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At least 19 recordsLinked to original sources
PubMed1979

Functional anatomy of the elbow joint and three-dimensional quantitative motion analysis of the elbow joint.

This work consists of two parts. Part One is a three-dimensional study of the passive motion of the elbow joint and revealed that the elbow joint was not a true hinge joint. Part Two is a three-dimensional quantitative motion analysis which was undertaken to compare shoulder and trunk motion in normal subjects with those with contracted elbows. This analysis revealed that shoulder rotation, shoulder abduction, trunk flexion and trunk rotation compensates for a contracted elbow.

Elbow Joint↗
PubMedDate not supplied

Semiconstrained total elbow arthroplasty.

Diminution of elbow function may be both embarrassing and severely disabling, especially in patients with multiple arthritic joints. Over the past century, multiple techniques of soft tissue reconstruction of the elbow have been advocated. In general, they do not compare well with total elbow arthroplasty. Arthrolysis has often resulted in little improvement of elbow motion and interposition arthroplasty to instability. Synovectomy may however offer satisfactory relief of disability for the rheumatoid elbow provided that initially there is little evidence of joint destruction. The major problem with rigidly linked total elbow arthroplasty has been a high incidence of prosthetic loosening. Biomechanical analysis has shown that high moments tend to disrupt the osseousmethacrylate junction in the humoral medulary canal. Development of a semi-constrained total elbow prosthesis transfers the developed stress to the collateral soft tissues and reduces prosthetic loosening to approximately 3 per cent. This is about one-tenth of the incidence of loosening of the hinge type arthroplasty. This reduction in prosthetic loosening has been coupled with excellent gains in flexion and estension. However, improvement in forearm rotation has not been predictable, especially in elbows exhibiting preoperative fusion or fibrous ankylosis. Though the semi-counstrained total elbow has only been generally available for 3 years, a review of these results justifies its continued use for elbow reconstruction.

Arthritis, Rheumatoid↗
PubMed1978

The radiological diagnosis of posttraumatic effusion of the elbow joint and its clinical significance: the 'displaced fat pad' sign.

Alterations occur in the radiological appearance of the soft tissues after injury to the elbow joint. These are due to displacement of the intra-articular fat pads by capsular distension when an effusion is present. A prospective study of 89 consecutive elbow injuries was undertaken in an attempt to assess the usefulness and reliability of these changes in the diagnosis of minor elbow injuries and the assessment of their clinical progress. In 61 elbows (69 per cent) there was no radiological evidence of an effusion and no evidence of bony injury. All quickly returned to normal. In 28 elbows (31 per cent) radiological evidence of an effusion was present. Twenty-three (80 per cent) of these were also found to have a fracture in, or adjacent to the elbow joint. In 9 elbows the fracture could not be seen on the initial radiographs. Because of the presence of an effusion, repeat radiographs were taken and a fracture discovered. The presence of an effusion was associated with an increase in the time required for full recovery.

Adipose Tissue↗
PubMed1979

The determination of bone age in the elbow as compared to the hand. A study in 390 children.

In a prospective study, bone age (BA) from both hand and elbow was assessed in 390 children, aged 6-15 years, in order to determine: (a) whether or not BA assessment from the hand and from the elbow give comparable results, and (b) whether the accuracy of predicting skeletal age from the hand may be improved by the additional BA determination in the elbow. BA assessment in the hand was performed according to the method of Greulich and Pyle while the standards of Schinz and Baensch were used for the elbow. Statistical analysis of data was carried out according to age groups as well as according to groups of clinical diagnoses. With only one exception in the group of so-called "healthy individuals", there was no difference between "hand age" and "elbow age". Thus, except in a very small group of subjects, both methods of BA assessment were found to be equivalent in predicting skeletal age in children between 6-15 years. Equivocal results were obtained regarding the question of whether the accuracy of BA assessment in the hand may be improved by the simultaneous BA determination from the elbow. Until further studies on larger statistical material provide more conclusive information in this matter, we feel that the combined determination of BA in the hand and elbow is not warranted for clinical purposes.

Adolescent↗
PubMed1976

Electrodiagnosis of ulnar nerve lesions at the elbow.

To determine electrical criteria which might be helpful in the diagnosis of ulnar nerve entrapment at the elbow, clinical and electrodiagnostic features in 78 patients with suspected ulnar nerve entrapment at the elbow are described and compared to the results of sensory and motor conduction in the ulnar nerve in a control group of normal persons. These criteria include (1) absent or abnormal evoked sensory nerve action potential in the little finger, (2) motor conduction velocity of less than 45.0 meters/sec in across elbow segment of the ulnar nerve with elbow flexed at 35 degrees, and (3) abnormal electromyographic findings including the presence of increased insertional activity or signs of denervation in the first dorsal interosseous, abductor digiti minimi, and/or flexor carpi ulnaris muscles. Electromyographic abnormality was seen in 77.5% of patients with ulnar motor conduction velocity of less than 45.0 meters/sec across the elbow. The first dorsal interosseous was the most commonly affected muscle. A study of certain important anatomic and histologic factors, such as the arrangement and relative concentration of the motor and sensory fibers at certain key points inthe course of the ulnar nerve trunk, is necessary to understand the correlation between the clinicopathologic and electrodiagnostic features in patients with ulnar nerve entrapment at the elbow.

Adult↗
PubMed1977

Total replacement of the elbow joint.

Total replacement of the elbow joint has been performed on 86 elbows at the Mayo Clinic, all but 15 in patients with rheumatoid arthritis. The Mayo design, which replaces both radiohumeral and humeroulnar joints, was used in 41 elbows, almost all in rheumatoid patients, with 71% good results. The Coonrad hinge with polyethylene bushings was used in 34 elbows; it was successful in 64% of rheumatoid patients, but failed in 46% of posttraumatic patients with bone loss. Previous designs have failed because of humeral loosening. Total elbow replacement is a technique still to be perfected in medical centers before general release.

Arthritis, Rheumatoid↗
PubMed2026

Comprehensive analysis of mRNA-microRNA-lncRNA expression profiles in post-traumatic elbow heterotopic ossification using RNA sequencing and experimental validation.

BACKGROUND: This study aimed to profile the molecular signatures of post-traumatic elbow heterotopic ossification (HO) to identify key regulators and potential therapeutic targets. METHODS: Total RNA from post-traumatic elbow HO tissues (n=4) and normal bone tissues (n=6) was subjected to high-throughput sequencing to identify differentially expressed mRNAs (DEGs), microRNAs (DEMs), and lncRNAs (DELs). Bioinformatics analyses included Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, protein-protein interaction network construction, and transcription factor (TF)-microRNA-mRNA network analysis. The expression trends of four most upregulated and four most downregulated DEGs were validated by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). RESULTS: We identified 2,138 DEGs, 40 DEMs, and 905 DELs. DEGs were significantly enriched in biological process "bone mineralization," cellular component "plasma membrane," molecular function "integrin binding," and pathways including PI3K-Akt, NF-κB, JAK-STAT, and TNF signaling pathways. Hub genes with high connectivity included MMP9, IL6, MMP3, CTSK, and BGLAP. Integrated network analysis highlighted the transcription factor JUN and key microRNAs (hsa-miR-124-3p, hsa-miR-548c-3p, and hsa-miR-135b). The qRT-PCR results confirmed the expression trends of selected DEGs. CONCLUSIONS: This study, for the first time, profiled the differentially expressed mRNAs, microRNAs, and lncRNAs in post-traumatic elbow HO using high-throughput RNA sequencing. These findings provide valuable insights into the molecular mechanisms of HO following elbow trauma. The identified hub genes (MMP9, IL6, MMP3, CTSK, and BGLAP), key TF (JUN), and key microRNAs (hsa-miR-124-3p, hsa-miR-548c-3p, and hsa-miR-135b) may serve as potential therapeutic targets for preventing and treating post-traumatic elbow HO.

Humans↗
PubMed1975

Precentral unit activity following torque pulse injections into elbow movements.

(1) Precentral neural activity was studied in relation to transient load changes on self-paced elbow movements. Four Cebus monkeys were trained to turn a freely moving handle back and forth between two targets by alternating self-paced elbow flexions and extensions. Torque pulses (of 10 or 100 msec) injected randomly to load or unload the movements stretched or slackened the appropiate prime movers: biceps or triceps. Perturbed movements oscillated at about 5.5 Hz but were completed successfully in about the same time as unperturbed movements. (2) Torque pulses evoked distinct "early" responses with latencies of 20-40 msec in 134 out of 153 precenteral neurons. Oppositely directed torque pulses evoked reciprocal (i.e. increased or decreased) early responses in 61 neurons, and uniform responses in 27 neurons. (3) Early responses were followed by "late" responses with peaks succeeding one another at about 5.5 Hz in 111 neurons, but another 16 exhibited late responses only. (4) Timing of both early and late cortical responses was tightly coupled to peripheral changes. Early responses were timed by the initial torque-induced passive elbow jerk. Timing of late responses was best related to subsequent peak decelerations of accelerations. Intensity of the early but not of all late precentral responses was tightly coupled to peripheral events. (5) Torque pulses that impeded flexions or extensions evoked spinal stretch reflexes in biceps or triceps with EMG latencies of about 15 msec, leading to an acceleration peak about 25 msec later. A second EMG burst followed the first in about 30 msec. The second burst occurred about 20 msec after onset of the early precentral response, which is thought to have caused it, as well as a second acceleration peak that was seen about 60 msec after precentral response (for flexion load pulses). Peaks of late precentral responses were followed by acceleration peaks within about 70 msec. (6) An interaction akin to the spinal stretch reflex is thus revealed between elbow perturbations, early responses of precentral neurons and subsequent elbow movements: discharges of neurons that usually fire in relation to an intended movement can be altered by sudden load changes so that the neurons tend to reduce mismatch between intended and actual movements (cortical load compensation), created by the perturbation. An analagous interaction may also occur with late cortical responses.

Adaptation, Physiological↗
PubMed1992

Cadaveric study on the vascular anatomy of the ulnar nerve at the elbow--a basis for anterior transposition?

The clinical results of anterior transposition of the ulnar nerve in compressive ulnar neuropathy have been unsatisfactory. This study aims at qualifying and quantifying the vascular anatomy of the ulnar nerve at the elbow so as to enable us to appreciate the possible effects of anterior transposition of the ulnar nerve. In our study of 16 cadaveric limbs, we found that the average number of nutrient vessels supplying the ulnar nerve is 14.3. The main contributing vessel in the arm is the superior ulnar collateral artery, at the elbow, the inferior ulnar collateral artery proximally, and the posterior ulnar recurrent artery distally. In the forearm, the main supply is from the ulnar artery. The average length of the nutrient vessels ranges from 1 cm at the elbow to about 2.6 cm in the arm. The nutrient vessels at the elbow are short, small and numerous. Blood supply to the nerve is segmental in nature. In our histological study of the nerve at the elbow, we found that overall, there are more vascular channels in the intrinsic system than the extrinsic system (statistical significance p < 0.01). From this study, we were able to postulate that there is devascularisation of the ulnar nerve following an anterior transposition. The significance of the devascularisation will require further studies.

Cadaver↗
PubMed1977

Ulnar nerve instability: ulnar nerve injury due to elbow flexion.

The term "ulnar nerve instability" describes the chronic conditions of subluxation and relocation of the ulnar nerve at the elbow with flexion and extension of the elbow, respectively. This condition is more common than generally thought. Recurrent subluxation of the nerve at the elbow results in a tractional and frictional neuritis. The nerve is vulnerable to trauma in its subluxed position, lying superficially on the medial humeral epicondyle. In certain cases of ulnar nerve instability associated with a tight overlying band bridging the heads of origin of the flexor carpi ulnaris, nerve injury can occur with flexion of the elbow. Thus, internal as well as external compressive factors as a cause of ulnar nerve neuropathy must be considered. Described is an elbow flexion test helpful in the diagnosis and prognosis of cases of ulnar nerve instability associated with the tight overlying band.

Adolescent↗
PubMedDate not supplied

Report on compound dislocation of the elbow with entrapment of the brachial artery.

Entrapment of the brachial artery within a compound dislocated elbow joint seems not to have been reported previously. Brachial artery rupture is the usual vascular injury associated with a compound elbow dislocation. A review of the surgical literature suggests that wide spectrum of disability may follow interruption of brachial artery flow at the elbow. While most patients experience no immediate or late ischemic symptoms because of the rich collateral network about the elbow, intermittent claudication or gangrene of the hand is possible and has been well-documented in the literature. To assure adequate circulation to the hand and prevent potential complications, reanastomosis or venous graft replacement of the damaged arterial segment is recommended at the time of traumatic disruption of the brachial artery.

Arm↗
PubMed1976

Intra-articular injuries of the elbow: pitfalls of diagnosis and treatment.

Poor results in treating fractures and dislocations about the elbow may be avoided if the surgeon is aware of the possible injuries, examines good radiographs of both elbows, and treats the injury promptly and appropriately. A displaced fracture of the lateral or medial condyle of the humerus should be suspected if there is a flake fracture of the adjoining metaphysis; open reduction and internal fixation give better results than closed reduction. A shear fracture of the capitulum humeri can only be seen on a lateral radiograph; excision of the fragment, followed by mobilization, is sufficient for a good functional result. Dislocation of the elbow in a child may avulse the medial epicondyle, which sometimes lodges in the joint; it is essential to recognize this and remove the fragment without delay to avoid early degenerative arthritis. An apparently isolated fracture of the ulna should alert the surgeon to the possibility of a dislocation of the radial head; the dislocation and the fracture must be reduced and stabilized to conserve elbow function.

Adolescent↗
PubMed1977

Flexion and supination deformities of the elbow in tetraplegics.

Fixed flexion and supination deformities of the elbow occur occasionally in tetraplegics. The patients in whom this was seen were those who following injury had a neurological level at C5 and who subsequently developed radial wrist extension and brachioradialis function. They were generally patients who spent long hours with their elbows flexed and supinated. A simple effective method of biceps tenotomy and plaster correction is described. Recurrence of deformity was seen if the flexion supination posture was continued. Strength of elbow flexion was not reduced. Patients maintained correction if they refrained from poor elbow posture and wore a simple plastic splint. The procedure of correction is not difficult and because of its simplicity it can be repeated if deformity recurs.

Adult↗
PubMed1975

Recurrent ulnar-nerve dislocation at the elbow.

Recurring luxation of the ulnar nerve at the elbow is not uncommon (16.2%), occurring about equally in young and old, male and female, athletes and non-athletes but the greater mobility is usually at the dominant arm. The probable cause of such dislocation is congenital laxity of supporting ligaments. Being more vulnerable to injury than normally-positioned nerves, however, complicating neuritis can does occur. Subluxating nerves which stop on the tip of the medial humeral epicondyle upon 90 degrees or more of flexion at the elbow are more subject to direct trauma than completely displaced neural structures which cross the epicondyle upon elbow flexion. The latter may develop friction neuritis which occurs most frequently in industrial workers and occasionally requires surgical transfer. Deep intramuscular implantation, with or without neurolysis, is definetely superior to subcutaneous placement of the affected nerve. In this report are described chemically-induced ulnar neuritis from cortisone injections about the medial humeral epicondyle; pressure ulnar neuritis in patients with enforced bed rest and from improper positioning on operating table with permanent neural deficit and the relationship of such hypermobile ulnar nerves to extension-flexion (whiplash) trauma to the neck. It is emphasized that most of these complications could have been avoided had the patient and his physician known that such anomalies were present. Of particular importance is the avoidance of pressure to the medial aspect of a flexed elbow in surgical patients under general anesthesia. The unrelated co-existence of intermittently-symptomatic hypermobile ulnar nerves and extension-flexion neck trauma may occur. Recognition of isolated unlar neuritis in these patients is definitely important from the diagnostic, treatment and medical-legal aspects of such cervical spine injuries.

Adult↗