[Trends of development in prosthetic surgery in the shoulder joint, elbow joint, hand joint and foot joint].
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Forecasting↗
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Results for “Elbow Joint”
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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↗
[Osteochondrosis dissecans of the elbow joint].
Thirty-one elbow joints in 29 patients (28 males, only 1 female), operated on for osteochondritis dissecans, were available for follow-up after an average of 10 years. The mean age at diagnosis was 24.4 years, but 11 patients were younger than 20. In 23 out of 29 patients the right elbow was involved, including 2 cases with bilateral involvement. In 20 cases removing the free bodies was the only surgical procedure performed, but in 2 cases it was combined with resection of the radial head. At follow-up, only one-third of the patients had no complaints. Nevertheless, daily activity was not restricted for any of the cases. Degenerative arthritic changes were found in only a few cases. These results are illustrated by means of three typical cases, which are compared with six similar cases in the international literature.
Adolescent↗
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↗
[Effect of distraction by various forces on the elbow joint in rabbits].
The elbow joints of 115 adult live rabbits have been subjected to experimental distraction by various forces and for different intervals. The forces applied were one tenth and one half, respectively, of the mean body weights; thus, a calculated reduction of one eleventh and five elevenths, respectively, of the force transmitted through the articulating joint surfaces was achieved. The distraction was performed for periods of 1, 2, 4 and 8 weeks. The forces were administered by means of an extraarticular device which allowed motion of the joints. Controls had been provided for to prove the noneffectiveness of the distraction device per se to the joint structures under study. Both upper limbs--one side always served as control--were subjected to radiological, histological/histochemical, angiographic and cytological examination; cartilage in addition was treated by vital staining or, alternatively, by producing splitting lines. The results were as follows: (1) Extensive local and more generalized hyperemia involving the whole limb in question was produced regardless of strength and duration of distraction. (2) Under all experimental conditions subsynovial hemorrhage and hemarthrosis developed. (3) Subsynovial hemorrhage caused the development of granulomatous and, subsequently, fibrous synovitis with simultaneously demonstrable hemosiderin depots. (4) Hemarthrosis was persistent during the entire period of observation. (5) Articular cartilage revealed moderate signs of degeneration and also irregularities of the usual pattern of splitting lines after continuous distraction for 8 weeks. At the same time, subchondral bone atrophy appeared. Vital staining revealed increased cartilage staining under mild distraction; moderate and marked distraction caused definitively less staining. Subsynovial hemorrhage and hemarthrosis are explained as partial vacuum effects. Concerning the moderate cartilage changes, a multifactorial genesis is presumed; the possible role of chemical, nutritional and mechanical factors is discussed. The widespread hyperemia most likely is caused by mechanical stimulation going along with joint distraction; capsular hyperemia might be a phenomenon immediately related to synovitis. Finally, the experimental results are discussed relative to observations made during clinical traction therapy.
Animals↗
[Development and functional anatomy of the human elbow joint (author's transl)].
According to the general function of the upper limb the importance of the human elbow joint is discussed including phylogenetic aspects. The ontogenesis of this joint is analysed by serially sectioned human embryos of different stages. The important period is at the end of the second month, as the articular elements are formed at this time. The density distribution of the subchondral bone of the elbow joint corresponds to the results from photoelastic models. They are compared with the stress diagrams calculated by Pauwels. The density distribution of the articulating elements corresponds to the local stress. The analysis of the elbow joint of children of different ages shows, that there is no basis connection between the shape of the different formed articular surfaces of the ulna and the orientation of the epiphyseal plate. For the structural changes of the articular surfaces in the incisura trochlearis ulnae functional explanations are given with regard to Pauwels' deductions on the mechanical stress and the hypothesis on the causal histogenesis.
Biomechanical Phenomena↗
Time-varying stiffness of human elbow joint during cyclic voluntary movement.
The objective of this study was to determine the extent to which subjects modulate their elbow joint mechanical properties during ongoing arm movement. Small pseudo-random force disturbances were applied to the wrist with an airjet actuator while subjects executed large (1 rad) elbow joint movements. Using a lumped parameter model of the muscle, tendon and proprioceptive feedback dynamics, a time-varying system identification technique was developed to analyze the phasic changes in the elbow joint's mechanical response. The mechanical properties were found to be time-varying, and well approximated by a quasi-linear second-order model. The stiffness of the arm was found to drop during movement. The arm was always underdamped, with the damping ratio changing during movement. Inertia estimates were constant and consistent with previous measurements. Overall, the moving arm was found to be very compliant, with a peak stiffness value less than the lowest value measured during posture, and a natural frequency of less than 3 Hz. Changing the speed of movement, or the load from gravity, changed the stiffness measured, but not in strict proportion to the change in net muscle torque.
Adult↗
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↗
[Arthroscopy of the wrist and elbow joint].
Arthroscopy of the wrist and elbow is a helpful diagnostic procedure in patients with chronic disability not demonstrated by clinical and radiological examinations. At the wrist, especially triangular fibrocartilage, chondral or ligamentous defects can often not be demonstrated by other tests. Arthroscopy of the wrist allows examination of more than a dozen separate articular surfaces and the function of eight discrete joints. The geometry of the elbow joint limits intra-articular inspection and the use of instruments. The risk of neurovascular injuries is great and depends on exact puncture sites and portals. Its efficiacy is not yet proven.
Adult↗
[Arrangement of the joint capsule in the radiohumeral part of the elbow joint (author's transl)].
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Cadaver↗
[St. George's model of total elbow-joint prosthesis].
The elbow-prosthesis, design St. George, a hinge prosthesis is developed according to the principle of the Low Friction Arthroplasty. Only small resection of the joint is necessary so that in the "second line of defence" a resection-arthroplasty of elbow is possible. The experiences on 44 implanted prosthesis and the results of 37 cases are described. Restriction of motion, pain, instability and ankylosis in case of rheumatiod arthritis and posttraumatic arthrosis were the main indications.
Adult↗
[Chronic recurrent dislocation of the elbow joint (author's transl)].
This paper discusses 3 recurrent dislocations of the elbow joint. As possible cause for the etiology of the dislocation the author offers the post-traumatic flattening of the semilunar notch of the ulna. In 2 cases, a successful repair using the Kapel procedure was performed.
Adolescent↗
[Hysteretic properties of movements in the elbow joint of unanesthetized cats with various methods of activation of muscle-antagonists].
Movements of the elbow joint were studied in unanesthetized cats. These movements were evoked by microstimulation of the motor cortex or by vibration of the forepaw and then compared with reaction from direct stimulation of muscles in the anesthetized animals. Interaction of the hysteretic effects in the antagonistic muscles of the joint was studied during stimulation of two points of the motor cortex which produced opposite-directed movements. Coactivation of the antagonists was shown to increase both the joint stiffness and the uncertainty of the equilibrium value of the joint angle. The uncertainty myotatic reflexes during intracortical microstimulation were more significantly depressed in the muscle receiving more intensive activation from the given point in the motor cortex. On the contrary, myotatic reflexes during vibration were well expressed in the both antagonistic muscles. At the same time the uncertainty effects during forepaw vibration were displayed similarly as it was in the cortically evoked movements.
Animals↗
Flexion-extension sensitivity of elbow joint afferents in cat.
Single units from stretch receptors in the elbow joint of the cat were studied in split-down filaments of the musculocutaneous nerve of the cat. The majority of fibres isolated responded to elbow extension with a phasic and then graded tonic or slowly adapting response. All fibres had a maximum adapted discharge at full extension. Over half the units also gave a phasic or tonic response at full flexion of the elbow, but this was non-graded and only appeared at the extreme position of the arm. These results are discussed briefly in the context of previous joint afferent studies.
Action Potentials↗
[Arthrography of the elbow joint, its diagnostic value for the traumatic lesions of the elbow in children (author's transl)].
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Adolescent↗
A radiological sign of entrapment of the median nerve in the elbow joint after posterior dislocation. A report of two cases.
Two boys with entrapment of the median nerve in the elbow joint after closed reduction of a posterior dislocation with fracture of the medial epicondyle showed a characteristic radiological sign in the anteroposterior radiograph after two to three months. The sign was a depression in the cortex on the ulnar side of the distal humeral metaphysis, with interruption of the local periosteal reaction. At operation in both patients the depression was found to correspond with the place where the median nerve reached the posterior surface of the humerus. Radiographs taken after transverse section of the nerve above and below the joint capsule and end-to-end suture showed gradual disappearance of the cortical depression.
Child↗
Infective arthritis of the elbow joint in horses.
Six horses were found to have infective arthritis of one elbow joint. The history, and presence of a small wound on the lateral aspect of the elbow suggested the condition was trauma induced. Two horses recovered following joint lavage under general anaesthesia and antibiotic therapy. The joint changes found post mortem in the others were characteristic of an infective arthritis.
Animals↗
[Osteochondrosis dissecans of the elbow joint and the therapy depending on stage of development (author's transl)].
Of 46 cases of Osteochondrosis dissecans (OD) of the elbow joint between 1949 and 1976 in 35 patients we could control 31 patients with totally 42 diseases. According to clinical symptoms and roentgenological signs we classified the OD in an early, medium and late stage of development. The success of the therapy was discussed depending on the method of therapy, on the stage of the disease and on the age of the patients.
Adolescent↗