause of trauma...
March 2018: Journal of Clinical Orthopaedics and Trauma
Shalin Patel, Dafang Zhang, Brandon E Earp
We report a case of a 29-year-old man who presented with a distal humeral shaft fracture sustained by blunt trauma. Physical examination and nerve conduction study were consistent with injury to the median and radial nerves proximal to the elbow. The patient underwent open reduction and internal fixation of the humeral shaft fracture with neurolysis of the median and radial nerves. Repeat electromyography at 6 months postoperatively showed recruitment of motor units in all muscles sampled, in keeping with clinical improvement...
March 2018: Archives of Bone and Joint Surgery
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