Arthroplasty, Replacement, Elbow ; Elbow Joint ; injuries ; surgery ; Fracture Fixation ; Humans

Arthroplasty, Replacement ; Elbow Joint ; injuries ; surgery ; Humans ; Joint Instability ; therapy ; Tennis Elbow ; therapy

Dislocation of the elbow joint is so frequent an injury, and its treatment so standardized, that most of the recent orthopaedic study devoted to the subject has focused on neurovascular complication or recurrent dislocation. Some authors reported minimal period of disability and better range of extension after three to five days short-term immobilization in simple acute dislocation. We, authors, had analyzed clinically 17 cases of acute dislocation of elbow joint who were treated at orthopaedic department of Catholic Medical College from Jan., 1978 to Dec., 1981. The results obtained were as follows: 1. The most prevalent age were second and third decades (76.5%). Males predominated by a ratio of 13:4. 2. The major mode of injury was slip down accident (58.8%). All cases were acute simple dislocation without open wound. 3. Posterolateral, dislocations were 13 cases (76.5%) and posterior dislocations were 3 cases (17.6%). These two type of dislocation were 94.1% of all cases. No anterior dislocation was noted. 4. Four fractures of radial head and one fracture of lateral epicondyle of humerus were seen. Associated fractures were noted in 29.4% of all cases. 5. Severe complication was none except one recurrent habituai dislocation and limitation of elbow extension, averaging 10.5 degrees, 6. In 9 cases which were immobilized for 3 to 5 days had an average loss of extension of 6 degrees and an average of 7 weeks of disability. In 7 cases which were immobilized for 3 weeks had an average loss of extension of 18 degrees and an average of 18.3 weeks of disability. Therefore, immediate reduction and 3 to 5 dhys of immobililization is excellent treatment for uncomplicated dislocations.
Clinical Study ; Dislocations ; Elbow Joint ; Elbow ; Head ; Humans ; Humerus ; Immobilization ; Male ; Wounds and Injuries

OBJECTIVES: To explore the changes of elbow flexor muscle strength after musculocutaneous nerve injury and its correlation with needle electromyography (nEMG) parameters. METHODS: Thirty cases of elbow flexor weakness caused by unilateral brachial plexus injury (involving musculocutaneous nerve) were collected. The elbow flexor muscle strength was evaluated by manual muscle test (MMT) based on Lovett Scale. All subjects were divided into Group A (grade 1 and grade 2, 16 cases) and Group B (grade 3 and grade 4, 14 cases) according to their elbow flexor muscle strength of injured side. The biceps brachii of the injured side and the healthy side were examined by nEMG. The latency and amplitude of the compound muscle action potential (CMAP) were recorded. The type of recruitment response, the mean number of turns and the mean amplitude of recruitment potential were recorded when the subjects performed maximal voluntary contraction. The quantitative elbow flexor muscle strength was measured by portable microFET 2 Manual Muscle Tester. The percentage of residual elbow flexor muscle strength (the ratio of quantitative muscle strength of the injured side to the healthy side) was calculated. The differences of nEMG parameters, quantitative muscle strength and residual elbow flexor muscle strength between the two groups and between the injured side and the healthy side were compared. The correlation between elbow flexor manual muscle strength classification, quantitative muscle strength and nEMG parameters was analyzed. RESULTS: After musculocutaneous nerve injury, the percentage of residual elbow flexor muscle strength in Group B was 23.43% and that in Group A was 4.13%. Elbow flexor manual muscle strength classification was significantly correlated with the type of recruitment response, and the correlation coefficient was 0.886 (P<0.05). The quantitative elbow flexor muscle strength was correlated with the latency and amplitude of CMAP, the mean number of turns and the mean amplitude of recruitment potential, and the correlation coefficients were -0.528, 0.588, 0.465 and 0.426 (P<0.05), respectively. CONCLUSIONS The percentage of residual elbow flexor muscle strength can be used as the basis of muscle strength classification, and the comprehensive application of nEMG parameters can be used to infer quantitative elbow flexor muscle strength.
Humans ; Elbow ; Electromyography ; Musculocutaneous Nerve ; Elbow Joint/physiology* ; Muscle, Skeletal ; Muscle Strength ; Peripheral Nerve Injuries

Adult ; Elbow Joint ; injuries ; Female ; Humans ; Joint Dislocations ; therapy ; Manipulation, Orthopedic ; methods ; Radius ; injuries

OBJECTIVETo introduce the experiences of applying MR to diagnose the imaging characters in chronic injury of the elbows in athletes.

METHODSFrom September 2005 to May 2008, 40 elbows of 34 athletes, included 21 males and 13 females,aged from 6 to 16 years old, averaged (12.3 +/- 3.1) years were taken axial, saggital and coronal planes MR Imaging.

RESULTSMagnetic resonance imaging showed thickening and effusion of olecranon synovial plicaes, bone marrow edema of lower humeral ossification, radial head, olecranon, ulna coronoid, ulnar collateral ligament trauma in chronic injury of the elbow joint.

CONCLUSIONMRI is a susceptible method for the diagnoses of chronic injury of the elbow.

Adolescent ; Athletic Injuries ; pathology ; Child ; Chronic Disease ; Elbow Joint ; injuries ; Female ; Humans ; Magnetic Resonance Imaging ; Male

Vascular injury in the arm associated with trauma usually results from penetrating injury. However, this vascular injury can also be caused by open dislocation of the elbow or closed fracture of the humerus. Although the elbow joint is the third most common site of joint dislocation, closed elbow dislocations without associated fractures rarely have concomitant arterial injury. The authors report a case of complete disruption of the brachial artery associated with closed dislocation of the elbow and massive soft tissue damage. The patient was successfully managed by early diagnosis, prompt reduction of the dislocation, and end to end anastomosis of the brachial artery and fasciotomy.
Arm ; Brachial Artery* ; Dislocations* ; Early Diagnosis ; Elbow Joint ; Elbow* ; Fractures, Closed ; Humans ; Humerus ; Joints ; Vascular System Injuries

INTRODUCTIONInjuries to the medial structures of the elbow due to overhead throwing games are well documented. However, variations of medial epicondyles are not well described, especially in athletes with fused medial epicondyles. In this study, we evaluated variations in the medial epicondyle of baseball players who were aged 15-17 years and had fused epicondyles.

METHODSIn this cross-sectional observational study, 155 skeletally mature baseball players with unilateral medial elbow pain and 310 elbow radiographs were reviewed by two independent reviewers. The medial epicondyles were categorised into three groups: normal, elongated or separated.

RESULTSAmong the 155 patients, 65 (41.9%) had normal epicondyles, 41 (26.5%) had elongated epicondyles and 49 (31.6%) had separated epicondyles. The medial epicondyle was larger on the dominant arm for 125 (80.6%) patients; the mean surface area on the dominant arm was 222.50 ± 45.77 mm, while that of the non-dominant arm was 189.14 ± 39.56 mm(p < 0.01). Among the three categories of medial epicondyles, separated epicondyles had the largest surface area, followed by elongated and normal epicondyles.

CONCLUSIONMedial epicondyles in adolescent throwing athletes can be categorised into three different groups according to their shape (normal, elongated and separated). We observed a correlation between the shape and the surface area of the medial epicondyle in adolescent throwing athletes, with separated medial epicondyles having the largest surface area. Further studies and follow-up are needed to determine the prognostic value and clinical significance of these morphological variations.

Adolescent ; Athletes ; Athletic Injuries ; diagnostic imaging ; physiopathology ; Baseball ; Cross-Sectional Studies ; Elbow ; injuries ; Elbow Joint ; diagnostic imaging ; physiopathology ; Humans ; Male ; Radiography

BACKGROUND: Several studies have reported the clinical outcomes of medial ulnar collateral ligament (MUCL) reconstruction of the elbow joint in throwing athletes, including the rate of return to sports. However, little has been known about the imaging outcomes after MUCL reconstruction. The aim of this study is to report the clinical and imaging outcomes after MUCL reconstruction using figure of eight fashion in the elite and professional baseball players. METHODS: This study included 17 baseball players, who underwent MUCL reconstruction between July 2007 and May 2010. The average follow-up period was 48.6 months. Imaging assessment consisted of preoperative plain and stress radiographs, magnetic resonance imaging, and postoperative serial ultrasonography. The clinical assessments were composed of visual analogue scale (VAS) for pain, range of motion, and the Conway scale. RESULTS: The mean VAS score was 6.4 (range, 3 to 8) preoperatively and 2.2 (range, 0 to 4) postoperatively (p < 0.05). There were nine players (53%) classified as excellent who returned to sports at the same or higher level compared to preinjury. Serial ultrasonography revealed well-maintained grafts at 3 and 12 months in all of the players. Five out of 17 players showed decreased echogenecity in the common flexor tendon at 3 months, which was considered as remaining tissue swelling and resolved completely at 12 months. CONCLUSIONS: All grafts are well-maintained until 12-months based on the ultrasonographic findings, although only 53% of the players returned to preinjury level.
Adolescent ; Athletic Injuries/*surgery/ultrasonography ; Baseball/*injuries ; Collateral Ligaments/injuries/*surgery/ultrasonography ; Elbow Joint/injuries/*surgery/ultrasonography ; Humans ; Male ; *Reconstructive Surgical Procedures ; Recovery of Function ; Transplants/ultrasonography ; Young Adult

Dislocation of the radial head in adults is uncommon. A simultaneous dislocation of the radial head and fracture of the ipsilateral distal end of radius with no other associated injuries is extremely rare. As far as we know, such an injury after an unusual mode of injury has been seldom reported in the English literature. We report such a case without any associated injuries or comorbidity. Closed reduction was performed within two hours after injury and results were satisfactory. Immobilisation was continued for 3 weeks. Gradual mobilisation was started after removal of the plaster under the supervision of a physiotherapist. At 6 months'follow-up, the patient had no residual pain at the elbow with full flexion and extension. Almost full supination with a restriction of last 10 degrees of pronation was achieved. There was no evidence of instability of the elbow.
Accidental Falls ; Adult ; Casts, Surgical ; Elbow Joint ; injuries ; Female ; Humans ; Immobilization ; Joint Dislocations ; Radius Fractures ; therapy