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

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

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

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

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

OBJECTIVEFractures of the capitellum and trochlea constitute less than 1% of all elbow fractures and a shear fracture involving the capitellum and extending medially into most of the trochlea is rarely reported. Type IV capitellum fracture is still controversial in regard to its radiographic appearance, surgical approach and osteosynthesis. We report 10 cases of type IV capitellum fracture with a view to elucidating its clinical features and treatment outcome.

METHODSWe treated 10 patients of type IV capitellum fracture with a mean age of 32 years. A uniform surgical approach and postoperative rehabilitation were followed.

RESULTSNine patients presented to us after a mean of 4 days of injury and one patient was nonunion after 6 months of injury who had been treated conservatively by a bone setter. Double arc sign was absent in 6 cases. Intraoperatively 6 capitellotrochlear fragments were devoid of soft tissue attachments. By Mayo Elbow Performance Score evaluation, 7 patients got excellent, 2 good and 1 fair results. One patient with associated elbow dislocation developed heterotopic ossification. There was no case of avascular necrosis, osteoarthrosis or fixation failures.

CONCLUSIONSType IV capitellum fractures are rare and belong to complex articular injuries. A good functional outcome can only be achieved with open reduction and stable internal fixation followed by early mobilization. Preoperative radiographic assessment and computed tomography help surgeons in choosing the right surgical approach and implants. Good surgical technique and stable internal fixation are the keys to early mobilization and good functional outcome.

Adolescent ; Adult ; Elbow Joint ; injuries ; Female ; Humans ; Joint Dislocations ; therapy ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged

Elbow Joint ; injuries ; surgery ; Female ; Humans ; Joint Dislocations ; surgery ; Young Adult

Child ; Child, Preschool ; Elbow Joint ; injuries ; Female ; Humans ; Infant ; Joint Dislocations ; therapy ; Male ; Musculoskeletal Manipulations ; methods