Elbow 38 articles
After elbow fracture-dislocation, surgeons confront numerous treatment options in pursuing a stable joint for early motion. The relative contributions of the radial head and coronoid, in combination, to elbow stability have not been defined fully.
A Large Humeral Avulsion of the Glenohumeral Ligaments Decreases Stability That Can Be Restored With Repair
Humeral avulsion of the glenohumeral ligaments (HAGL) has become a recognized cause of recurrent shoulder instability; however, it is unknown whether small and large HAGL lesions have similarly destabilizing effects and if large lesion repair results in restoration of stability.
Single-staged Treatment Using a Standardized Protocol Results in Functional Motion in the Majority of Patients With a Terrible Triad Elbow Injury
Terrible triad injuries of the elbow, defined as elbow dislocation with associated fractures to the radial head and coronoid, are associated with stiffness, pain, and loss of motion. Studies to date have consisted of small sample sizes and used heterogeneous surgical techniques, which render comparisons difficult and unreliable.
The “terrible triad” of the elbow is a complex injury that can lead to pain, stiffness, and posttraumatic arthritis if not appropriately treated. The primary goal of surgery for these injuries is to restore stability of the joint sufficient to permit early motion. Although most reports recommend repair and/or replacement of all coronoid and radial head fractures when possible, a recent cadaveric study demonstrated that type II coronoid fractures are stable unless the radial head is removed and not replaced.
Fixation Versus Replacement of Radial Head in Terrible Triad: Is There a Difference in Elbow Stability and Prognosis?
Surgical treatment for terrible triad injuries of the elbow (defined as elbow dislocations with concomitant fractures of the radial head and coronoid) remains a challenging clinical problem. Specifically, the question of whether to repair or replace the radial head remains controversial.
Heterotopic ossification (HO) is a common extrinsic cause of elbow stiffness after trauma. However, factors associated with the development of HO are incompletely understood.
Overstuffing of the radiocapitellar joint during metallic radial head arthroplasty has been reported to cause loss of elbow flexion, capitellar erosion, and early-onset osteoarthritis. Although this is known, there is no agreed-on measurement approach to determine whether overstuffing has occurred.
Does Radiographic Beam Angle Affect the Radiocapitellar Ratio Measurement of Subluxation in the Elbow?
Radial head alignment is the key to determine elbow reduction after treatment of subluxations or Monteggia fractures. The radiocapitellar ratio (RCR) quantifies the degree of subluxation, by evaluating radial head alignment with the capitellum of the humerus; this ratio is reproducible when measured on true lateral radiographs of nonsubluxated elbows. However, the impact of beam angulation on RCR measurement is unknown.
Since the 18th century, the existence of ulnar nerve innervation of the medial head of the triceps brachii muscle has been controversial. The evidence for or against such innervation has been based on macroscopic dissection, an unsuitable method for studying intraneural topography or intramuscular branching. The study of smaller specimens (embryos or fetuses) by means of serial histologic sections may resolve the controversy.
Surgical Technique: Spike Translation: A New Modification in Step-cut Osteotomy for Cubitus Varus Deformity
Various methods of osteotomy have been proposed for the treatment of cubitus varus. We designed a modification of the step-cut osteotomy to achieve more correction of the deformity. We describe this new technique called spike translation step-cut osteotomy and report the clinical and radiographic outcomes (deformity correction, ROM, function, osteotomy healing, complications) in a series of patients treated for cubitus varus using this technique.