PURPOSE: To define the significant factors for lateral condyle prominence following the lateral closing wedge osteotomy for cubitus varus. MATERIALS AND METHODS: Analyzed the 15 cases performed lateral closing wedge osteotomy for cubitus varus. We measured the carrying angle by the arm and forearm axis lines of soft tissues, lateral condyle prominence index, the distance from center of rotation to osteotomy site and the distance from center of rotation to elbow joint. RESULTS: The lateral condyle prominence group with lateral condyle prominence index (LCPI) over 300% was 5 cases (33%), and no prominence group was 10 cases (67%). The distance between CORA and osteotomy site in lateral condyle prominence group was mean 44 mm (range, 35-52) and no prominence group was mean 21 mm (range, 17-27). The distance between CORA and elbow joint was mean -3 mm (range -15~7) and 16 mm (range, 8-24) respectively. CONCLUSION: Lateral condyle prominence was developed in case of the increased preoperative LCPI, increased distance between CORA and osteotomy site, and decreased distance between CORA and elbow joint.
Arm ; Axis, Cervical Vertebra ; Congenital Abnormalities* ; Elbow Joint ; Forearm ; Osteotomy*

BACKGROUND: Nonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan. METHODS: Eight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, 90° flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion. RESULTS: Ulno-humeral joint moved to the varus on the coronal plane during flexion, 25.45° in the non-united cubitus valgus group and −2.03° in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane −26.75° in the non-united cubitus valgus group and −3.09° in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern. CONCLUSIONS: The non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.
Biomechanical Phenomena ; Congenital Abnormalities ; Elbow ; Elbow Joint ; Imaging, Three-Dimensional ; Joints ; Osteotomy ; Tomography, X-Ray Computed

PURPOSE: To compare postoperative outcomes in tardy ulnar nerve palsy. MATERIALS AND METHODS: Between January 1997 and June 2000, 31 patients with the tardy ulnar nerve palsy, who have received operative treatment were divided into a traumatic group and an idiopathic group, and were analyzed with respect to preoperative factors, severity, nerve conduction velocity and postoperative result retrospectively. RESULTS: The traumatic group was composed of 17 cases and the idiopathic group of 14 cases. The average age was 35.7 years in the traumatic group, and 50.6 years in the idiopathic group, and this was statistically different (p=0.001). Other factors were not statistically different between the two groups. The improvement rate, which excluded mild degree patients, was 58.3% (7 in 12 cases) in the traumatic group and 90.9% (10 in 11cases) in the idiopathic group, and this was statistically different (p=0.048, ) and favorable in the idiopathic group. CONCLUSION: In cases of tardy ulnar nerve palsy of the elbow joint, the symptoms and the nerve conduction velocity were statistically no different between the two groups. The postoperative result in the traumatic elbow deformity patients was poorer than that in the idiopathic group.
Congenital Abnormalities ; Elbow ; Elbow Joint ; Humans ; Neural Conduction ; Retrospective Studies ; Ulnar Nerve* ; Ulnar Neuropathies*

PURPOSE: To assess the clinical results of surgical treatment for established nonunion of the lateral humeral condyle and to determine the factors necessary for successful outcome. MATERIALS AND METHODS: 12 patients with nonunion of the lateral humeral condyle underwent open reduction, autogenous iliac bone graft and internal fixation with two smooth or treated K-wires between 1994 and 1999. Mean age was 16 years and the mean follow-up period was 2 years and 8 months. RESULTS: All of the patients achieved solid union at the nonunion site and were free of pain in the elbow upon strenuous activities. Average union time was 7.2 weeks after the surgery. Aggressive anatomical reduction of the fragment must not be undertaken because it may disturb a well adapted joint congruity in adults. Rigid internal fixation with iliac bone graft and preservation of the blood supply of the distal fragment are important factors for a successful outcome. The range of motion of the elbow joint decreased 10.5 degrees on average after surgery. Valgus deformity improved in four of six patients. CONCLUSION: The patients with symptomatic established nonunion are good candidates for surgery, even adults.
Adult ; Congenital Abnormalities ; Elbow ; Elbow Joint ; Follow-Up Studies ; Humans ; Joints ; Range of Motion, Articular ; Transplants

Cubitus varus and valgus is one of late complication of elbow fracture, and this deformity is caused usually by malunion in supracondylar fracture or epiphysial injury of the elbow joint. 40 supracondylar closed wedge osteotomies (on cubitus varus 25, cubitus valgus 15) were performed at the supracondylar level and were fixed with two K-wires or French method. The following results were obtained: 1. The frequency of deformity of cubitus varus was higher than that of cubitus valgus: cubitus varus, 25 cases and cubitus valgus, 15 cases. 2. Injury of the supracondylar of the humerus frequentry occured between the age of 6 and 15 (65%). 3. In cubitus varus the degree of deformity ranging from −11° to −30° was the most common whereas in cubitus valgus that ranging from 30° to 40°, 4. Incomplete ulnar nerve palsy was revealed in 15 postoperative cases of cubitus varus of which 3 cases were treated by anterior transposition. In all cubitus valgus, tardy ulnar nerve symptom was disappeared after correction. 5. Nerve damage could be avoid by performing the closed wedge osteotomy and upper connection combind with posterolateral incision in cubitus varus and medial incision in cubitus valgue. 6. Internal fixation associated with cross pinning with two K-wires or French method were performed and good result was obtained without complication even though older case.
Congenital Abnormalities ; Elbow ; Elbow Joint ; Humerus ; Methods ; Osteotomy ; Ulnar Nerve ; Ulnar Neuropathies

Elbow Joint ; innervation ; surgery ; Humans ; Male ; Median Nerve ; abnormalities ; Ulnar Nerve ; abnormalities ; Young Adult

Adult ; Elbow Joint ; injuries ; Female ; Humans ; Joint Dislocations ; therapy ; Musculoskeletal Manipulations ; Radius ; abnormalities ; Radius Fractures ; therapy ; Synostosis ; therapy ; Ulna ; abnormalities

We evaluated abnormalities in medial portion of elbow in high-school weightlifter compared with the non weightlifter using a stress radiography and ultrsonography. The experimental group(G1) was 26 high school weightlifters with an average age of 17 years old (range, 16.18 years). The control group (G2) were comprised of 25 age matched general students. Both groups received physical examination, simple and valgus stress radiography and ultrasonography on both side of elbow. Physical examination showed 26.9% (14/52 elbows) tenderness and 19.2% (10/52 elbows) valgus laxity in G1, no tenderness and laxity in G2. There were no differences in medial joint gaps on simple radiography (G1, 3.3 mm, G2, 2.7 mm; p>0.05), but the valgus stress view showed 5.6+/-0.8 mm medial joint gap in G1 and 3.8+/-0.8 mm in G2 (p<0.001). Ultrasonography in G1, angular deformity was found in 67.3% (36/52) and G2 all in normal (p<0.01). The horizontal distance was an average 4.9+/-1.23 mm for the G1 and 3.1+/-0.78 mm for the G2 (p<0.001). Vertical distance of the proximal portion of the ulna was average 0.58+/-0.94 mm for the G1 and 1.59+/-0.49 mm for the G2 (p<0.001). In G1, angular deformity of male was 50% (15/30 elbows) and female was 95% (21/22 elbows) (p<0.001). Change of horizontal and vertical distance were larger in female (p<0.05). In conclusion, there were increased incidence of medial elbow joint laxity in high school weightlifter, especially in female, regardless of career. Sustained valgus laxity could be prone to ulnar collateral ligament injury and should be evaluated with ultrasonography-assisted dynamic study.
Collateral Ligaments ; Congenital Abnormalities ; Elbow Joint* ; Elbow* ; Female ; Humans ; Incidence ; Joints ; Male ; Physical Examination ; Radiography ; Ulna ; Ultrasonography

History taking, physical examination and x-ray study of both elbows were made on 55 senior high school, college and vocational baseball pitchers who visited the Department of Orthopedic Surgery of Hanyang University Hospital from March 1, 1980 to April 30, 1980. The results of this study were as follows: 1. Average age of 13 high school pitchers was 17.2 years, of 20 college pitchers was 20.1 years, and of 22 vocational pitchers was 23.4 years and average duration of pitching of high school pitchers was 3.8 years, college pitchers was 7.4 years, and vocational pitchers was 9.8 years. 2. Overhand type pitchers were 39(70.9%) and it was the most common pitching style. 3. 45(81.8%) complained elbow pain and the order of frequency was medial, lateral, and posterior. 4. 45(81.8%) showed hpertrophy of forearm and 38(69.1%) showed hypertrophy of arm. 5. Valgus deformity of the elbow joint was observed In 34(61.8%) and flexion contracture of the elbow joint was in 41 (74.5%). 6. Changes on x-ray were ossicle, traction spur, humeroulnar hypertrophy, narrowing of joint space, calciflcation of soft tissue and others. 7. Changes on x-ray were in proportion to duration of pitching and especially combined Iesions were observed more often ln overhand type pitchers.
Arm ; Baseball ; Clinical Study ; Congenital Abnormalities ; Contracture ; Elbow Joint ; Elbow ; Forearm ; Humans ; Hypertrophy ; Joints ; Orthopedics ; Physical Examination ; Traction

Cubitus varus deformity caused usually by malunion in supracondylar fracture or epiphyseal injuries of the elbow joint, but the other causes of cubitus varus deformity have not been reported. 7 cases of cubitus varus deformity were found among the patients in Sam Yook Childrens Rehabilitation Center in Oct. 1981 all of whom used crutches in order to ambulate due to late sequele of poliomyelitis. The results were as follows. l. After long-term crutch walking, cubitus varus deformity and bowing around the proximal forearm were seen among the patients who mis-used the crutches. 2. Gross carrying angle was greater than radiographic carrying angle and it caused by hypertrophy of the extensor muscle group in forearm and bowing around the proximal forearm. 3. Etiologic factors of the cubitus varus deformity were considered to be improper measurement of the crutches, degree of paralysis of lower extremity and duration of the crutch walking, etc. 4. The mechanism of this deformity could be explained biomechanically by the abnormal axial loading onto the elbow following long-term crutch walking. 5. The correct measurement of the crutches and proper flexion of the elbow during crutch walking were stressed.
Child ; Congenital Abnormalities ; Crutches ; Elbow ; Elbow Joint ; Forearm ; Humans ; Hypertrophy ; Lower Extremity ; Paralysis ; Poliomyelitis ; Rehabilitation Centers ; Walking