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Elbow pain and anatomy

Andrew P Matson, David S Ruch
Essex-Lopresti injuries (ELIs) are characterized by fracture of the radial head, disruption of the forearm interosseous membrane, and dislocation of the distal radioulnar joint. This injury pattern results in axial and longitudinal instability of the forearm. Initial radiographs may fail to reveal the full extent of the injury, and therefore diagnosis in the acute setting requires a high index of suspicion. Early recognition and treatment are preferred as failure to fully treat the problem may result in chronic wrist pain from ulnar abutment or chronic elbow pain from radiocapitellar arthrosis...
August 2016: Journal of Wrist Surgery
William H Rossy, Luke S Oh
Overhead athletes subject their elbows to significant valgus stresses throughout the throwing cycle. A steady rise in the number of medial-sided elbow injuries over the years has lead to increased awareness regarding the pathophysiology of the "pitcher's elbow." As our understanding of the functional anatomy and throwing biomechanics has become more sophisticated, we have seen a concurrent improvement in the outcomes associated with managing these injuries. Despite this improvement, continued anatomical and biomechanical research is still needed to further optimize outcomes and return to sport...
June 2016: Current Reviews in Musculoskeletal Medicine
David B Soma
Evaluation and treatment of pediatric elbow injuries in sport can be difficult because of the complex anatomy, evolving bony and cartilaginous composition, and multiple varied forces applied during athletic competition. In addition, youth sports are now putting even greater demands on the elbow of young athletes. It is important to understand the risk factors for injury, age-appropriate conditions affecting the elbow, proper treatment of these conditions, and prevention strategies for elbow injuries in this young athletic population...
March 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Estelle Raffin, Nathalie Richard, Pascal Giraux, Karen T Reilly
A substantial body of evidence documents massive reorganization of primary sensory and motor cortices following hand amputation, the extent of which is correlated with phantom limb pain. Many therapies for phantom limb pain are based upon the idea that plastic changes after amputation are maladaptive and attempt to normalize representations of cortical areas adjacent to the hand area. Recent data suggest, however, that higher levels of phantom pain are associated with stronger local activity and more structural integrity in the missing hand area rather than with reorganization of neighbouring body parts...
April 15, 2016: NeuroImage
Jonathan J Streit, Yousef Shishani, Reuben Gobezie
Reverse shoulder arthroplasty may be performed using components that medialize or lateralize the center of rotation. The purpose of this prospective study was to directly compare 2 reverse shoulder arthroplasty designs. Two treatment groups and 1 control group were identified. Group I comprised 9 patients using a medialized Grammont-style (GRM) prosthesis with a neck-shaft angle of 155°. Group II comprised 9 patients using a lateralized (LAT) prosthesis with a neck-shaft angle of 135°. Pre- and postoperative assessment of range of motion, American Shoulder and Elbow Surgeons score, and visual analog scale pain score were performed...
December 2015: Orthopedics
Thomas W Wright, Pierre-Henri Flurin, Lynn Crosby, Aimee M Struk, Joseph D Zuckerman
In this article, we present clinical results of primary total shoulder arthroplasty for osteoarthritis using an implant that provides dual eccentricity and variable neck and version angles for reconstruction of proximal humeral anatomy. Two hundred one patients with symptomatic osteoarthritis underwent 218 total shoulder arthroplasties with a fourth-generation anatomical shoulder and a replicator plate at 4 centers between August 1, 2006, and December 31, 2010. Fourth-generation implants allow for varying humeral neck and version angles and have dual eccentricity so as to be consistently able to cover the humeral head cut...
November 2015: American Journal of Orthopedics
Brandon J Erickson, Joshua D Harris, Peter N Chalmers, Bernard R Bach, Nikhil N Verma, Charles A Bush-Joseph, Anthony A Romeo
CONTEXT: Ulnar collateral ligament (UCL) injuries lead to pain and loss of performance in the thrower's elbow. Ulnar collateral ligament reconstruction (UCLR) is a reliable treatment option for the symptomatic, deficient UCL. Injury to the UCL usually occurs because of chronic accumulation of microtrauma, although acute ruptures occur and an acute-on-chronic presentation is also common. EVIDENCE ACQUISITION: Computerized databases, references from pertinent articles, and research institutions were searched for all studies using the search terms ulnar collateral ligament from 1970 until 2015...
November 2015: Sports Health
Abdelhakim Bentounsi
Fracture-dislocation of the humeral condyle is exceptional in adults. The purpose was to analyze the results of surgical treatment by open reduction and internal fixation without ligamentous repair. There were six men with an average age of 31 years. According to the AO classification, five fractures were classified as AO type B1 and one as B2. Dislocation was reduced in emergency before osteosynthesis. Postoperatively, the joint was held immobile with a brace for 25.40 days. Five patients were reviewed after a mean follow-up of 52...
September 2015: Acta Orthopaedica Belgica
H De la Corte-Rodriguez, E C Rodriguez-Merchan
INTRODUCTION: Haemophilic arthropathy (HA) is an inevitable consequence of repeated haemarthroses in people with haemophilia, and principally affects their ankles, knees and elbows. It is advisable that haematological treatment be complemented with rehabilitation therapy and surgery. Orthoses are devices that are used within the framework of rehabilitation, in order to change the functional or structural characteristics of the neuromusculoskeletal system. MATERIALS AND METHODS: This article reviews the design, the materials and characteristics of orthoses and the indications for the various orthoses used in HA...
November 2015: Haemophilia: the Official Journal of the World Federation of Hemophilia
Jennifer Hauptfleisch, Collette English, Darra Murphy
The elbow is a complex joint. Magnetic resonance imaging (MRI) is often the imaging modality of choice in the workup of elbow pain, especially in sports injuries and younger patients who often have either a history of a chronic repetitive strain such as the throwing athlete or a distinct traumatic injury. Traumatic injuries and alternative musculoskeletal pathologies can affect the ligaments, musculotendinous, cartilaginous, and osseous structures of the elbow as well as the 3 main nerves to the upper limb, and these structures are best assessed with MRI...
April 2015: Topics in Magnetic Resonance Imaging: TMRI
Stephan J Sweet, Tad Takara, Lance Ho, James E Tibone
BACKGROUND: Humeral head defects such as degenerative disease or avascular necrosis are often treated with stemmed hemiarthroplasty or total shoulder arthroplasty. Despite its historical and clinical significance, stemmed humeral head replacement poses inherent technical challenges to placing spherical implants at the anatomically correct head height, version, and neck-shaft angle. PURPOSE: The aim of this study was to assess humeral head inlay arthroplasty as a joint-preserving alternative that maintains the individual head-neck-shaft anatomy...
March 2015: American Journal of Sports Medicine
Mateusz Łasecki, Cyprian Olchowy, Aleksander Pawluś, Urszula Zaleska-Dorobisz
BACKGROUND: Ulnar neuropathy is the second most common peripheral nerve neuropathy after median neuropathy, with an incidence of 25 cases per 100 000 men and 19 cases per 100 000 women each year. Skipping (snapping) elbow syndrome is an uncommon cause of pain in the posterior-medial elbow area, sometimes complicated by injury of the ulnar nerve. One of the reason is the dislocation of the abnormal insertion of the medial triceps head over the medial epicondyle during flexion and extension movements...
2014: Polish Journal of Radiology
Charlton Stucken, Michael G Ciccotti
Biceps and triceps ruptures are rare, but can cause significant disability. They typically result from a forceful eccentric contraction, resulting in weakness and pain. Biceps and triceps tendon injuries represent the most and least common tendinous injuries about the elbow, respectively. Nonoperative management of these injuries is generally reserved for partial ruptures or patients unfit for surgery. Surgical repair has become the preferred method of treatment for acute, complete ruptures. Anatomy, epidemiology, clinical evaluation, and treatment of these injuries are described in this review...
September 2014: Sports Medicine and Arthroscopy Review
Todd S Ellenbecker, Robert Nirschl, Per Renstrom
CONTEXT: Injuries to the tendons of the elbow occur frequently in the overhead athlete, creating a significant loss of function and dilemma to sports medicine professionals. A detailed review of the anatomy, etiology, and pathophysiology of tendon injury coupled with comprehensive evaluation and treatment information is needed for clinicians to optimally design treatment programs for rehabilitation and prevention. EVIDENCE ACQUISITIONS: The PubMed database was searched in January 2012 for English-language articles pertaining to elbow tendon injury...
March 2013: Sports Health
Chelsea M Lohman, Michael P Smith, Gregory S Dedrick, Jean-Michel Brismée
CONTEXT: Epicondylalgia is a common condition involving pain-generating structures such as tendon, neural, and chondral tissue. The current noninvasive reference standard for identifying chondral lesions is magnetic resonance imaging. Musculoskeletal ultrasound (MUS) may be an inexpensive and effective alternative. OBJECTIVE: To determine the intrarater reliability and validity of MUS for identifying humeroradial joint (HRJ) chondral lesions. DESIGN: Cross-sectional study...
January 2014: Journal of Athletic Training
Khaled M Balam, Abdallah S Zahrany
OBJECTIVE: This is a prospective case series study, which was designed to evaluate the clinical outcome of posterior percutaneous plating of the humerus. MATERIALS AND METHODS: From the year 2010 to 2011, 37 patients with middle and distal third humeral fractures who met the inclusion criteria were surgically treated by minimally invasive plate osteosynthesis through posterior approach. Their age ranged from 19 to 43 with an average of 27.8 years. Type of fractures varied from B to C, and all of them were traumatic...
July 2014: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Keith S Boniface, Kunal Ajmera, Joanna S Cohen, Yiju Teresa Liu, Hamid Shokoohi
BACKGROUND: Identification of fluid in the elbow joint by physical examination alone can be challenging. Ultrasound can assist in the diagnosis of elbow effusion, and guide aspiration of the effusion. OBJECTIVES: We illustrate the anatomy and ultrasound guidance technique of a posterior approach to elbow arthrocentesis using examples of normal and pathologic elbow joint ultrasound images. DISCUSSION: The posterior distal humerus at the level of the olecranon fossa provides an excellent acoustic window into the joint space...
November 2013: Journal of Emergency Medicine
Ruth A Delaney, Michael T Freehill, Laurence D Higgins, Jon J P Warner
BACKGROUND: Partial humeral head resurfacing arthroplasty uses a stemless device, which conserves bone and restores normal anatomy. We hypothesized that this does not offer a reasonable alternative to full resurfacing or total shoulder arthroplasty. METHODS: We performed a retrospective study of 39 shoulders with focal chondral defects of the humeral head treated with partial resurfacing arthroplasty. A minimum of 2 years' follow-up was reported, unless failure and operative intervention superseded this duration...
January 2014: Journal of Shoulder and Elbow Surgery
Nicolai Baecher, Scott Edwards
Olecranon fractures are common injuries of the upper extremity; majority are treated surgically. A variety of fixation techniques are available to surgeons in modern practice, but there is little comparative clinical research to guide one's decision. Nonetheless, good results over all are to be expected after surgical management. This article presents a review of the current understanding and available evidence in the treatment of olecranon fractures, their relevant anatomy, fracture patterns, fixation options, and outcomes...
March 2013: Journal of Hand Surgery
F Draghi, G M Danesino, R de Gautard, S Bianchi
Ultrasound studies are frequently requested for the work-up of patients with local elbow pain, which is generally caused by overuse syndromes, trauma, inflammatory diseases, or neuropathies. The technique used to examine this joint will vary to some extent depending on the precise location of the pain and other clinical findings. The aim of this article is to describe the standard technique used for elbow ultrasound, the normal anatomy of the joint, and the appearance on ultrasound of normal elbow anatomy and the alterations associated with some of the more common disorders affecting this joint...
June 2007: Journal of Ultrasound
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