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

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

One hundred and five Labrador dogs were randomly divided into two groups to determine the number of animals that develop elbow dysplasia when treated with an oral supplement compared to untreated ones. Efficacy of the oral treatment was also evaluated once illness was diagnosed. The supplement (Hyaloral) contained hyaluronic acid, hydrolysed collagen, glucosamine, chondroitin sulphate, and gamma oryzanol. Clinical evaluation of the elbow joints was completed at months 3, 6, 12, and 20 by orthopaedic evaluations, radiography, serologic and blood analysis, and veterinarian evaluation of dysplasia symptoms. All side effects were recorded. In the control group, 33.3% of the dogs developed radiographic evidence of elbow dysplasia compared to 18.5% in the treated group. Symptoms of dysplasia at 12 months differed between the treated (12.5%) and control (61.5%) animals, and were significantly different at 20 months (p < 0.05). Differences in lameness along with movement and swelling of the elbows between groups were observed after 12 months. The treated group had improved significantly by the last visit (p < 0.05). No adverse side effects were reported. In conclusion, oral treatment with Hyaloral may have a potential cumulative action that provides protection against dysplasia and significantly improves symptoms of elbow dysplasia.
Administration, Oral ; Animals ; Collagen/*therapeutic use ; Dietary Supplements/analysis ; Dog Diseases/*prevention & control ; Dogs ; Drug Combinations ; Elbow Joint/*abnormalities ; Genetic Diseases, Inborn/prevention & control/*veterinary ; Hyaluronic Acid/*therapeutic use ; Joint Diseases/prevention & control/*veterinary ; Spain ; Species Specificity

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

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

PURPOSE: To determine useful diagnostic criteria of cubital tunnel syndrome (CTS), using ultrasonographic ulnar nerve cross-sectional areas (UNCSA) measurements. MATERIALS AND METHODS: The CTS group included 28 patients confirmed with nerve conduction study and the control group included 17 healthy adults. Ulnar nerve cross-sectional areas (UNCSA) were measured at the distal 1/3 upper arm level and in the cubital tunnel (CTN). US findings of CTS were ulnar nerve dislocation (n = 2), ulnar nerve subluxation (n = 5), ganglion (n = 1), sever elbow joint osteoarthritis (n = 1) and elbow joint valgus deformity after fracture (n = 1). UNCSA, the ratio of UNCSA in CTN to distal 1/3 upper arm level (CH ratio), and the difference of UNCSA between CTN and distal 1/3 upper arm level (CH difference) were evaluated to obtain the optimal diagnostic cutoff value of CTS, using ROC curve. RESULTS: The mean UNCSA in CTN was 0.168 cm2 in the CTS and 0.067 cm2 in the control. The CTS could be diagnosed when UNCSA, the CH ratio and the CH difference are larger than 0.096 cm2, 1.371 and 0.036 cm2 respectively. The ROC curve area was largest and the sensitivity, specificity was respectively 82.4%, 95.8%, when the CH difference was used as cutoff value. CONCLUSIONS: Ultrasound is useful for the detection of CTS pathogenic lesions in CTN. The highest diagnostic accuracy was acquired when the CH difference is larger than 0.036 cm2.
Adult ; Arm ; Congenital Abnormalities ; Cubital Tunnel Syndrome ; Dislocations ; Diterpenes ; Elbow Joint ; Ganglion Cysts ; Humans ; Neural Conduction ; Osteoarthritis ; ROC Curve ; Sensitivity and Specificity ; Ulnar Nerve

OBJECTIVE: To report one case of cubital tunnel syndrome due to repetitive work METHOD: The authors examined a worker who complained of severe muscle atrophy between the right thumb and index finger, claw deformity and numbness of the 5th finger. We evaluated him with physical examination, neurophysiologic studies (nerve conduction study, NCV; electromygraphy, EMG), plain Xray and magnetic resonance image(MRI) at the right elbow. We also investigated his occupational history, and analyzed his work motions, using rapid upper limb assessment (RULA) of the work cycle at his previous work site. RESULT: The patient had been a ship welder for 17 years, followed by 6 years of dismantling boxes and loading/unloading materials. The latter job required inappropriate elbow posture such as repetitive flexion and extension. The NCV study revealed slow conduction velocity of the right ulnar motor and sensory nerve, decreased action potential of the right hand intrinsic muscles and flexor carpi ulnaris. The simple X-ray film showed normal finding, but MRI showed a finding compatible with cubital tunnel syndrome combined with enlargement of the right ulnar nerve at right elbow, 0.6cm intraarticular loose body and medial aspect of the medial epicondyle of the right distal humerus. CONCLUSION: We confirmed the diagnosis of cubital tunnel syndrome that was related to his packing job which had demanded repetitive flexion and extension of elbow joint. At the time of writing, surgery was being considered as appropriate treatment.
Action Potentials ; Animals ; Congenital Abnormalities ; Cubital Tunnel Syndrome* ; Diagnosis ; Elbow ; Elbow Joint ; Fingers ; Hand ; Hoof and Claw ; Humans ; Humerus ; Hypesthesia ; Magnetic Resonance Imaging ; Muscles ; Muscular Atrophy ; Physical Examination ; Posture ; Ships ; Thumb ; Ulnar Nerve ; Upper Extremity ; Workplace ; Writing ; X-Ray Film

The clinical, radiological and pathologic features of a biphasic synovial sarcoma in the left elbow joint of a two-year-old male Rottweiler are presented. The tumor showed positive immunoreactivity for vimentin, Epithelial Membrane Antigen (EMA), p53 and PCNA, while it was negative for the cytokeratin used, S-100, Rb and p21. Immunohistochemistry for EMA allowed the identification of epithelioid components of synovial sarcoma, and may, therefore, contribute in establishing a diagnosis of biphasic synovial sarcoma. Intratumoral variation in PCNA immunoreactivity was minimal, indicating that the various tumor components proliferate at more or less similar rates. Overall, the characterized immunohistochemical profile for canine synovial sarcoma, not defined previously, may provide clues to the histogenesis of the phenotypically mesenchymal and epithelial elements of the tumor, and may be of value in the differential diagnosis of challenging cases, decreasing the risk of under- and mis-diagnosis. Although more cases need to be studied to determine whether there is a consistent pattern of immunostaining in canine synovial sarcoma, its potential significance is discussed in relation to the histogenesis, molecular pathology and differential diagnosis of canine synovial sarcoma.
Animals ; CA-15-3 Antigen/analysis ; Dog Diseases/*pathology/radiography ; Dogs ; Elbow Joint/abnormalities/pathology/radiography ; Forelimb ; Histocytochemistry/veterinary ; Immunohistochemistry/veterinary ; Keratins/analysis ; Male ; Oncogene Protein p21(ras)/analysis ; Proliferating Cell Nuclear Antigen/analysis ; Retinoblastoma Protein/analysis ; Sarcoma, Synovial/chemistry/pathology/radiography/*veterinary ; Soft Tissue Neoplasms/chemistry/radiography/*veterinary ; Tumor Suppressor Protein p53/analysis ; Vimentin/analysis

PURPOSE: To evaluate the clinical manifestations of contracted joints and the radiological features in mucopolysaccharidosis(MPS). MATERIALS AND METHODS: From January 1996 to March 2002, 15 children from a pool of children diagnosed with MPS through a fibroblast culture and an enzyme assay, who could tolerate a large umber of examinations, underwent orthopedic physical and radiological examinations. RESULTS: There were limitations in the abduction and internal rotation of the shoulder, extension limitation of the wrist, and internal rotation of the hip joint and flexion contractures of the elbow and DIP joints. Scoliotic deformities were all within the physiological curve. There were only three cases of a dorsolumbar kyphotic change and there were no neurological deficits due to the spinal deformities. The mean bone age was delayed compared with the mean chronological age. As the chronological age increased, the gap between the chronological age and the bone age increased. CONCLUSION: Joint contracture, which is the most severe symptom in orthopedic aspect, was more severe in the upper extremities than in the lower extremities. The spinal deformity was relatively mild and there were no neurological problems. The bone age tended to be delayed as the chronological age increased.
Child ; Congenital Abnormalities ; Contracture* ; Elbow ; Enzyme Assays ; Fibroblasts ; Hip Joint ; Humans ; Joints* ; Lower Extremity ; Mucopolysaccharidoses* ; Orthopedics ; Shoulder ; Upper Extremity ; Wrist

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*