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At least 145 records · Page 8Linked to original sources
PubMed1992

Recognition of arterial injury in elbow dislocation.

The clinical presentation of patients with elbow dislocations was reviewed to identify those factors indicating an increased risk for arterial injury. Sixty-two patients were treated for 63 elbow dislocations between January 1981 and July 1991. Eight patients (13%) sustained a concomitant arterial injury involving the brachial (7) and radial (1) arteries. Three clinical findings, absence of a radial pulse, open dislocation, and presence of systemic injuries, were correlated with arterial injury. A palpable radial pulse was absent in six (75%) patients with an arterial injury but in only two (4%) with normal vessels (p less than 0.0001, chi square). Five (33%) open dislocations had an associated arterial injury, whereas three (6%) arterial injuries occurred in closed dislocations (p less than 0.006, chi square). Systemic injury occurred in five dislocations (63%) with arterial injuries and 14 dislocations (25%) without arterial injury (p less than 0.04, chi square). Multivariate analysis showed that absence of a radial pulse was the only factor that significantly predicted arterial injury (p less than 0.0001). Although most elbow dislocations are not associated with arterial injury, absence of a radial pulse or presence of an open dislocation or both should alert the clinician to the increased possibility of an associated vascular injury.

Adult↗
PubMed2006

Muscle changes in brachial plexus birth injury with elbow flexion contracture: an MRI study.

BACKGROUND: Muscle pathology of the arm and forearm in brachial plexus birth injury (BPBI) with elbow flexion contracture has not been evaluated with MRI. OBJECTIVE: To determine whether limited range of motion of the elbow in BPBI is correlated with specific patterns of muscular pathology. MATERIALS AND METHODS: For 15 BPBI patients, total active motion (TAM) of the elbow (extension-flexion) and the forearm (pronation-supination) were measured. MRI of the elbow joints and musculature allowed assessment of elbow congruency. Fatty infiltration and size reduction of the muscles were graded semiquantitatively. RESULTS: Mean TAM of the elbow was 113 degrees (50 degrees-140 degrees) and that of the forearm 91 degrees (10 degrees-165 degrees). The greater the size reduction of the brachioradialis muscle, the more diminished was elbow TAM. The more extensive the BPBI and muscle pathology of the pronator teres muscle, the more limited was the TAM of the forearm. Pathology of the supinator and brachialis muscles was evident in every patient. CONCLUSION: Extensive BPBI may result in marked limitation of TAM. Elbow flexion contracture seems to be caused mainly by brachialis muscle pathology. Prosupination of the forearm is better preserved when the pronator teres is not severely affected. MRI can reliably show the extent of muscle pathology in BPBI.

Adolescent↗
PubMedDate not supplied

[Alloarthroplasty of war injuries of the elbow joint].

War injuries require specific approach in order to be optimally managed. In case of penetrating or explosive joint injuries, the management should be done with regard of the war surgery doctrine. Besides, it is very hard to prognose the disability degree after the completed treatment. If we point out that the average age of our patients with implanted elbow endoprosthesis was between 23 to 35 years, our efforts to reduce the disability are understandable. For all the reasons cited above, in the last two years we started with the total elbow arthroplasty. In all the patients with implanted elbow endoprosthesis, the improvement in the amplitude of elbow movements was observed. In 20% cases the pain was significantly decreased, and in 80% cases, the elbow became painless.

Arthroplasty, Replacement↗
PubMed1976

[A rare form of median nerve injury during elbow dislocation].

The following is a report concerning a rare complication in the case of an elbow luxation. In the course of repositioning, the nervus medianus slipped into the joint cavity, causing total paralysis of the nerve medianus. Operative revision of the nerve and restoration through interfascular nerve transplantation. Results one half a year after the operation are already satisfactory. Since this complication does not sand in immediate connection with the accident, and in consequence representing a serious injury, besides being very rare--the literature produced only 6 cases--we see ourselves induced to further discuss the mechanism of injury and the problems of such an accident, and to point out the necessity of an early revision.

Child↗
PubMedDate not supplied

An analysis of 100 symptomatic baseball players.

The management of baseball elbow injuries, both operative and nonoperative, was usually successful, permitting continued high-level athletic participation. Surgery was particularly effective in those cases with loose bodies. In the shoulder, symptoms occurred in the anterior and posterior regions. Each area presented difficulties in accurate diagnosis. The management of anterior symptoms was primarily nonoperative, surgery being reserved as a salvage procedure. In the posterior capsular syndrome, the source of pain is still unclear.

Athletic Injuries↗
PubMed1978

[Arterial involvement in elbow-proximal injuries].

Nine cases of distal brachial artery injury were discussed. We refer to case No. 7 in which a complete dorsal displacement of the artery occurred through the fracture-line of the epicondyle. Trauma caused dislocation, laceration, or spasm of the artery, with or without intravascular thrombosis. Vascular spasm should not be diagnosed unless an arteriogram is available. If not done preoperatively, it can be done during operation. In this case inspection of the vessel during operation seems essential. Venous interposition is satisfactory for bridging defects of the distal brachial artery even in the elbow region.

Adolescent↗
PubMed1994

[Surgical therapy of radial head fracture--results of osteosynthesis and resection treatment].

Between 1982 and 1993 we performed internal fixation or resection in 95 adult patients for radial head fracture. It was possible to follow up 68 patients for an average of 2.1 years. In 53 cases the initial injury was an isolated radial head fracture, which was treated by internal fixation in 41 and resection in 12 cases. Good results were obtained in 80% of patients. A satisfactory outcome was associated with young age, little initial fragment dislocation, internal fixation with screw + K-wire, and early postoperative physiotherapy. Primary resection for crush fractures of the radial head did not have negative long-term effects. In a comparison group with complex elbow injuries (elbow luxation in 9 and a Monteggia-type injury in 6 cases) in addition, results were considerably poorer and did not depend on the above-mentioned factors.

Adult↗
PubMed1999

Traumatic nerve injuries about the elbow.

Although not common, nerve injuries about the elbow occur because of the proximity of the three upper extremity nerves or because of the relationship of the median, ulnar, and radial nerves to the bony and soft-tissue structures about the elbow joint. Nerve injuries at and about the elbow joint occur more frequently with fractures than with any other kind of trauma. Nerve injuries may be found with periarticular fractures, dislocations, gunshot wounds, lacerations, and other iatrogenic causes.

Brachial Plexus↗
PubMed1997

Anterior interosseus nerve injury following elbow arthroscopy.

Elbow arthroscopy is becoming an increasingly invaluable tool for both evaluation of and treatment of a variety of interarticular disease processes. Case reports have documented radial and posterior interosseus injuries following anterior capsular release. To date, this is the first report of an anterior interosseus nerve injury following arthroscopic surgery of the elbow. Arthroscopic surgery offers unparalleled visualization of the multiple articulations and facets of the elbow. It has been reported as useful for removal of loose bodies, synovectomy, release of arthrofibrosis, and the treatment of osteochondritis dessicans. However, the technique does require thorough knowledge of neurovascular structures about the elbow as well as appreciation of the protective layers including the capsule, brachialis, and brachioradialis muscles. This report documents direct injury to the anterior interosseus branch of the median nerve during an elbow debridement and synovectomy in a 65-year-old patient with rheumatoid arthritis.

Aged↗
PubMed1960

Elbow and wrist injuries in sports.

Any disabling injury of the elbow or wrist should be studied roentgenographically for evidence of fracture which may not be otherwise evident but which may cause permanent disability unless the joint is immobilized for healing."Tennis elbow" may be treated with physical therapy and analgesic injection but may require splinting or tendon stripping. Elbow sprain can occur in the growing epiphysis but is rare in adults. A jarring fall on the hand may cause fracture or dislocation at the elbow. Full extension of the joint should be restored gradually by active exercise rather than passive or forcible stretching. Fracture at the head of the radius may cause joint hemorrhage with severe pain which can be relieved by aspiration. A displacing fracture at the head of the radius requires removal of the head to prevent arthritic changes. Myositis ossificans contraindicates operation until after it has cleared. Healing of wrist fractures may be facilitated by exercise of the shoulder and elbow while the wrist is still in a cast. Fractures of the navicular bone are difficult to detect even roentgenographically and splinting may have to be done on clinical evidence alone.

Adult↗
PubMedDate not supplied

Sports-related injuries of the elbow.

Sports-related injuries about the elbow occur commonly and are often managed by a wide variety of health care providers. It is particularly important that a surgeon well versed in arthroscopy, reconstructive trauma, and peripheral nerve techniques evaluates potentially complex injuries. It is equally imperative that the preoperative care regimen and postoperative management be conducted by an experienced therapist who understands elbow biomechanics and function. Acute pathology, such as fracture or severe ligamentous and tendinous injury, usually warrants operative treatment. A thorough understanding of the anatomy and biomechanics of the elbow is crucial since the expected recovery in the nonathlete will not suffice for the competitive athlete. Demanding activities, such as the overhead-throwing motion cycle, require a much more complete recovery than simple return to activities of daily living. Chronic elbow problems in the athlete can often be managed with appropriate therapy and modification to the training protocol. Poor response to conservative means should lead to a more thorough evaluation by an experienced elbow surgeon as these injuries can often be career ending. The spectrum of commonly seen lesions in the athlete's elbow is described here, as are conservative care measures, operative treatments, and postoperative management.

Adult↗
PubMed2002

Little league elbow: valgus overload injury in the paediatric athlete.

This article describes a variety of elbow injuries often seen in young, throwing athletes. Understandings of normal skeletal development, as well as the biomechanics of throwing, provide a basis on which to evaluate, diagnose and manage "little league elbow". With emphasis on an anatomically-based differential diagnosis, the pathologic forces placed upon the young thrower's elbow, and the subsequent injury patterns, are reviewed. Medial side injuries are the most common and relate to chronic forces of valgus overload produced during the early and late cocking phases of throwing. The majority of this force is placed on the medial epicondyle and produces age-dependent injury patterns, such as apophysitis in childhood and epicondylar avulsion fractures in the more mature athlete. With repetitive valgus overload, lateral side injuries such as Panner's disease and osteochondritis dissecans of the capitellum and radial head become more apparent. These injuries relate to the compressive forces produced by the late cocking and early acceleration phases of throwing. Finally, posterior injury patterns consistent with olecranon apophysitis and posteromedial impingement, as well as flexion and capsular contracture, can be seen. The key in the treatment of "little league elbow" is prevention and this responsibility lies not only with the evaluating or team physician, but also with the coach, trainer, parents and officials. Proper throwing mechanics must be emphasised at an early age, and the determinants of elbow injury among young pitchers better understood. Early recognition and proper treatment of such injuries will then prevent later sequelae or functional disability.

Athletic Injuries↗
PubMed2006

Golf injuries and rehabilitation.

There are more than 25 million golfers in the united States, and many have an injury related to golf. Low back injuries are the most common golf injuries, followed by elbow injuries. Successful treatment of golf injuries often includes modification of the golf swing. Adaptations allow many individuals, including those who are physically challenged, to enjoy playing golf.

Adult↗
PubMed2006

Baseball and softball injuries.

Baseball and softball injuries can be a result of both acute and overuse injuries. Soft tissue injuries include contusions, abrasions, and lacerations. Return to play is allowed when risk of further injury is minimized. Common shoulder injuries include those to the rotator cuff, biceps tendon, and glenoid labrum. Elbow injuries are common in baseball and softball and include medial epicondylitis, ulnar collateral ligament injury, and osteochondritis dissecans. Typically conservative treatment with relative rest, medication, and a rehabilitation program will allow return to play. Surgical intervention may be needed for certain injuries or conservative treatment failure.

Athletic Injuries↗
PubMedDate not supplied

Operative treatment of ulnar collateral ligament injuries of the elbow in athletes.

Over a 6-year period, the senior author (JRA) performed 91 ulnar collateral ligament reconstructions (N = 78) or repairs (N = 13). All patients were male and between the ages of 15 and 39 years (average, 21.6). Thirty-seven patients (41%) were professional baseball players, 41 (45%) were collegiate baseball players, and 7 (7.7%) were high school or recreational players. Subcutaneous ulnar nerve transposition with stabilization of the nerve with fascial slings of the flexor pronator mass was performed in all patients, and additional procedures were performed in 27 patients (29.7%), including 22 excisions of posteromedial olecranon osteophytes. Average follow-up was 35.4 months. Ten patients had preoperative ulnar nerve symptoms, nine of whom had complete resolution of symptoms after surgery. Complications occurred in eight patients. The average time from surgery to initiation of the interval throwing program was 3.4 months, and the average time to return to competitive throwing was 9.8 months. Sixty-seven patients (74%) were available for follow-up; of these, 53 (79%) had returned to their previous levels of competition or to a higher level. Reconstruction of the ulnar collateral ligament, with transposition and stabilization of the ulnar nerve and appropriate rehabilitation, was found to be effective in correcting medial instability of the elbow and allowed most athletes to return to previous levels of play in less than 1 year.

Adolescent↗