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At least 181 records · Page 10Linked to original sources
PubMed1984

[Injuries of the elbow and forearm in children].

The article reviews aids in radiological diagnosis of elbow lesions in children. It is most essential to know the anatomical conditions, the development of the ossification centres, of the statisticsl frequency of the individual types of lesions, and of the numerous combined sequels to traumas. The valuable aid given by th roentenological visualisation of the extracapsular fat (anterior and posterior), especially in undefined lesions, is discussed, as well as the importance of other fat pad signs which are helpful in identifying anatomic conditions. Most of the wrong diagnoses can be avoided if a few fundamental points are observed, such as identification of the epicondylus medialis according to age, positive or negative visualisation of extracapsular fat, and visualisation of both adjoining joints in lower arm fractures claimed to be of an isolated nature.

Adolescent↗
PubMed1994

[Radial head prosthesis with floating cup in recent and old injuries of the elbow: preliminary results].

PURPOSE OF THE STUDY: In recent traumatology (complex radial head fractures with severe sprain of the medial collateral ligament), as well as in sequellae (extensive release for severe elbow stiffness), the implantation of a radial head prosthesis may be necessary to stabilize the humero-ulnar joint and the radial shaft. Its major advantage consists of allowing immediate postoperative mobilization. Swanson first proposed a silastic replacement of the radial head which turned out to have serious mechanical and biological disadvantages. MATERIAL AND METHODS: We propose a new Titanium implant, which is stiffer, and made of 2 parts connected by a spherical joint, thus maintaining an optimum congruence between the prosthetic component and the humeral condyle in any position of the joint (flexion/extension or pronosupination). This prosthesis was implanted in 4 recent fractures and reviewed after an average follow-up of 23 months [12-36]. RESULTS: Results were excellent in 2 cases, and good in 1 case: functional assessment was fair in the last case, in which the initial lesion consisted of a complex ulnar fracture associated with a Mason 3 fracture of the radial head. An osteosynthesis of the ulnar shaft and olecranon had preceeded implantation of the radial head prosthesis. In 5 additional cases with severe posttraumatic elbow stiffness, the prosthesis was implanted during elbow release, regularly allowing durable stabilization of the joint in an anatomic position, and in 2 of these cases, permanent correction of the radio-ulnar index. In these last cases, proximal migration of the radial shaft had occurred after resection of the radial head. In one case, this migration had resulted in ulnar fusion complicating a Sauve-Kapandji procedure. In the other case, proximal migration of the radius had resulted in painful distal radio-ulnar dislocation. In this second group, patients were followed-up an average of 31 months [12-46]. No complication has yet been recorded (no osteolysis, no stem breakage, no wear, no loosening). DISCUSSION: Indications for implantation of a radial head prosthesis were deduced from these observations: in recent trauma, implantation of the prosthesis should only be indicated in those fractures, in which osteosynthesis appears not to be possible (Mason 3 or 4), with the following associations: radial head fracture with severe sprain of the medical collateral ligament--patients with positive radio-ulnar index--extensive lesions of the interosseous membrane (Essex-Lopresti, or Monteggia affecting the ulnar shaft)--associated fracture of the proximal ulna (olecranon, coronoid process...). In sequellae, we propose the following indications: extensive elbow release compromising elbow stability--painful inferior radio-ulnar dislocation complicating resection of the radial head--valgus instability complicating radial head resection.

Adolescent↗
PubMed1996

Management of fractures and dislocations of the elbow in children.

Elbow injuries are common in children. The keys to a good outcome include timely, accurate characterization of the injury, stable anatomic reduction, utilization of closed treatment methods whenever possible and limited soft tissue dissection when operative treatment is required. Awareness of the developmental physeal anatomy of the elbow, common injury patterns and potential complications are essential in the management of these injuries. This review presents a practical approach to the management of elbow traumatic injury in the child, providing guidelines for evaluation and treatment for the less common pediatric elbow injuries.

Child↗
PubMed1994

Pediatric elbow fractures: MRI evaluation.

Magnetic resonance imaging (MRI) was performed in eight patients under the age of 8 years who suffered elbow fractures, to assess possible fracture extension into the distal nonossified epiphysis of the humerus in seven cases and to determine the displacement and location of the radial head in one case. MRI allowed accurate depiction of the fracture line when it extended into the cartilaginous epiphysis. In four cases, MRI findings were confirmed at surgery. In five cases, surgery was obviated because no articular extension of the fracture was seen on MRI (4 cases) or because no displacement was noted (1 case). In one patient, the plain film diagnosis of a Salter type II fracture was changed to Salter type IV on the basis of the MRI findings. It is concluded that MRI might play a role in the preoperative evaluation of pediatric patients presenting with elbow trauma when extension of the fracture cannot be determined with routine radiographic studies. Elbow injuries in children may be difficult to diagnose by routine clinical and radiographic techniques [1, 4, 12, 14]. Diagnostic difficulty is due to the presence of multiple ossification centers of the distal humeral epiphysis and proximal radius and ulna; these are mostly cartilaginous until the age of 11-12 years and therefore invisible on radiographs. Following distal radial and distal tibial physeal fractures, epiphyseal elbow injuries are the most frequent epiphyseal injuries [8, 16]. These fractures tend to be unstable and often require surgical intervention. In addition, lasting sequelae such as cubitus valgus and delayed ulnar nerve palsy can occur if these fractures are not treated properly [8].(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMedDate not supplied

Pediatric floating elbow.

SUMMARY: A retrospective review of 16 patients with floating elbow injuries over a 9-year period at a tertiary care children's hospital confirms that these injuries are associated with substantial swelling and the potential to develop compartment syndrome, particularly when circumferential cast immobilization is used. Among 10 patients in whom the forearm was treated with closed reduction and plaster immobilization, a compartment syndrome developed in 2, and 4 patients had incipient compartment syndrome that responded to splitting of the cast; 3 of these subsequently required remanipulation of the distal radius. One patient with compartment syndrome had Volkmann ischemic contracture. Six patients underwent stabilization of both the distal humeral and forearm fractures with percutaneously inserted Kirschner wires, thereby allowing postreduction immobilization in a split cast. None of these patients had problems with excessive swelling or compartment syndrome. Percutaneous Kirschner wire fixation of both the humeral and forearm fractures in pediatric floating elbow injuries allows noncircumferential immobilization, thereby reducing the risk of compartment syndrome.

Adolescent↗
PubMed1981

Ipsilateral elbow and forearm injuries in children.

Twenty-five children with combined elbow injury and forearm bone fractures have been reviewed. The incidence of serious complications was low, and only one patient was significantly handicapped. Open reduction and internal fixation of the supracondylar fracture with closed treatment of the forearm fracture gave the best results.

Adolescent↗
PubMed2004

PLRI: posterolateral rotatory instability of the elbow.

Recurrent and persistent instability of the elbow has long been a source of confusion and dismay for both patients and physicians. Early recognition after elbow injury and careful attention to soft tissue repair during lateral elbow surgery may diminish the incidence of this condition. Repair and reconstruction of the lateral ulnar collateral ligament (LUCL) now offers practical and often successful solutions for patients with posterolateral rotatory instability (PLRI) of the elbow.

Athletic Injuries↗
PubMed1986

Nonosseous athletic injuries of the elbow, forearm, and hand.

This article deals with soft-tissue injuries of the upper extremity incurred by competitive athletes. The authors describe the pathophysiology, conservative and operative management of musculotendinous elbow injuries, entrapment neuropathy, tendinous disorders, vascular injuries, and dermatologic conditions in athletes. Protective gear for many of the aforementioned injuries are also described.

Athletic Injuries↗
PubMed2001

Treatment options for complex elbow fracture dislocations.

The management of complex elbow fractures and fracture-dislocations requires an accurate assessment of the patterns of elbow injury. The surgical management of these injuries, in order to restore elbow stability and function, includes reconstruction of the articular surfaces and stabilization of the periarticular soft tissues. A surgical algorithm is presented to provide guidelines for treating these complex injuries.

Algorithms↗
PubMed1997

Reliability of fat-pad sign in radial head/neck fractures of the elbow.

In a prospective study at a single centre between August 1995 and March 1996, 193 patients with elbow injuries were studied. Standard radiographs of the elbows were taken. A total of 181 X-rays were reported by one person concerning the presence or absence of fractures and fat-pad signs. The radiographs were analysed and positive predictive values were calculated for the presence of the fat-pad sign with radial head/neck fractures. The sensitivity for radial head/neck fracture is 85.4 per cent, while the specificity is only 50 per cent. The fat-pad sign must be used cautiously as an indicator of radial head/neck fractures; its absence is a more reliable indicator of the absence of a radial head/ neck fracture.

Adolescent↗
PubMed1976

Intravenous regional anaesthesia in children.

Fifty children, aged 3-12 yr, received intravenous regional anaesthesia for the treatment of either simple forearm fractures or elbow injuries. The technique obviated delays in treatment and allowed the child to be discharged from hospital immediately after treatment. There were no complications resulting from anaesthesia, but there was one anaesthetic failure.

Anesthesia, Conduction↗