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Elbow pain and anatomy

Sean M Booth, Abdulbaset Abosala, Chris Peach
Introduction: The complex anatomy and biomechanics of the elbow joint can lead to diagnostic uncertainty when a clinician is determining the cause of a patient's anterior elbow pain. We present a case of anterior elbow pain with an uncommon and often overlooked etiology. Elbow pain due to compression of the lateral antebrachial nerve (LACN) has an unknown incidence or prevalence. Case Report: A 27-year-old left-hand dominant male presented to our orthopedic elbow clinic complaining of bilateral elbow clicking and discomfort which had been present for several years...
September 2017: Journal of Orthopaedic Case Reports
Raul Barco, Samuel A Antuña
Medial elbow pain is uncommon when compared with lateral elbow pain.Medial epicondylitis is an uncommon diagnosis and can be confused with other sources of pain.Overhead throwers and workers lifting heavy objects are at increased risk of medial elbow pain.Differential diagnosis includes ulnar nerve disorders, cervical radiculopathy, injured ulnar collateral ligament, altered distal triceps anatomy or joint disorders.Children with medial elbow pain have to be assessed for 'Little League elbow' and fractures of the medial epicondyle following a traumatic event...
August 2017: EFORT open reviews
E Carità, A Donadelli, L Cugola, P Perazzini
BACKGROUND/PURPOSE: Radial head replacement is frequently used in treatment of radial head fractures or sequela. Impossibility to restore a correct anatomy, acute elbow traumatic instability and failure of osteosynthesis hardware are the most common indications. The authors describe their case studies and results on the implantation of various radial head prostheses. MATERIALS: Between June 2005 and June 2016, 28 radial head prostheses were implanted in the same number of patients with an average follow-up of 49 months (6-104)...
December 2017: Musculoskeletal Surgery
Chantal L Welsink, Kaj T A Lambers, Derek F P van Deurzen, Denise Eygendaal, Michel P J van den Bekerom
BACKGROUND: Most total elbow arthroplasty (TEA) designs aim to replicate anatomy and provide stability in the treatment of the degenerative elbow joint. Given the promising results that have been reported following the use of TEA for the treatment of complex fractures, the indications for this procedure are growing. The objective of the present study was to review the most recent literature on the results of the most commonly performed TEAs. METHODS: A comprehensive literature search was conducted...
July 2017: JBJS Reviews
Leo T Kroonen, Samantha L Piper, Andrew C Ghatan
The incidence of osteoarthritis in the general population is low, but it can be seen in manual laborers, throwing athletes, and people dependent on crutches and wheelchairs. Patients often complain of pain at the terminal extents of motion, and imaging shows osteophyte formation at the tips of the coronoid and olecranon processes as well as thickening of the bone between the coronoid and the olecranon fossae. Recent advances in arthroscopic instrumentation and techniques have led to a growing interest in the arthroscopic treatment of elbow osteoarthritis...
August 2017: Journal of Hand Surgery
Paul Michelin, Grégoire Leleup, Mourad Ould-Slimane, Marie Caroline Merlet, Benjamin Dubourg, Fabrice Duparc
BACKGROUND: Chronic ulnar nerve entrapment worsened by elbow flexion is the most common injury, but rare painful conditions may also be related to ulnar nerve instability. The posterior bundle of the medial collateral ligament (pMCL) and the retinaculum, respectively form a soft floor and a ceiling for the cubital tunnel. The aim of our study was to dynamically assess these soft structures of the cubital tunnel focusing on those involved in the biomechanics of the ulnar nerve. METHODS: Forty healthy volunteers had a bilateral ultrasonography of the cubital tunnel...
November 2017: Surgical and Radiologic Anatomy: SRA
Osman Walid, Braiki Meriem, Alaya Zeineb, Naouar Nader, Ben Ayeche Mohamed
INTRODUCTION: The coexistence of fractures of capitulum humeri and radial head in the elbow joint is a rare entity. CASE REPORT: A 30-year-old woman was admitted to our hospital after having sustained a fall on her outstretched right arm. She complained of pain, swelling, and restriction of motion of the right elbow joint. Anteroposterior and lateral radiographs revealed displaced fractures in the capitellum and the radial head. The patient was operated. Fractures were exposed through a lateral (Kocher) incision...
September 2016: Journal of Orthopaedic Case Reports
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
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
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