WorldWideScience

Sample records for elbow immobilization affects

  1. The effects of below-elbow immobilization on driving performance.

    Science.gov (United States)

    Jones, Evan M; Barrow, Aaron E; Skordas, Nic J; Green, David P; Cho, Mickey S

    2017-02-01

    There is limited research to guide physicians and patients in deciding whether it is safe to drive while wearing various forms of upper extremity immobilization. The purpose of this study is to evaluate the effect of below-elbow removable splints and fiberglass casts on automobile driving performance. 20 healthy subjects completed 10 runs through a closed, cone-marked driving course while wearing a randomized sequence of four different types of immobilization on each extremity (short arm thumb spica fiberglass cast, short arm fiberglass cast, short arm thumb spica splint, and short arm wrist splint). The first and last driving runs were without immobilization and served as controls. Performance was measured based on evaluation by a certified driving instructor (pass/fail scoring), cones hit, run time, and subject-perceived driving difficulty (1-10 analogue scoring). The greatest number of instructor-scored failures occurred while immobilized in right arm spica casts (n=6; p=0.02) and left arm spica casts (n=5; p=0.049). The right arm spica cast had the highest subject-perceived difficulty (5.2±1.9; pimmobilization had significantly increased perceived difficulty compared to control, except for the left short arm splint (2.5±1.6; p>0.05). There was no significant difference in number of cones hit or driving time between control runs and runs with any type of immobilization. Drivers should use caution when wearing any of the forms of upper extremity immobilization tested in this study. All forms of immobilization, with exception of the left short arm splint significantly increased perceived driving difficulty. However, only the fiberglass spica casts (both left and right arm), significantly increased drive run failures due to loss of vehicle control. We recommend against driving when wearing a below-elbow fiberglass spica cast on either extremity. Copyright © 2016. Published by Elsevier Ltd.

  2. Finite element evaluation of erosion/corrosion affected reducing elbow

    International Nuclear Information System (INIS)

    Basavaraju, C.

    1996-01-01

    Erosion/corrosion is a primary source for wall thinning or degradation of carbon steel piping systems in service. A number of piping failures in the power industry have been attributed to erosion/corrosion. Piping elbow is one of such susceptible components for erosion/corrosion because of increased flow turbulence due to its geometry. In this paper, the acceptability of a 12 in. x 8 in. reducing elbow in RHR service water pump discharge piping, which experienced significant degradation due to wall thinning in localized areas, was evaluated using finite element analysis methodology. Since the simplified methods showed very small margin and recommended replacement of the elbow, a detailed 3-D finite element model was built using shell elements and analyzed for internal pressure and moment loadings. The finite element analysis incorporated the U.T. measured wall thickness data at various spots that experienced wall thinning. The results showed that the elbow is acceptable as-is until the next fuel cycle. FEA, though cumbersome, and time consuming is a valuable analytical tool in making critical decisions with regard to component replacement of border line situation cases, eliminating some conservatism while not compromising the safety

  3. Racquet string tension directly affects force experienced at the elbow: implications for the development of lateral epicondylitis in tennis players

    Science.gov (United States)

    Mohandhas, Badri R; Makaram, Navnit; Drew, Tim S; Wang, Weijie; Arnold, Graham P

    2016-01-01

    Background Lateral epicondylitis (LE) occurs in almost half of all tennis players. Racket-string tension is considered to be an important factor influencing the development of LE. No literature yet exists that substantiates how string-tension affects force transmission to the elbow, as implicated in LE development. We establish a quantitative relationship between string-tension and elbow loading, analyzing tennis strokes using rackets with varying string-tensions. Methods Twenty recreational tennis players simulated backhand tennis strokes using three rackets strung at tensions of 200 N, 222 N and 245 N. Accelerometers recorded accelerations at the elbow, wrist and racket handle. Average peak acceleration was determined to correlate string-tension with elbow loading. Results Statistically significant differences (p elbow at 200 N string-tension (acceleration of 5.58 m/s2) was compared with that at 222 N tension (acceleration of 6.83 m/s2) and 245 N tension (acceleration of 7.45 m/s2). The 200 N racket induced the least acceleration at the elbow. Conclusions Although parameters determining force transmission to the elbow during a tennis stroke are complex, the present study was able to control these parameters, isolating the effect of string-tension. Lower string-tensions transmit less force to the elbow in backhand strokes. Reducing string-tension should be considered favourably with respect to reducing the risk of developing LE. PMID:27583017

  4. Racquet string tension directly affects force experienced at the elbow: implications for the development of lateral epicondylitis in tennis players.

    Science.gov (United States)

    Mohandhas, Badri R; Makaram, Navnit; Drew, Tim S; Wang, Weijie; Arnold, Graham P; Abboud, Rami J

    2016-07-01

    Lateral epicondylitis (LE) occurs in almost half of all tennis players. Racket-string tension is considered to be an important factor influencing the development of LE. No literature yet exists that substantiates how string-tension affects force transmission to the elbow, as implicated in LE development. We establish a quantitative relationship between string-tension and elbow loading, analyzing tennis strokes using rackets with varying string-tensions. Twenty recreational tennis players simulated backhand tennis strokes using three rackets strung at tensions of 200 N, 222 N and 245 N. Accelerometers recorded accelerations at the elbow, wrist and racket handle. Average peak acceleration was determined to correlate string-tension with elbow loading. Statistically significant differences (p < 0.05) were observed when average peak acceleration at the elbow at 200 N string-tension (acceleration of 5.58 m/s(2)) was compared with that at 222 N tension (acceleration of 6.83 m/s(2)) and 245 N tension (acceleration of 7.45 m/s(2)). The 200 N racket induced the least acceleration at the elbow. Although parameters determining force transmission to the elbow during a tennis stroke are complex, the present study was able to control these parameters, isolating the effect of string-tension. Lower string-tensions transmit less force to the elbow in backhand strokes. Reducing string-tension should be considered favourably with respect to reducing the risk of developing LE.

  5. Posttraumatic stiff elbow

    Directory of Open Access Journals (Sweden)

    Ravi Mittal

    2017-01-01

    Full Text Available Posttraumatic stiff elbow is a frequent and disabling complication and poses serious challenges for its management. In this review forty studies were included to know about the magnitude of the problem, causes, pathology, prevention, and treatment of posttraumatic stiff elbow. These studies show that simple measures such as internal fixation, immobilization in extension, and early motion of elbow joint are the most important steps that can prevent elbow stiffness. It also supports conservative treatment in selected cases. There are no clear guidelines about the choice between the numerous procedures described in literature. However, this review article disproves two major beliefs-heterotopic ossification is a bad prognostic feature, and passive mobilization of elbow causes elbow stiffness.

  6. Tennis elbow

    Science.gov (United States)

    Epitrochlear bursitis; Lateral epicondylitis; Epicondylitis - lateral; Tendonitis - elbow ... tennis or other racket sports, hence the name "tennis elbow." Backhand is the most common stroke to cause ...

  7. Short-Term Limb Immobilization Affects Cognitive Motor Processes

    Science.gov (United States)

    Toussaint, Lucette; Meugnot, Aurore

    2013-01-01

    We examined the effects of a brief period of limb immobilization on the cognitive level of action control. A splint placed on the participants' left hand was used as a means of immobilization. We used a hand mental rotation task to investigate the immobilization-induced effects on motor imagery performance (Experiments 1 and 2) and a number mental…

  8. An indication of major genes affecting hip and elbow dysplasia in four Finnish dog populations

    NARCIS (Netherlands)

    Maki, K.; Janss, L.L.G.; Groen, A.F.; Liinamo, A.E.; Ojala, M.

    2004-01-01

    The aim of the study was to assess the possible existence of major genes influencing hip and elbow dysplasia in four dog populations. A Bayesian segregation analysis was performed separately on each population. In total, 34 140 dogs were included in the data set. Data were analysed with both a

  9. Elbow Fractures

    Science.gov (United States)

    ... is also an important factor when treating elbow fractures. Casts are used more frequently in children, as their risk of developing elbow stiffness is small; however, in an adult, elbow stiffness is much more likely. Rehabilitation directed by your doctor is often used to ...

  10. Pulled elbow in children.

    Science.gov (United States)

    Yamanaka, Syunsuke; Goldman, Ran D

    2018-06-01

    Question Our practice is seeing children with relatively minor injuries to their elbows, with a history of "swinging" them when their hands are being held to cross the road. Nothing is usually found on a physical examination. I know that this is likely a "pulled elbow." Can we manage this in the clinic setting rather than sending the family to the emergency department? What would be the best course of action in the clinic setting? Answer Pulled elbow, also called nursemaid's elbow , is a radial head subluxation caused by axial traction or a sudden pull of the extended pronated arm, and it is a very common phenomenon. The practice of swinging children while holding their hands should be abandoned. In the case of pulled elbow, the child usually avoids moving the affected arm, holding it close to his or her body, without considerable pain, and no obvious swelling or deformity can be seen. While a fracture should be excluded, pulled elbow can usually be identified based on this presentation. The reduction procedure can easily be done in the office setting, with an 80% success rate and no complications. The hyperpronation maneuver (holding the elbow at 90° and then firmly pronating the wrist) to reduce pulled elbow has been found to be better than a supination-flexion maneuver (holding the elbow at 90° with one hand, supinating and flexing the elbow rapidly with the other) and should be exercised first. When 2 trials of reduction are unsuccessful, the child's arm should be splinted and the family should be sent for further evaluation. Copyright© the College of Family Physicians of Canada.

  11. Elbow Pain

    Science.gov (United States)

    ... tear damage than are many other joints. Seek emergency care if you have: An obvious deformity in ... http://www.mayoclinic.org/symptoms/elbow-pain/basics/definition/SYM-20050874 . Mayo Clinic Footer Legal Conditions and ...

  12. The thrower's elbow.

    Science.gov (United States)

    Patel, Ronak M; Lynch, T Sean; Amin, Nirav H; Calabrese, Gary; Gryzlo, Stephen M; Schickendantz, Mark S

    2014-07-01

    Overhead throwing activities expose the elbow to tremendous valgus stress, making athletes vulnerable to a specific constellation of injuries. Although baseball players, in particular pitchers, are the athletes affected most commonly, overhead throwing athletes in football, volleyball, tennis, and javelin tossing also are affected. The purpose of this review is to review the anatomy, biomechanics, pathophysiology, and treatment of elbow disorders related to overhead throwing athletes. Although focus is on management of ulnar collateral ligament injuries, all common pathologies are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Touching my left elbow: the anatomical structure of the body affects the illusion of self-touch.

    Science.gov (United States)

    White, Rebekah C; Aimola Davies, Anne M

    2011-01-01

    A self-touch paradigm is used to create the illusion that one is touching one's own left elbow when one is actually touching the examiner's arm. Our new self-touch illusion is sensitive to the anatomical structure of the body: you can touch your left elbow with your right index finger but not with your left index finger. Illusion onset was faster and illusion ratings were higher when participants administered touch using the plausible right index finger compared with the implausible left index finger.

  14. Intuitional experiment and numerical analysis of flow characteristics affected by flow accelerated corrosion in elbow pipe system

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyung Joon [School of Mechanical and Aerospace Engineering, Seoul National University, Gwanak-gu, Seoul 151-744 (Korea, Republic of); Kim, Kyung Hoon, E-mail: kimkh@khu.ac.kr [Department of Mechanical Engineering, Kyung Hee University, Seochun 1, Yongin, Gyeonggi 446-701 (Korea, Republic of)

    2016-05-15

    Highlights: • Wall-thinning erosion of pipelines in plants leads to fatal accidents unexpectedly. • Flow Acceleration Corrosion (FAC) is a main reason of wall-thinning. • For industrial safety, it is necessary to verify the tendency of FAC. • We focused on local wall thinning by FAC with intuitional visualization experiment and numerical analysis in elbow pipe.

  15. [Elbow dislocation].

    Science.gov (United States)

    de Pablo Márquez, B; Castillón Bernal, P; Bernaus Johnson, M C; Ibañez Aparicio, N M

    Elbow dislocation is the most frequent dislocation in the upper limb after shoulder dislocation. Closed reduction is feasible in outpatient care when there is no associated fracture. A review is presented of the different reduction procedures. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Elbow tendinopathy.

    Science.gov (United States)

    Pitzer, Michael E; Seidenberg, Peter H; Bader, Dov A

    2014-07-01

    Overuse injuries of the lateral and medial elbow are common in sport, recreational activities, and occupational endeavors. They are commonly diagnosed as lateral and medial epicondylitis; however, the pathophysiology of these disorders demonstrates a lack of inflammation. Instead, angiofibroblastic degeneration is present, referred to as tendinosis. As such, a more appropriate terminology for these conditions is epicondylosis. This is a clinical diagnosis, and further investigations are only performed to rule out other clinical entities after conventional therapy has failed. Yet, most patients respond to conservative measures with physical therapy and counterforce bracing. Corticosteroid injections are effective for short-term pain control but have not demonstrated long-term benefit. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Pronation-Supination Motion Is Altered in a Rat Model of Post-Traumatic Elbow Contracture.

    Science.gov (United States)

    Dunham, Chelsey L; Castile, Ryan M; Chamberlain, Aaron M; Galatz, Leesa M; Lake, Spencer P

    2017-07-01

    The elbow joint is highly susceptible to joint contracture, and treating elbow contracture is a challenging clinical problem. Previously, we established an animal model to study elbow contracture that exhibited features similar to the human condition including persistent decreased range of motion (ROM) in flexion-extension and increased capsule thickness/adhesions. The objective of this study was to mechanically quantify pronation-supination in different injury models to determine if significant differences compared to control or contralateral persist long-term in our animal elbow contracture model. After surgically inducing soft tissue damage in the elbow, Injury I (anterior capsulotomy) and Injury II (anterior capsulotomy with lateral collateral ligament transection), limbs were immobilized for 6 weeks (immobilization (IM)). Animals were evaluated after the IM period or following an additional 6 weeks of free mobilization (FM). Total ROM for pronation-supination was significantly decreased compared to the uninjured contralateral limb for both IM and FM, although not different from control limbs. Specifically, for both IM and FM, total ROM for Injury I and Injury II was significantly decreased by ∼20% compared to contralateral. Correlations of measurements from flexion-extension and pronation-supination divulged that FM did not affect these motions in the same way, demonstrating that joint motions need to be studied/treated separately. Overall, injured limbs exhibited persistent motion loss in pronation-supination when comparing side-to-side differences, similar to human post-traumatic joint contracture. Future work will use this animal model to study how elbow periarticular soft tissues contribute to contracture.

  18. Criteria of immobilization duration of the affected foot in diabetic Charcot neuro-osteoarthropathy

    Directory of Open Access Journals (Sweden)

    Anastasia Gennad'evna Demina

    2014-10-01

    Full Text Available Long-term offloading is the key factor in the treatment of the acute stage of Charcot foot. The indication for remobilization and transition of the affected foot to weight-bearing activities is believed to be based on two factors: the absence of the clinical signs of inflammation and results of the objective diagnostic tests. At the present time, consensus about appropriate methods sufficient for initiating weight-bearing activities after immobilization is absent. This paper discusses current data on clinical and laboratory tests and methods and describes their advantages and disadvantages.

  19. Tennis elbow surgery

    Science.gov (United States)

    Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is often an outpatient surgery. This means you will not stay in the hospital overnight. You will be given ...

  20. Tennis elbow surgery - discharge

    Science.gov (United States)

    ... epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed a ...

  1. Elbow Injuries and Disorders

    Science.gov (United States)

    ... Many things can make your elbow hurt. A common cause is tendinitis, an inflammation or injury to the tendons that attach muscle to bone. Tendinitis of the elbow is a sports injury, often from playing tennis or golf. You ...

  2. Nursemaid's Elbow (For Parents)

    Science.gov (United States)

    ... Parents Parents site Sitio para padres General Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & ... For Parents / Nursemaid's Elbow Print About Nursemaid's Elbow Toddlers and preschoolers are at risk for a common ...

  3. Stability of immobilization remediation of several amendments on cadmium contaminated soils as affected by simulated soil acidification.

    Science.gov (United States)

    Guo, Fuyu; Ding, Changfeng; Zhou, Zhigao; Huang, Gaoxiang; Wang, Xingxiang

    2018-06-04

    Chemical immobilization is a practical approach to remediate heavy metal contamination in agricultural soils. However, the potential remobilization risks of immobilized metals are a major environmental concern, especially in acid rain zones. In the present study, changes in the immobilization efficiency of several amendments as affected by simulated soil acidification were investigated to evaluate the immobilization remediation stability of several amendments on two cadmium (Cd) contaminated soils. Amendments (hydrated lime, hydroxyapatite and biochar) effectively immobilized Cd, except for organic fertilizer, and their immobilizations were strongly decreased by the simulated soil acidification. The ratio of changes in CaCl 2 -extractable Cd: pH (△CaCl 2 -Cd/△pH) can represent the Cd remobilization risk of different amended soils. Hydroxyapatite and biochar had a stronger durable immobilizing effect than did hydrated lime, particularly in soil with a lower pH buffering capacity, which was further confirmed by the Cd concentration and accumulation in lettuce. These results can be attributed to that hydroxyapatite and biochar transformed greater proportions of exchangeable Cd to other more stable fractions than lime. After 48 weeks of incubation, in soil with a lower pH buffering capacity, the immobilization efficiencies of lime, hydroxyapatite, biochar and organic fertilizer in the deionized water group (pH 6.5) were 71.7%, 52.7%, 38.6% and 23.9%, respectively, and changed to 19.1%, 33.6%, 26.5% and 5.0%, respectively, in the simulated acid rain group (pH 2.5). The present study provides a simple method to preliminarily estimate the immobilization efficiency of amendments and predict their stability in acid rain regions before large-scale field application. In addition, hydrated lime is recommended to be combined with other acid-stable amendments (such as hydroxyapatite or biochar) to remediate heavy metal-contaminated agricultural soils in acid precipitation

  4. Short-Term Upper Limb Immobilization Affects Action-Word Understanding

    Science.gov (United States)

    Bidet-Ildei, Christel; Meugnot, Aurore; Beauprez, Sophie-Anne; Gimenes, Manuel; Toussaint, Lucette

    2017-01-01

    The present study aimed to investigate whether well-established associations between action and language can be altered by short-term upper limb immobilization. The dominant arm of right-handed participants was immobilized for 24 hours with a rigid splint fixed on the hand and an immobilization vest restraining the shoulder, arm, and forearm. The…

  5. Diagnostyka i leczenie zachowawcze łokcia tenisisty = Diagnosis and conservative treatment of tennis elbow

    Directory of Open Access Journals (Sweden)

    Gustaw Wójcik

    2017-02-01

      Introduction. Tennis elbow is a relatively common disorder of the musculoskeletal system, for which effective treatment strategy is still unknown. It is responsible for considerable pain and loss of function of the affected limb. Characteristic for the diseases are degenerative changes in the structure of collagen and abnormalities in blood supply associated with the process of neovascularization. Pathology is due to cycles of repetitive stress leading to tissue damage. The sensitivity of imaging depends on the duration of the disease. The first period of the disease is usually caused by trauma, which may be accompanied by inflammation, which is why the most effective treatment may be anti-inflammatory therapy and immobilization of a limb. The subsequent period  is connected with degenerative changes, and treatment relies mainly on combating the painful symptoms. Conditions refractory to conservative treatment are eligible for surgery. The objective of the study. Presentation of current knowledge about diagnosis and treatment of enthesopathy of the lateral epicondyle of the humerus. Materials and method. The work is based on a review of literature of Baz PubMed, Scopus and Web of Science. Conclusions. The primary imaging technique for the diagnosis of tennis elbow is ultrasound. Classic radiology is rather used for the differentiation of other diseases related to the elbow. Modern methods of treatment of tennis elbow are based on the treatment of degenerative changes. Anti-inflammatory treatment is ineffective in the above disease.

  6. Elbow joint instability

    DEFF Research Database (Denmark)

    Olsen, Bo Sanderhoff; Henriksen, M G; Søjbjerg, Jens Ole

    1994-01-01

    The effect of simultaneous ulnar and radial collateral ligament division on the kinematics of the elbow joint is studied in a cadaveric model. Severance of the anterior part of the ulnar collateral ligament and the annular ligament led to significant elbow joint instability in valgus and varus...

  7. Elbow arthroplasty in perspective

    NARCIS (Netherlands)

    Heijink, A.

    2017-01-01

    This thesis focuses on the effect of biomechanical aspects of prosthesis design and outcome after radial head and total elbow arthroplasty. First, we examine the available evidence regarding the role of several unfavorable biomechanical conditions about the elbow in the development of

  8. Exposures of the elbow.

    Science.gov (United States)

    Axelrod, Terry S

    2014-11-01

    This article describes the basic bony, ligamentous, and neurologic anatomy of the structures about the elbow. The surgical exposures of the elbow joint are described, providing details of the various posterior, lateral, and medial approaches to the articular segments. Clinical applications describing the potential benefits of each surgical exposure are provided as examples. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Short-term immobilization and recovery affect skeletal muscle but not collagen tissue turnover in humans

    DEFF Research Database (Denmark)

    Christensen, Britt; Dyrberg, Eva; Aagaard, Per

    2008-01-01

    Not much is known about the effects of immobilization and subsequent recovery on tendon connective tissue. In the present study, healthy young men had their nondominant leg immobilized for a 2-wk period, followed by a recovery period of the same length. Immobilization resulted in a mean decrease...... of 6% (5,413 to 5,077 mm(2)) in cross-sectional area (CSA) of the triceps surae muscles and a mean decrease of 9% (261 to 238 N.m) in strength of the immobilized calf muscles. Two weeks of recovery resulted in a 6% increased in CSA (to 5,367 mm(2)), whereas strength remained suppressed (240 N...... muscle size and strength, while tendon size and collagen turnover were unchanged. While recovery resulted in an increase in muscle size, strength was unchanged. No significant difference in tendon size could be detected between the two legs after 2 wk of recovery, although collagen synthesis...

  10. Factors affecting the immobilization of fungal biomass on CNT as a biosorbent for textile dyes removal

    Science.gov (United States)

    Adebayo Bello, Ibrahim; Kabbashi, Nassereldeen A.; Zahangir Alam, Md; Alkhatib, Ma'an F.; Nabilah Murad, Fatin

    2017-07-01

    Effluents from dye and textile industries are highly contaminated and toxic to the environment. High concentration of non-biodegradable compounds contributes to increased biochemical oxygen demand (BOD) and chemical oxygen demand (COD) of the wastewater bodies. Dyes found in wastewater from textile industries are carcinogenic, mutagenic or teratogenic. Biological processes involving certain bacteria, fungi and activated carbon have been employed in treating wastewater. These methods are either inefficient or ineffective. These complexities necessitates search for new approaches that will offset all the shortcomings of the present solutions to the challenges faced with textile wastewater management. This study produced a new biosorbent by the immobilization of fungal biomass on carbon nanotubes. The new biosorbent is called “carbon nanotubes immobilized biomass (CNTIB)” which was produced by immobilization technique. A potential fungal strain, Aspergillus niger was selected on the basis of biomass production. It was found out in this studies that fungal biomass were better produced in acidic medium. Aspergillus niger was immobilized on carbon nanotubes. One-factor-at-a time (OFAT) was employed to determine the effect of different factors on the immobilization of fungal biomass on carbon nanotubes and optimum levels at which the three selected parameters (pH, culture time and agitation rate) would perform. Findings from OFAT showed that the optimum conditions for immobilization are a pH of 5, agitation rate of 150rpm and a culture time of 5 days.

  11. The elbow and its disorders

    International Nuclear Information System (INIS)

    Morrey, B.F.

    1985-01-01

    This book contains 49 chapters. Some of the chapter titles are: Diagnostic Radiographic Techniques of the Elbow; Radiography of the Pediatric Elbow; Muscle and Tendon Trauma: Tennis Elbow; Nerve Injuries; Tendon Injurires about the Elbow; and Ligamentous and Articular Injuries in the Athlete

  12. ELBOW AND WRIST INJURIES IN SPORTS

    Science.gov (United States)

    Marmor, Leonard; Bechtol, Charles O.

    1960-01-01

    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. PMID:14421374

  13. A Removable Long-arm Soft Cast to Treat Nondisplaced Pediatric Elbow Fractures: A Randomized, Controlled Trial.

    Science.gov (United States)

    Silva, Mauricio; Sadlik, Gal; Avoian, Tigran; Ebramzadeh, Edward

    2018-04-01

    The ideal type of immobilization for nondisplaced pediatric elbow fractures has not been established. We hypothesized that the use of a long-arm cylinder made of soft cast material will result in similar outcomes to those obtained with a traditional long-arm hard cast. We randomly assigned 100 consecutive children who presented with a closed, nondisplaced, type I supracondylar humeral fracture or an occult, closed, acute elbow injury, to 1 of 2 groups: group A (n=50) received a long-arm, traditional fiberglass (hard) cast. Group B (n=50) received a long-arm, soft fiberglass cast. After 4 weeks, the cast was removed in group A by a member of our staff using a cast saw, and in group B by one of the patient's parents by rolling back the soft fiberglass material. We compared the amount of fracture displacement and/or angulation, recovery of range of motion, elbow pain, and patient satisfaction. There were no instances of unplanned removal of the cast by the patient or parent. No evidence of fracture displacement or angulation was seen in either group. The final carrying angle of the affected elbow was nearly identical of that of the normal, contralateral elbow in both groups (P=0.64). At the latest follow-up appointment, elbows in groups A and B had a similar mean arc of motion (156 vs. 154 degrees; P=0.45), and had achieved identical relative arc of motion of 99.6% and 99.5% of that of the normal, contralateral side, respectively (P=0.94). Main pain scores were low and comparable over the study period. All patients in both groups reported the highest rate of satisfaction at the eighth week of follow-up. The results indicate that children with nondisplaced supracondylar humeral fractures can be successfully managed with the use of a removable long-arm soft cast, maintaining fracture alignment and resulting in comparable rates of range of motion, pain, and patient satisfaction. The use of a removable immobilization that can reliably maintain fracture alignment and

  14. Posterolateral elbow joint instability

    DEFF Research Database (Denmark)

    Olsen, Bo Sanderhoff; Søjbjerg, Jens Ole; Nielsen, K K

    1998-01-01

    Thirty-five osteoligamentous elbows were included in a study on the kinematics of posterolateral elbow joint instability during the pivot shift test (PST) before and after separate ligament cuttings in the lateral collateral ligament complex (LCLC). Division of the annular ligament or the lateral...... ulnar collateral ligament caused no laxity during the PST. Division of the lateral collateral ligament caused maximal laxity of 4 degrees and 23 degrees during forced PST in valgus and external rotation (supination), respectively. Cutting of the LCLC at the ulnar or the humeral insertion was necessary...... for any PST stressed elbow joint laxity to occur. Total division of the LCLC induced a maximal laxity of 7.9 degrees and 37 degrees during forced PST in valgus and external rotation (supination), respectively. This study suggests the lateral collateral ligament to be the primary soft tissue constraint...

  15. Central uplift of custom immobilization radiotherapy patients with lower limb overhead sagittal laser affected without mobile

    International Nuclear Information System (INIS)

    Velazquez Miranda, S.; Delgado Gil, M. M.; Ortiz Seidel, M.

    2011-01-01

    If you have a laser moving overhead sagittal or the location of tumors in the lower extremities is laborious, as to reference properly in the CT, is necessary before tattooing in the treatment table using their ability to relate the lateral midline with tattoos on the limb. For anatomical forms often happens that lasers are not displayed on the areas of our interest. The problem can be overcome if between the legs raise the bag or custom immobilizer above the height of the patient's abdomen, as this will have a central reference reliable and well designed lasers.

  16. Nerve injuries do occur in elbow arthroscopy.

    Science.gov (United States)

    Hilgersom, Nick F J; van Deurzen, Derek F P; Gerritsma, Carina L E; van der Heide, Huub J L; Malessy, Martijn J A; Eygendaal, Denise; van den Bekerom, Michel P J

    2018-01-01

    The purpose is to create more awareness as well as emphasize the risk of permanent nerve injury as a complication of elbow arthroscopy. Patients who underwent elbow arthroscopy complicated by permanent nerve injury were retrospectively collected. Patients were collected using two strategies: (1) by word-of-mouth throughout the Dutch Society of Shoulder and Elbow Surgery, and the Leiden University Nerve Centre, and (2) approaching two medical liability insurance companies. Medical records were reviewed to determine patient characteristics, disease history and postoperative course. Surgical records were reviewed to determine surgical details. A total of eight patients were collected, four men and four women, ageing 21-54 years. In five out of eight patients (62.5%), the ulnar nerve was affected; in the remaining three patients (37.5%), the radial nerve was involved. Possible causes for nerve injury varied among patients, such as portal placement and the use of motorized instruments. A case series on permanent nerve injury as a complication of elbow arthroscopy is presented. Reporting on this sequel in the literature is little, however, its risk is not to be underestimated. This study emphasizes that permanent nerve injury is a complication of elbow arthroscopy, concurrently increasing awareness and thereby possibly aiding to prevention. IV, case series.

  17. Elbow mass flow meter

    Science.gov (United States)

    McFarland, A.R.; Rodgers, J.C.; Ortiz, C.A.; Nelson, D.C.

    1994-08-16

    The present invention includes a combination of an elbow pressure drop generator and a shunt-type mass flow sensor for providing an output which gives the mass flow rate of a gas that is nearly independent of the density of the gas. For air, the output is also approximately independent of humidity. 3 figs.

  18. Lateral epicondylitis of the elbow.

    Science.gov (United States)

    Vaquero-Picado, Alfonso; Barco, Raul; Antuña, Samuel A

    2016-11-01

    Lateral epicondylitis, also known as 'tennis elbow', is a very common condition affecting mainly middle-aged patients.The pathogenesis remains unknown but there appears to be a combination of local tendon pathology, alteration in pain perception and motor impairment.The diagnosis is usually clinical but some patients may benefit from additional imaging for a specific differential diagnosis.The disease has a self-limiting course of between 12 and 18 months, but in some patients, symptoms can be persistent and refractory to treatment.Most patients are well-managed with non-operative treatment and activity modification. Many surgical techniques have been proposed for patients with refractory symptoms.New non-operative treatment alternatives with promising results have been developed in recent years. Cite this article: Vaquero-Picado A, Barco R, Antuña SA. Lateral epicondylitis of the elbow. EFORT Open Rev 2016;1:391-397. DOI: 10.1302/2058-5241.1.000049.

  19. Management of tennis elbow

    Directory of Open Access Journals (Sweden)

    Chesterton LS

    2011-06-01

    Full Text Available Linda S Chesterton, Christian D Mallen, Elaine M HayArthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, UKDate of preparation: April 21, 2011Conflict of interest: None declaredClinical question: What is the best treatment for tennis elbow?Results: Despite a wealth of research, there is no true consensus on the most efficacious management of tennis elbow especially for effective long-term outcomes. Corticosteroid injections do show large pain-relieving effects in the short term but are associated with risks of adverse events and long-term reoccurrence. Advice with a “wait and see” approach is recommended as the first-line treatment in primary care for most cases. In the medium term physiotherapy and or low-level laser therapy may be effective.Implementation: Rule out alternative diagnosis. Onward referral may be indicated if the condition does not resolve after 12 months.Keywords: tennis elbow, corticosteroids, physiotherapy, laser therapy

  20. Myositis Ossificans Traumatica Causing Ankylosis of the Elbow

    OpenAIRE

    Kanthimathi, B.; Udhaya Shankar, S.; Arun Kumar, K.; Narayanan, V. L.

    2014-01-01

    Myositis ossificans traumatica is an unusual complication following a muscle contusion injury. A significantly large myositic mass causing ankylosis of the elbow is even rarer. We report a 13-year-old boy who presented with a 14-month history of a fixed elbow with no movement and a palpable bony mass in the anterior aspect of the elbow. He had sustained significant trauma to the affected limb 1 month prior to onset of symptoms, which was managed by native massage and bandaging for 4 weeks. Th...

  1. Percutaneous ultrasonic tenotomy for chronic elbow tendinosis: a prospective study.

    Science.gov (United States)

    Barnes, Darryl E; Beckley, James M; Smith, Jay

    2015-01-01

    Elbow tendinopathy is the most common cause of elbow pain affecting active populations. Surgical excision is reserved for patients with refractory symptoms. Percutaneous ultrasonic tenotomy performed under local anesthesia also removes degenerated tissue and therefore provides an alternative treatment option to surgical excision. This investigation prospectively documented the safety and 1-year efficacy of ultrasonic percutaneous tenotomy performed by a single operator. Nineteen patients, aged 38 to 67 years, in whom >6 months of conservative management for medial (7) or lateral (12) elbow tendinopathy had failed were prospectively studied. All patients were treated with percutaneous ultrasonic tenotomy of the elbow by a single operator. Visual analog scale (VAS) for pain, the 11-item version of the Disabilities of the Arm, Shoulder, and Hand (Quick DASH) index, and the Mayo Elbow Performance Score (MEPS) were assessed by an independent observer before treatment and at 6 weeks, 3 months, 6 months, and 12 months after treatment. No procedural complications occurred. Total treatment time was elbow tendinopathy up to 1 year after the procedure. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  2. Flexibility of trunnion piping elbows

    International Nuclear Information System (INIS)

    Lewis, G.D.; Chao, Y.J.

    1987-01-01

    Flexibility factors and stress indices for piping component such as straight pipe, elbows, butt-welding tees, branch connections, and butt-welding reducers are contained in the code, but many of the less common piping components, like the trunnion elbow, do not have flexibility factors or stress indices defined. The purpose of this paper is to identify the in-plane and out-of-plane flexibility factors in accordance with code procedures for welded trunnions attached to the tangent centerlines of long radius elbows. This work utilized the finite element method as applicable to plates and shells for calculating the relative rotations of the trunnion elbow-ends for in-plane and out-of-plane elbow moment loadings. These rotations are used to derive the corresponding in-plane and out-of-plane flexibility factors. (orig./GL)

  3. Elbow flexor and extensor muscle weakness in lateral epicondylalgia.

    Science.gov (United States)

    Coombes, Brooke K; Bisset, Leanne; Vicenzino, Bill

    2012-05-01

    To evaluate whether deficits of elbow flexor and extensor muscle strength exist in lateral epicondylalgia (LE) in comparison with a healthy control population. Cross-sectional study. 150 participants with unilateral LE were compared with 54 healthy control participants. Maximal isometric elbow flexion and extension strength were measured bilaterally using a purpose-built standing frame such that gripping was avoided. The authors found significant side differences in elbow extensor (-6.54 N, 95% CI -11.43 to -1.65, p=0.008, standardised mean difference (SMD) -0.45) and flexor muscle strength (-11.26 N, 95% CI -19.59 to -2.94, p=0.009, SMD -0.46) between LE and control groups. Within the LE group, only elbow extensor muscle strength deficits between sides was significant (affected-unaffected: -2.94 N, 95% CI -5.44 to -0.44). Small significant deficits of elbow extensor and flexor muscle strength exist in the affected arm of unilateral LE in comparison with healthy controls. Notably, comparing elbow strength between the affected and unaffected sides in unilateral epicondylalgia is likely to underestimate these deficits. Trial Registration Australian New Zealand Clinical Trials Register ACTRN12609000051246.

  4. Evaluation and Management of Elbow Tendinopathy

    Science.gov (United States)

    Taylor, Samuel A.; Hannafin, Jo A.

    2012-01-01

    Context: Elbow tendinopathy is a common cause of pain and disability among patients presenting to orthopaedic surgeons, primary care physicians, physical therapists, and athletic trainers. Prompt and accurate diagnosis of these conditions facilitates a directed treatment regimen. A thorough understanding of the natural history of these injuries and treatment outcomes will enable the appropriate management of patients and their expectations. Evidence Acquisitions: The PubMed database was searched in December 2011 for English-language articles pertaining to elbow tendinopathy. Results: Epidemiologic data as well as multiple subjective and objective outcome measures were investigated to elucidate the incidence of medial epicondylitis, lateral epicondylitis, distal biceps and triceps ruptures, and the efficacy of various treatments. Conclusions: Medial and lateral epicondylitis are overuse injuries that respond well to nonoperative management. Their etiology is degenerative and related to repetitive overuse and underlying tendinopathy. Nonsteroidal anti-inflammatory drugs and localized corticosteroid injections yield moderate symptomatic relief in short term but do not demonstrate benefit on long-term follow-up. Platelet-rich plasma injections may be advantageous in cases of chronic lateral epicondylitis. If 6 to 12 months of nonoperative treatment fails, then surgical intervention can be undertaken. Distal biceps and triceps tendon ruptures, in contrast, have an acute traumatic etiology that may be superimposed on underlying tendinopathy. Prompt diagnosis and treatment improve outcomes. While partial ruptures confirmed with magnetic resonance imaging can be treated nonoperatively with immobilization, complete ruptures should be addressed with primary repair within 3 to 4 weeks of injury. PMID:23016111

  5. Limb immobilization and corticobasal syndrome.

    Science.gov (United States)

    Graff-Radford, Jonathan; Boeve, Bradley F; Drubach, Daniel A; Knopman, David S; Ahlskog, J Eric; Golden, Erin C; Drubach, Dina I; Petersen, Ronald C; Josephs, Keith A

    2012-12-01

    Recently, we evaluated two patients with corticobasal syndrome (CBS) who reported symptom onset after limb immobilization. Our objective was to investigate the association between trauma, immobilization and CBS. The charts of forty-four consecutive CBS patients seen in the Mayo Clinic Alzheimer Disease Research Center were reviewed with attention to trauma and limb immobilization. 10 CBS patients (23%) had immobilization or trauma on the most affected limb preceding the onset or acceleration of symptoms. The median age at onset was 61. Six patients manifested their first symptoms after immobilization from surgery or fracture with one after leg trauma. Four patients had pre-existing symptoms of limb dysfunction but significantly worsened after immobilization or surgery. 23 percent of patients had immobilization or trauma of the affected limb. This might have implications for management of CBS, for avoiding injury, limiting immobilization and increasing movement in the affected limb. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Hyperextension of the elbow joint

    DEFF Research Database (Denmark)

    Tyrdal, Stein; Olsen, Bo Sanderhoff

    1998-01-01

    According to an epidemiologic study (Scand J Med Sci 1996/ 6: 297-302) the mechanism of "handball goalie's elbow" may be forced hyperextension. The pathomechanics of hyperextension were studied in nine macroscopically normal male cadaver elbow joints. The mean age of the donors was 43.2 years...... of the medial collateral ligament; (3) occasional incomplete rupture of the lateral collateral ligament; and (4) small fragments of cartilage near the posterior edge of the ulna in one of the specimens. One or more of these lesions may be responsible for the symptoms in "handball goalie's elbow."...

  7. Articular Contact Area and Pressure in Posteromedial Rotatory Instability of the Elbow.

    Science.gov (United States)

    Bellato, Enrico; Fitzsimmons, James S; Kim, Youngbok; Bachman, Daniel R; Berglund, Lawrence J; Hooke, Alexander W; O'Driscoll, Shawn W

    2018-03-21

    Joint incongruity in posteromedial rotatory instability (PMRI) has been theorized to determine early articular degenerative changes. Our hypothesis was that the articular contact area and contact pressure differ significantly between an intact elbow and an elbow affected by PMRI. Seven cadaveric elbows were tested under gravity varus stress using a custom-made machine designed to simulate muscle loads and allow passive elbow flexion (0° to 90°). The mean contact area and contact pressure data were collected and processed using the Tekscan sensor and software. After testing the intact specimen (intact elbow), a PMRI injury was simulated (PMRI elbow) and the specimen was tested again. The PMRI elbows were characterized by initial joint subluxation and significantly elevated articular contact pressure. Both worsened, corresponding with a reduction in contact area, as the elbow was flexed from 0° until the joint subluxation and incongruity spontaneously reduced (at a mean [and standard error] of 60° ± 5° of flexion), at which point the mean contact pressure decreased from 870 ± 50 kPa (pre-reduction) to 440 ± 40 kPa (post-reduction) (p contact area increased from 80 ± 8 mm to 150 ± 58 mm (p contact area from the coronoid fracture edge toward the lower portion of the coronoid. At the flexion angle at which the PMRI elbows reduced, both the contact area and the contact pressure of the intact elbows differed significantly from those of the PMRI elbows, both before and after the elbow reduction (p contact area and increased contact pressures due to joint subluxation and incongruity could explain the progressive arthritis seen in some elbows affected by PMRI. This biomechanical study suggests that the early degenerative changes associated with PMRI reported in the literature could be subsequent to joint incongruity and an increase in contact pressure between the coronoid fracture surface and the trochlea.

  8. 21 CFR 888.3170 - Elbow joint radial (hemi-elbow) polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Elbow joint radial (hemi-elbow) polymer prosthesis. 888.3170 Section 888.3170 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-elbow) polymer prosthesis. (a) Identification. An elbow joint radial (hemi-elbow) polymer...

  9. Calcific periarthritis of the elbow presenting as acute tennis elbow.

    Science.gov (United States)

    Jawad, F; Jawad, A S M

    2014-01-01

    A 28-year-old woman presented with sudden acute lateral epicondylitis. There was no history of preceding trauma or repetitive use of the arm. Because of the acute onset and signs of acute inflammation, an X-ray was arranged. The X-ray showed a hyperdense calcified elongated globule distal to the lateral epicondyle. A diagnosis of calcific periarthritis (calcium apatite) of the elbow was made. Calcific periarthritis has rarely been reported as a cause of acute elbow pain.

  10. Elbow arthroscopy: indications, techniques, outcomes, and complications.

    Science.gov (United States)

    Adams, Julie E; King, Graham J W; Steinmann, Scott P; Cohen, Mark S

    2015-01-01

    Elbow arthroscopy is a tool useful for the treatment of a variety of pathologies about the elbow. The major indications for elbow arthroscopy include débridement for septic elbow arthritis, synovectomy for inflammatory arthritis, débridement for osteoarthritis, loose body extraction, contracture release, treatment of osteochondral defects and selected fractures or instability, and tennis elbow release. To achieve favorable outcomes after elbow arthroscopy, the surgeon should be aware of contraindications, technical considerations, anatomic principles, and the need for proper patient positioning and portal selection. Elbow arthroscopy is an effective procedure for the treatment of inflammatory arthritis, osteoarthritis, and lateral epicondylitis.

  11. Investigation on ultrasonic guided waves propagation in elbow pipe

    International Nuclear Information System (INIS)

    Qi, Minxin; Zhou, Shaoping; Ni, Jing; Li, Yong

    2016-01-01

    Pipeline plays an indispensable role in process industries, whose structural integrity is of great significance for the safe production. In this paper, the axial crack-like defects in 90° elbows are inspected by using the T (0, 1) mode guided waves. The detection sensitivity for different defect locations is firstly investigated by guided waves experimentally. The propagation of guided waves in the bent pipe is then simulated by using finite element method. The results show that the rates of T (0, 1) mode passing through elbow correlate strongly with the excitation frequency. Less mode conversion is generated at the frequency of 38 kHz when passing through the elbow, while most of energy converted into F (1, 2) mode at the frequency of 75 kHz. The crack in different locations of the elbow can affect the rates of mode conversion. It can be found that the crack in the middle of the elbow inhibits mode conversion and shares the highest detection sensitivity, while the crack in the extrados of elbow causes more mode conversion.

  12. Tennis elbow: associated psychological factors.

    Science.gov (United States)

    Aben, Aurelie; De Wilde, Lieven; Hollevoet, Nadine; Henriquez, Carlos; Vandeweerdt, Marc; Ponnet, Koen; Van Tongel, Alexander

    2018-03-01

    The etiology of tennis elbow is multifactorial. Overuse of the wrist extensors along with anatomic factors, such as flexibility problems, aging, and poor blood circulation, may play a role. This study investigated whether patients with tennis elbow have a different psychological profile compared with healthy controls. Patients with clinical signs of tennis elbow, consulting at the Ghent University Hospital between September 2015 and January 2017, were offered a paper-and-pencil questionnaire about Big Five personality traits, perfectionism, anxiety, depression, work satisfaction, and working conditions. Healthy controls in the same risk group were offered the same questionnaires. We recruited 69 patients (35 men, 34 women) and 100 controls (44 men, 56 women). Tennis elbow patients scored significantly lower on the personality traits extraversion and agreeableness. Men, in particular, scored significantly higher on perfectionism and were more likely to develop an anxiety disorder or a depression. Concerning work, patients indicated a significantly higher workload (especially men) and a significantly lower autonomy (especially women). Female patients also indicated less contact with colleagues. However, work satisfaction was relatively high in both groups. The results suggest that there is a relationship between complaints related to tennis elbow and psychological characteristics. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  13. Feasibility of four-dimensional preoperative simulation for elbow debridement arthroplasty.

    Science.gov (United States)

    Yamamoto, Michiro; Murakami, Yukimi; Iwatsuki, Katsuyuki; Kurimoto, Shigeru; Hirata, Hitoshi

    2016-04-02

    Recent advances in imaging modalities have enabled three-dimensional preoperative simulation. A four-dimensional preoperative simulation system would be useful for debridement arthroplasty of primary degenerative elbow osteoarthritis because it would be able to detect the impingement lesions. We developed a four-dimensional simulation system by adding the anatomical axis to the three-dimensional computed tomography scan data of the affected arm in one position. Eleven patients with primary degenerative elbow osteoarthritis were included. A "two rings" method was used to calculate the flexion-extension axis of the elbow by converting the surface of the trochlea and capitellum into two rings. A four-dimensional simulation movie was created and showed the optimal range of motion and the impingement area requiring excision. To evaluate the reliability of the flexion-extension axis, interobserver and intraobserver reliabilities regarding the assessment of bony overlap volumes were calculated twice for each patient by two authors. Patients were treated by open or arthroscopic debridement arthroplasties. Pre- and postoperative examinations included elbow range of motion measurement, and completion of the patient-rated questionnaire Hand20, Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score, and the Mayo Elbow Performance Score. Measurement of the bony overlap volume showed an intraobserver intraclass correlation coefficient of 0.93 and 0.90, and an interobserver intraclass correlation coefficient of 0.94. The mean elbow flexion-extension arc significantly improved from 101° to 125°. The mean Hand20 score significantly improved from 52 to 22. The mean Japanese Orthopaedic Association-Japan Elbow Society Elbow Function Score significantly improved from 67 to 88. The mean Mayo Elbow Performance Score significantly improved from 71 to 91 at the final follow-up evaluation. We showed that four-dimensional, preoperative simulation can be generated by

  14. Epicondilite lateral do cotovelo Lateral epicondylitis of the elbow

    Directory of Open Access Journals (Sweden)

    Marcio Cohen

    2012-01-01

    Full Text Available A epicondilite lateral, também conhecida como cotovelo do tenista, é uma condição comum que acomete de 1 a 3% da população. O termo epicondilite sugere inflamação, embora a análise histológica tecidual não demonstre um processo inflamatório. A estrutura acometida com mais frequência é a origem do tendão extensor radial curto do carpo e o mecanismo de lesão está associado à sua sobrecarga. O tratamento incruento é o de escolha e inclui: repouso, fisioterapia, infiltração com cortisona ou plasma rico em plaquetas e a utilização de imobilização específica. O tratamento cirúrgico é recomendado quando persistem impotência funcional e dor. Tanto a técnica cirúrgica aberta quanto a artroscópica com ressecção da área tendinosa degenerada apresenta bons resultados na literatura.Lateral epicondylitis, also known as tennis elbow, is a common condition that is estimated to affect 1% to 3% of the population. The word epicondylitis suggests inflammation, although histological analysis on the tissue fails to show any inflammatory process. The structure most commonly affected is the origin of the tendon of the extensor carpi radialis brevis and the mechanism of injury is associated with overloading. Nonsurgical treatment is the preferred method, and this includes rest, physiotherapy, cortisone infiltration, platelet-rich plasma injections and use of specific immobilization. Surgical treatment is recommended when functional disability and pain persist. Both the open and the arthroscopic surgical technique with resection of the degenerated tendon tissue present good results in the literature.

  15. Corticosteroid injection for tennis elbow or lateral epicondylitis: a review of the literature

    OpenAIRE

    Saccomanni, Bernardino

    2010-01-01

    Lateral epicondylitis or tennis elbow is a painful and functionally limiting entity affecting the upperextremity and is frequently treated by hand surgeons. Corticosteroid injection is one of the most common interventions for lateral epicondylitis or tennis elbow. Here, a review of the medical literature on this treatment is presented.

  16. Myositis ossificans traumatica causing ankylosis of the elbow.

    Science.gov (United States)

    Kanthimathi, B; Udhaya Shankar, S; Arun Kumar, K; Narayanan, V L

    2014-12-01

    Myositis ossificans traumatica is an unusual complication following a muscle contusion injury. A significantly large myositic mass causing ankylosis of the elbow is even rarer. We report a 13-year-old boy who presented with a 14-month history of a fixed elbow with no movement and a palpable bony mass in the anterior aspect of the elbow. He had sustained significant trauma to the affected limb 1 month prior to onset of symptoms, which was managed by native massage and bandaging for 4 weeks. The clinicoradiological diagnosis was suggestive of myositis ossificans, and the myositic mass was completely excised. Histopathology revealed lamellar bone. The 2-year follow-up showed full function of the affected limb and no signs of recurrence. We report this case of clinical interest due to the unusually large myositic mass.

  17. Pulled elbow in infancy: diagnostic role of imaging

    International Nuclear Information System (INIS)

    Scapinelli, Raffaele; Borgo, Andrea

    2005-01-01

    Purpose. Pulled elbow is a common injury in infancy. Typically the child, after a sudden pull, refuses to use the arm. The history and clinical findings are sufficient to make the diagnosis, and radiography or ultrasonography are not necessary. When imaging procedures are performed, a few small signs are useful to confirm the diagnosis of pulled elbow. Materials and methods. The authors reviewed the radiographic and ultrasonographic signs reported to be suggestive of pulled elbow (increased radio-condylar distance, increased radio-coronoid distance, proximal radio-ulnar diastasis, deviation of the radio-condylar line) and attempted to confirm their presence in children affected by this trauma. Results. Increased radio-condylar and radio-coronoid distance were present in 8 of 8 cases: proximal radio-ulnar diastasis and deviation of the radio-condylar line were inconsistently present. Ultrasonography gave contradictory results. Conclusions. In typical cases of pulled elbow, radiography or ultrasonography are not necessary for diagnosis and treatment. imaging procedures are recommended only in the case of non typical history, in the presence of deformity or traumatic skin lesions and in children over six years of age. Increased radio-coronoid distance on the affected side is the most frequent and visible sign, which can confirm the diagnosis of pulled elbow. Increased radio-condylar distance is also present, but it is not easy to visualize. Proximal radio-ulnar diastasis and deviation of the radio-condylar line are inconstant. Ultrasonography is difficult to standardize [it

  18. Effect of cryotherapy after elbow arthrolysis: a prospective, single-blinded, randomized controlled study.

    Science.gov (United States)

    Yu, Shi-yang; Chen, Shuai; Yan, He-de; Fan, Cun-yi

    2015-01-01

    To investigate the effect of cryotherapy after elbow arthrolysis on elbow pain, blood loss, analgesic consumption, range of motion, and long-term elbow function. Prospective, single-blinded, randomized controlled study. University hospital. Patients (N=59; 27 women, 32 men) who received elbow arthrolysis. Patients were randomly assigned into a cryotherapy group (n=31, cryotherapy plus standard care) or a control group (n=28, standard care). Elbow pain at rest and in motion were measured using a visual analog scale (VAS) on postoperative day (POD) 1 to POD 7 and at 2 weeks and 3 months after surgery. Blood loss and analgesic consumption were recorded postoperatively. Elbow range of motion (ROM) was measured before surgery and on POD 1, POD 7, and 3 months after surgery. The Mayo Elbow Performance Score (MEPS) was evaluated preoperatively and 3 months postoperatively. VAS scores were significantly lower in the cryotherapy group during the first 7 PODs, both at rest and in motion (Pcryotherapy group than the control group for pain relief (P.05). Cryotherapy is effective in relieving pain and reducing analgesic consumption for patients received elbow arthrolysis. The application of cryotherapy will not affect blood loss, ROM, or elbow function. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Echipament acționat cu mușchi pneumatici destinat recuperării pacienților cu afecțiuni posttraumatice ale articulației cotului/Pneumatic muscle actuated equipment for the rehabilitation of patients with post-traumatic affections of the elbow joint

    Directory of Open Access Journals (Sweden)

    Georgiana VETRICE

    2016-12-01

    Full Text Available Loss of motion following joint surgery is a common complication and has negative effects on individuals. The diminished motion autonomy of persons suffering from post-traumatic affections of the elbow joint can be addressed by continuous passive motion, a treatment method entailing constant moving of the joint, however, without requiring any patient effort. The paper presents a novel type of rehabilitation equipment for the elbow joint, using this technique. The novelty consists in the utilization of pneumatic muscles as actuators and in the two axes of motion. Pneumatic actuation presents benefits from compliance, meaning favourable response to commands, due to air compressibility, as well as from an excellent force-to-weight ratio.

  20. Measurement issues in the sonographic assessment of tennis elbow.

    Science.gov (United States)

    Poltawski, Leon; Jayaram, Vijay; Watson, Tim

    2010-05-01

    Sonography is increasingly being used for assessment in tennis elbow research and clinical practice, but there are a lack of data regarding its validity, reliability, and responsiveness to change for this application. Studies using the modality were reviewed to establish current levels of evidence for these measurement properties. There is reasonable evidence regarding its validity for identifying tennis elbow tendinopathy, but a lack of data addressing its reliability and responsiveness. Practical issues affecting image quality are discussed, and recommendations for further investigation are suggested, to enhance the credible use of sonography with this debilitating condition.

  1. Orthotic devices for tennis elbow

    NARCIS (Netherlands)

    Struijs, P. A.; Smidt, N.; Arola, H.; van Dijk, C. N.; Buchbinder, R.; Assendelft, W. J.

    2001-01-01

    BACKGROUND: Lateral epicondylitis (tennis elbow) is a frequently reported condition. A wide variety of treatment strategies has been described. As of yet, no optimal strategy has been identified. OBJECTIVES: The objective of this review was to assess the effectiveness of orthotic devices for

  2. Eponyms in elbow fracture surgery

    NARCIS (Netherlands)

    Somford, Matthijs P.; Wiegerinck, Johannes I.; Hoornenborg, Daniël; van den Bekerom, Michel P. J.; Eygendaal, Denise

    2015-01-01

    Eponyms are common in medicine and in orthopaedic surgery. For future reference and historical considerations, we present common eponyms in elbow fracture surgery. We describe in short the biography of the name giver and give, where possible, the original description on which the eponym was based.

  3. Total elbow arthroplasty in primary osteoarthritis of the elbow.

    Science.gov (United States)

    Kozak, T K; Adams, R A; Morrey, B F

    1998-10-01

    Primary osteoarthritis of the elbow is an infrequent condition typically managed by some form of debridement. There is no comment in the literature regarding prosthetic replacement for this condition. We report 5 patients (mean age, 68), with a minimum assessment of 3 years (range, 37-125 years) after total elbow arthroplasty. Complications in 4 patients included subluxation, fracture of a humeral component with particulate synovitis, heterotopic ossification, recurrent osteophyte formation, and transient ulnar neuropathy. Although revision was required in 2 of the 5, currently all experience had satisfactory outcomes. While replacement has proven ultimately to be a successful option for this high-demand patient group because of the high complication rate, we do not recommend replacement unless alternate operative options are deemed unacceptable.

  4. Unsteady hydraulic characteristics in pipe with elbow under high Reynolds condition

    Energy Technology Data Exchange (ETDEWEB)

    Ono, A.; Kimura, N.; Kamide, H.; Tobita, A. [Japan Atomic Energy Agency, O-arai, Ibaraki (Japan)

    2011-07-01

    In the design of Japan Sodium-cooled Fast Reactor (JSFR), coolant velocity is beyond 9 m/s in the primary hot leg pipe of 1.27 m diameter. The Reynolds number in the piping reaches 4.2x10{sup 7}. Moreover, a short-elbow (r/D=1.0, r: curvature radius, D: pipe diameter) is adopted in the hot leg pipe in order to achieve compact plant layout and reduce plant construction cost. Therefore, the flow-induced vibration (FIV) arising from the piping geometry may occur in the short-elbow pipe. The FIV is due to the excitation force which is caused by the pressure fluctuation on the wall. The pressure fluctuation on the pipe wall is closely related with the flow fluctuation. In this study, water experiments using two types of 1/8 scaled elbows with different curvature ratio, r/D=1.0 and 1.5 (short-elbow and long-elbow), were conducted in order to investigate the mechanism of velocity and pressure fluctuation in the elbow and its downstream. The experiments were carried out at Re=5.4x10{sup 5} conditions. Measurement of velocity fluctuation and pressure fluctuation in two types of elbows with different curvature revealed that behavior of separation region and the circumferential secondary flow affected the pressure fluctuation on the wall of the elbow greatly. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

    Poeyhiae, Tiina H; Koivikko, Mika P; Lamminen, Antti E [University of Helsinki, Helsinki Medical Imaging Center, Helsinki (Finland); Peltonen, Jari I; Nietosvaara, A Y [Helsinki University Central Hospital, Hospital for Children and Adolescents, Helsinki (Finland); Kirjavainen, Mikko O [Helsinki University Central Hospital, Department of Orthopaedics and Traumatology, Helsinki (Finland)

    2007-02-15

    Muscle pathology of the arm and forearm in brachial plexus birth injury (BPBI) with elbow flexion contracture has not been evaluated with MRI. To determine whether limited range of motion of the elbow in BPBI is correlated with specific patterns of muscular pathology. 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. Mean TAM of the elbow was 113 (50 -140 ) and that of the forearm 91 (10 -165 ). 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. 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. (orig.)

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

    International Nuclear Information System (INIS)

    Poeyhiae, Tiina H.; Koivikko, Mika P.; Lamminen, Antti E.; Peltonen, Jari I.; Nietosvaara, A.Y.; Kirjavainen, Mikko O.

    2007-01-01

    Muscle pathology of the arm and forearm in brachial plexus birth injury (BPBI) with elbow flexion contracture has not been evaluated with MRI. To determine whether limited range of motion of the elbow in BPBI is correlated with specific patterns of muscular pathology. 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. Mean TAM of the elbow was 113 (50 -140 ) and that of the forearm 91 (10 -165 ). 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. 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. (orig.)

  7. The effects of gender, level of co-contraction, and initial angle on elbow extensor muscle stiffness and damping under a step increase in elbow flexion moment.

    Science.gov (United States)

    Lee, Yunju; Ashton-Miller, James A

    2011-10-01

    Flexion buckling of an arm under the large ground reaction loads associated with arresting a fall to the ground increases the risk for head and thorax injuries. Yet, the factors that determine the arm buckling load remain poorly understood. We tested the hypothesis in 18 healthy young adults that neither gender, triceps co-contraction level (i.e., 25, 50, or 75% MVC) nor elbow angle would affect the rotational stiffness and damping resistance to step changes in elbow flexion loading. Data on the step response were gathered using optoelectronic markers (150 Hz) and myoelectric activity measurements (2 kHz), and an inverse dynamics analysis was used to estimate elbow extensor stiffness and damping coefficients. A repeated-measures analysis of variance showed that gender (p = 0.032), elbow flexion angle and co-contraction level (both p initial elbow flexion angle and maximum co-contraction, female stiffness and damping coefficients were 18 and 30% less, respectively, than male values after normalization by body height and weight. We conclude that the maximum extensor rotational stiffness and damping at the elbow is lower in women than in men of the same body size, and varies with triceps co-contraction level and initial elbow angle.

  8. Biceps brachii long head overactivity associated with elbow flexion contracture in brachial plexus birth palsy.

    Science.gov (United States)

    Sheffler, Lindsey C; Lattanza, Lisa; Sison-Williamson, Mitell; James, Michelle A

    2012-02-15

    The etiology of elbow flexion contracture in children with brachial plexus birth palsy remains unclear. We hypothesized that the long head of the biceps brachii muscle assists with shoulder stabilization in children with brachial plexus birth palsy and that overactivity of the long head during elbow and shoulder activity is associated with an elbow flexion contracture. Twenty-one patients with brachial plexus birth palsy-associated elbow flexion contracture underwent testing with surface electromyography. Twelve patients underwent repeat testing with fine-wire electromyography. Surface electrodes were placed on the muscle belly, and fine-wire electrodes were inserted bilaterally into the long and short heads of the biceps brachii. Patients were asked to perform four upper extremity tasks: elbow flexion-extension, hand to head, high reach, and overhead ball throw. The mean duration of muscle activity in the affected limb was compared with that in the contralateral, unaffected limb, which was used as a control. Three-dimensional motion analysis, surface dynamometry, and validated function measures were used to evaluate upper extremity kinematics, elbow flexor-extensor muscle imbalance, and function. The mean activity duration of the long head of the biceps brachii muscle was significantly higher in the affected limb as compared with the contralateral, unaffected limb during hand-to-head tasks (p = 0.02) and high-reach tasks (p = 0.03). No significant differences in mean activity duration were observed for the short head of the biceps brachii muscle between the affected and unaffected limbs. Isometric strength of elbow flexion was not significantly higher than that of elbow extension in the affected limb (p = 0.11). Overactivity of the long head of the biceps brachii muscle is associated with and may contribute to the development of elbow flexion contracture in children with brachial plexus birth palsy. Elbow flexion contracture may not be associated with an elbow

  9. Lateral epicondylitis of the elbow.

    Science.gov (United States)

    Tosti, Rick; Jennings, John; Sewards, J Milo

    2013-04-01

    Lateral epicondylitis, or "tennis elbow," is a common musculotendinous degenerative disorder of the extensor origin at the lateral humeral epicondyle. Repetitive occupational or athletic activities involving wrist extension and supination are thought to be causative. The typical symptoms include lateral elbow pain, pain with wrist extension, and weakened grip strength. The diagnosis is made clinically through history and physical examination; however, a thorough understanding of the differential diagnosis is imperative to prevent unnecessary testing and therapies. Most patients improve with nonoperative measures, such as activity modification, physical therapy, and injections. A small percentage of patients will require surgical release of the extensor carpi radialis brevis tendon. Common methods of release may be performed via percutaneous, arthroscopic, or open approaches. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Radiography of the pediatric elbow

    International Nuclear Information System (INIS)

    Hoffman, A.D.

    1985-01-01

    The ability to obtain adequate and appropriate radiographs of the elbow depends on a number of variables. Often the pattern and timing of the appearance of the numerous secondary ossifications centers at the elbow is a source of confusion to those who deal infrequently with children. To obtain diagnostic radiographs consistently requires well-maintained, modern equipment and technologists who pay careful attention to the details of radiographic technique. Radiology technicians are generally empathetic with the anxiety that a child (and an accompanying parent or guardian) may feel when confronted with the need to enter a radiology exposure room with its ominous appearing, bulky machinery. It is always helpful to reassure the patient gently that the examination is easy and will not cause any discomfort

  11. Posterolateral Rotatory Apprehension Test in Tennis Elbow.

    Science.gov (United States)

    Chanlalit, Cholawish; Phorkhar, Termphong

    2015-11-01

    Tennis elbow is a syndrome that commonly diagnosed in patient who comes with lateral elbow pain. Instability pain in tennis elbow patient was observed and reported in many previous literatures. Posterolateral rotatory apprehension test was proposed for diagnosis of posterolateral rotatory instability of elbow. However, no review literatures that studied about posterolateral rotatory apprehensions test in tennis elbow. To find out the relationship between posterolateral rotatory apprehension test and tennis elbow. There were 44 patients that were recruited in this study. We examined the posterolateral rotatory apprehension test in tennis elbow patients. The examination was done in our outpatient clinic from March 2012 to April 2012. The data was collected to find out the ratio of negative test in tennis elbow patient. The results from the posterolateral rotatory apprehension test were negative in 43 patients. The ratio of the negative test result was 98%. A result from posterolateral rotatory apprehension test should be negative in general tennis elbow patients. If this test is used in a tennis elbow patients who are suspected with hidden instability and the result is positive, further evaluation is strongly suggested.

  12. Microorganism immobilization

    Science.gov (United States)

    Compere, Alicia L.; Griffith, William L.

    1981-01-01

    Live metabolically active microorganisms are immobilized on a solid support by contacting particles of aggregate material with a water dispersible polyelectrolyte such as gelatin, crosslinking the polyelectrolyte by reacting it with a crosslinking agent such as glutaraldehyde to provide a crosslinked coating on the particles of aggregate material, contacting the coated particles with live microorganisms and incubating the microorganisms in contact with the crosslinked coating to provide a coating of metabolically active microorganisms. The immobilized microorganisms have continued growth and reproduction functions.

  13. Modified Pectoralis Major Tendon Transfer for Reanimation of Elbow Flexion as a Salvage Procedure in Complete Brachial Plexus Injury: A Case Report

    Directory of Open Access Journals (Sweden)

    S Taran

    2013-03-01

    Full Text Available Traumatic brachial plexus injuries rarely recover spontaneously and if the window period for neurotisation has elapsed, the only option for restoration of function lies in a salvage procedure. Many such salvage procedures have been described in the literature with variable functional results. We report the case of a 16-year-old boy who presented after unsuccessful treatment for a complete brachial plexus injury; we performed a pectoralis major tendon transfer to attain elbow flexion. Postoperatively, the elbow was splinted with flexion at 100°. After 4 weeks of immobilization the splint was removed and the patient could actively flex his elbow from 30° to 100°.

  14. The effect of elbow angle and external moment on load sharing of elbow muscles

    NARCIS (Netherlands)

    Praagman, M.; Chadwick, E.K.J.; van der Helm, F.C.T.; Veeger, H.E.J.

    2010-01-01

    To study elbow muscle load sharing we investigated the effect of external flexion-extension (FE) and pronation-supination (PS) moments and elbow angle on muscle activation and oxygen consumption (V̇O2).Two data sets were obtained. First, (n=6) electromyography (EMG) of elbow flexors (long and short

  15. Elbow dysplasia in the dog : pathophysiology, diagnosis and control : review article

    Directory of Open Access Journals (Sweden)

    R.M. Kirberger

    1998-07-01

    Full Text Available Elbow dysplasia is a non-specific term denoting abnormal development of the elbow. Elbow dysplasia encompasses the clinical and radiographic manifestation of ununited anconeal process, fragmented medial coronoid process, osteochondritis dissecans, erosive cartilage lesions and elbow incongruity. The net result is elbow arthrosis, which may be clinically inapparent or result in marked lameness. These conditions may be diagnosed by means of routine or special radiographic views and other imaging modalities, or the precise cause of the arthrosis or lameness may remain undetermined. Breeds most commonly affected are the rottweiler, Bernese mountain dog, Labrador and golden retriever and the German shepherd dog. Certain breeds are more susceptible to a particular form of elbow dysplasia and more than 1 component may occur simultaneously. The various conditions are thought to result from osteochondrosis of the articular or physeal cartilage that results in disparate growth of the radius and ulna. Heritability has been proven for this polygenic condition and screening programmes to select suitable breeding stock have been initiated in several countries and have decreased the incidence of elbow dysplasia.

  16. Functional treatment versus plaster for simple elbow dislocations (FuncSiE: a randomized trial

    Directory of Open Access Journals (Sweden)

    Verleisdonk Egbert JMM

    2010-11-01

    Full Text Available Abstract Background Elbow dislocations can be classified as simple or complex. Simple dislocations are characterized by the absence of fractures, while complex dislocations are associated with fractures. After reduction of a simple dislocation, treatment options include immobilization in a static plaster for different periods of time or so-called functional treatment. Functional treatment is characterized by early active motion within the limits of pain with or without the use of a sling or hinged brace. Theoretically, functional treatment should prevent stiffness without introducing increased joint instability. The primary aim of this randomized controlled trial is to compare early functional treatment versus plaster immobilization following simple dislocations of the elbow. Methods/Design The design of the study will be a multicenter randomized controlled trial of 100 patients who have sustained a simple elbow dislocation. After reduction of the dislocation, patients are randomized between a pressure bandage for 5-7 days and early functional treatment or a plaster in 90 degrees flexion, neutral position for pro-supination for a period of three weeks. In the functional group, treatment is started with early active motion within the limits of pain. Function, pain, and radiographic recovery will be evaluated at regular intervals over the subsequent 12 months. The primary outcome measure is the Quick Disabilities of the Arm, Shoulder, and Hand score. The secondary outcome measures are the Mayo Elbow Performance Index, Oxford elbow score, pain level at both sides, range of motion of the elbow joint at both sides, rate of secondary interventions and complication rates in both groups (secondary dislocation, instability, relaxation, health-related quality of life (Short-Form 36 and EuroQol-5D, radiographic appearance of the elbow joint (degenerative changes and heterotopic ossifications, costs, and cost-effectiveness. Discussion The successful

  17. Synovial chondromatosis of the elbow in a child

    Directory of Open Access Journals (Sweden)

    Rishi Narasimhan

    2011-01-01

    Full Text Available Synovial chondromatosis is cartilaginous metaplasia of mesenchymal remnants of synovial tissue of the joints. Its main characteristic is the formation of cartilaginous nodules in the synovium and inside the articular space (loose bodies. It usually presents between the third and fifth decades and is rare in children. It presents as a mono-articular pathology affecting large joints such as the knee, hip, and elbow. The main symptoms are pain, swelling, and limitation of movements in the affected joint. Diagnosis is made by panoramic radiographs, computed tomography scan, and mainly magnetic resonance imaging and on surgery. The authors describe of synovial chondromatosis presenting in the elbow of an 11 year-old girl which is unreported to the best of our knowledge.

  18. Trauma and sports injuries of the elbow

    NARCIS (Netherlands)

    Kodde, I.F.

    2016-01-01

    This thesis deals with current issues in the management of trauma and sports injuries of the elbow. Common sports injuries of the elbow involve ruptures of the distal biceps tendon and the ulnar collateral ligament. We evaluated one of the current thoughts, that the height of the radial bicipital

  19. Humeral windows in revision total elbow arthroplasty.

    Science.gov (United States)

    Peach, Chris A; Salama, Amir; Stanley, David

    2016-04-01

    The use of cortical windows for revision elbow arthroplasty has not previously been widely reported. Their use aids safe revision of a well fixed humeral prosthesis and can be used in the setting of dislocation, periprosthetic fracture or aseptic loosening of the ulnar component. We describe our technique and results of cortical windows in the distal humerus for revision elbow arthroplasty surgery.

  20. Radiographic arthrosis after elbow trauma: interobserver reliability.

    NARCIS (Netherlands)

    Lindenhovius, A.; Karanicolas, P.J.; Bhandari, M.; Ring, D.; Kampen, A. van; et al.,

    2012-01-01

    PURPOSE: This study measured observer variation in radiographic rating of elbow arthrosis. METHODS: Thirty-seven independent orthopedic surgeons graded the extent of elbow arthrosis in 20 consecutive sets of plain radiographs, according to the Broberg and Morrey rating system (grade 0, normal joint;

  1. Nerve injuries do occur in elbow arthroscopy

    NARCIS (Netherlands)

    Hilgersom, Nick F. J.; van Deurzen, Derek F. P.; Gerritsma, Carina L. E.; van der Heide, Huub J. L.; Malessy, Martijn J. A.; Eygendaal, Denise; van den Bekerom, Michel P. J.

    2018-01-01

    The purpose is to create more awareness as well as emphasize the risk of permanent nerve injury as a complication of elbow arthroscopy. Patients who underwent elbow arthroscopy complicated by permanent nerve injury were retrospectively collected. Patients were collected using two strategies: (1) by

  2. Radiographic Arthrosis After Elbow Trauma: Interobserver Reliability

    NARCIS (Netherlands)

    Lindenhovius, Anneluuk; Karanicolas, Paul Jack; Bhandari, Mohit; Ring, David; Allan, Cristopher; Axelrod, Terry; Baratz, Mark; Beingessner, Daphne; Cassidy, Charles; Coles, Chad; Conflitti, Joe; Rocca, Gregory Della; van Dijk, C. Niek; Elmans, L. H. G. J.; Feibe, Roger; Frihagen, Frede; Gosens, Taco; Greenberg, Jeffrey; Grosso, Elena; Harness, Neil; van der Heide, Huub; Jeray, Kyle; Kalainov, David; van Kampen, Albert; Kawamura, Sumito; Kloen, Peter; McCormac, Bob; McKee, Michael; Page, Richard; Pesantez, Rodrigo; Peters, Anil; Petrisor, Brad; Poolman, Rudolf; Richardson, Martin; Seiler, John; Swiontkowski, Marc; Trumble, Thomas; Wright, Thomas; Zalavras, Charalampos; Zura, Robert

    2012-01-01

    Purpose This study measured observer variation in radiographic rating of elbow arthrosis. Methods Thirty-seven independent orthopedic surgeons graded the extent of elbow arthrosis in 20 consecutive sets of plain radiographs, according to the Broberg and Morrey rating system (grade 0, normal joint;

  3. Total elbow arthroplasty for primary osteoarthritis.

    Science.gov (United States)

    Schoch, Bradley S; Werthel, Jean-David; Sánchez-Sotelo, Joaquín; Morrey, Bernard F; Morrey, Mark

    2017-08-01

    Primary osteoarthritis of the elbow is a less common indication for total elbow arthroplasty (TEA). Higher complication rates in younger, active patients may offset short-term improvements in pain and function. The purpose of this study was to determine pain relief, functional outcomes, complications, and survival of TEA in this population. Between 1984 and 2011, 20 consecutive TEAs were performed for primary elbow osteoarthritis. Two patients died before the 2-year follow-up. Mean age at surgery was 68 years (range, 51-85 years). Outcome measures included pain, motion, Mayo Elbow Performance Score, satisfaction, complications, and reoperations. Mean follow-up was 8.9 years (range, 2-20 years). Three elbows sustained mechanical failures. Complications included intraoperative fracture (n = 2), wound irrigation and débridement (n = 1), bony ankylosis (n = 1), humeral loosening (n = 1), humeral component fracture (n = 1), and mechanical failure of a radial head component (n = 1). Fifteen elbows without mechanical failure were examined clinically. Pain improved from 3.6 to 1.5 (P  .05), with preoperative flexion contractures not improving. Mayo Elbow Performance Scores were available for 13 elbows without mechanical failure, averaging 81.5 points (range, 60-100 points); these were graded as excellent (n = 5), good (n = 2), and fair (n = 6). Subjectively, all patients without mechanical failure were satisfied. TEA represents a reliable surgical option for pain relief in patients with primary osteoarthritis. However, restoration of extension is not always obtained, indicating that more aggressive soft tissue releases or bony resection should be considered. Complications occurred in a large number of elbows, but mechanical failure was low considering the nature of this population and the length of follow-up. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  4. Efficacy of tennis elbow (epicondylitis humeri radialis) treatment in CBR "Praxis".

    Science.gov (United States)

    Pecar, Dzemal; Avdić, Dijana

    2009-02-01

    Tennis elbow (Epicondylitis humeri radialis) is the most frequent reason that patients with elbow pain report to a physician. The exact cause of elbow pain is still unclear. However, it is certainly causally connected with connective intersection between forearm muscle and bone in the elbow region. In this paper, we analyzed patients that, over the period of 15 years, reported to "Praxis" clinic for elbow pain treatment (Epicondylitis humeri radialis). Of the total number of 228 patients, 126 were male, 101 female while one patient was younger than 14. Initial analysis established that average overall health condition grade was 2,87 at the onset of treatment. Following the treatment completion that grade was 4,48. Of the total number of 223 patients who were treated by combined method of manipulation and local corticosteroid instillation, eight patients received physical therapy as well. Thus, surgical treatment was not necessary in any patient. The patients' treatment included: 1. Application of manipulative methods in order to reestablish mobility in the "blocked" radio-humeral and the upper radio-ulnar joints. 2. Local instillation of corticosteroid depot in order to control inflammation (enthesitis) and thus, eliminate pain and establish physiological conditions for functioning of joint and local structures. Unlike conservative method which includes initial immobilization due to irritation and inflammation development prevention with concomitant analgesic and antirheumatic therapy, initial application of manipulation with reinstatement of joint mobility instead of immobilization with subsequent instillation of steroid preparations achieves functional restitution and fast reinstatement of full working ability, as a rule.

  5. Efficacy of tennis elbow (Epicondylitis humeri radialis treatment in CBR "PRAXIS".

    Directory of Open Access Journals (Sweden)

    Džemal Pecar

    2009-02-01

    Full Text Available Tennis elbow (Epicondylitis humeri radialis is the most frequent reason that patients with elbow pain report to a physician. The exact cause of elbow pain is still unclear. However, it is certainly causally connected with connective intersection between forearm muscle and bone in the elbow region.In this paper, we analyzed patients that, over the period of 15 years, reported to “Praxis” clinic for elbow pain treatment (Epicondylitis humeri radialis. Of the total number of 228 patients, 126 were male, 101 female while one patient was younger than 14. Initial analysis established that average overall health condition grade was 2,87 at the onset of treatment. Following the treatment completion that grade was 4,48.Of the total number of 223 patients who were treated by combined method of manipulation and local corticosteroid instillation, eight patients received physical therapy as well. Thus, surgical treatment was not necessary in any patient.The patients’ treatment included:Application of manipulative methods in order to reestablish mobility in the “blocked” radio-humeral and the upper radio-ulnar joints.Local instillation of corticosteroid depot in order to control inflammation (enthesitis and thus, eliminate pain and establish physiological conditions for functioning of joint and local structures. Unlike conservative method which includes initial immobilization due to irritation and inflammation development prevention with concomitant analgesic and antirheumatic therapy, initial application of manipulation with reinstatement of joint mobility instead of immobilization with subsequent instillation of steroid preparations achieves functional restitution and fast reinstatement of full working ability, as a rule.

  6. EFFICACY OF TENNIS ELBOW (EPICONDYLITIS HUMERI RADIALIS) TREATMENT IN CBR “PRAXIS”

    Science.gov (United States)

    Pecar, Džemal; Avdić, Dijana

    2009-01-01

    Tennis elbow (Epicondylitis humeri radialis) is the most frequent reason that patients with elbow pain report to a physician. The exact cause of elbow pain is still unclear. However, it is certainly causally connected with connective intersection between forearm muscle and bone in the elbow region. In this paper, we analyzed patients that, over the period of 15 years, reported to “Praxis” clinic for elbow pain treatment (Epicondylitis humeri radialis). Of the total number of 228 patients, 126 were male, 101 female while one patient was younger than 14. Initial analysis established that average overall health condition grade was 2,87 at the onset of treatment. Following the treatment completion that grade was 4,48. Of the total number of 223 patients who were treated by combined method of manipulation and local corticosteroid instillation, eight patients received physical therapy as well. Thus, surgical treatment was not necessary in any patient. The patients’ treatment included: Application of manipulative methods in order to reestablish mobility in the “blocked” radio-humeral and the upper radio-ulnar joints. Local instillation of corticosteroid depot in order to control inflammation (enthesitis) and thus, eliminate pain and establish physiological conditions for functioning of joint and local structures. Unlike conservative method which includes initial immobilization due to irritation and inflammation development prevention with concomitant analgesic and antirheumatic therapy, initial application of manipulation with reinstatement of joint mobility instead of immobilization with subsequent instillation of steroid preparations achieves functional restitution and fast reinstatement of full working ability, as a rule. PMID:19284391

  7. Anthropometric characterisation of elbow angles and lines among Indian children

    Directory of Open Access Journals (Sweden)

    Bhanu Awasthi

    2017-01-01

    Full Text Available Background: For understanding injuries in paediatric elbow and checking the degree of reduction after manipulation, various radiological criteria using anthropometric parameters are used. Since anthropometric parameters of Caucasians are different from European and Mongoloids, their parameters cannot be applied on our population. Hence, there is a need to characterise anthropometric parameters of elbow among children in the Indian population. Materials and Methods: The study population comprised all cases of injury to the elbow joint between 3 and 13 years of age reporting to the Department of Orthopaedics during the study. The X-rays films were preserved, and the angles and lines (as anthropometric parameters were drawn on the radiographs. Results: Mean ± (standard deviation [SD] for Baumann angle in children included in this study was 75° ± 4.70°. Mean ± (SD of Baumann angle in males was 76° ± 4.44° and females was 74° ± 5.37°. Mean ± (SD for lateral capitellohumeral angle in children from 3 to 13 years of age was 49 ± 5.75. Conclusions: As the values of normal side have been found to affect the functional and cosmetic outcome of the affected extremity, slight changes in values of our population in comparison to that of the Western population can significantly affect the outcome.

  8. A Rare Cause of Elbow Pain: Hegemann%u2019s Disease

    Directory of Open Access Journals (Sweden)

    Tugrul Alici

    2014-03-01

    Full Text Available Non-traumatic elbow pain is rarely seen in children and pre-adolescents. Osteochondral lesions may be the source of chronic elbow pain, swelling, and loss of motion in children or adolescents. Osteochondritis dissecans (OCD is described as a lesion of subchondral bone resulting in separation of the articular cartilage and subchondral bone. It is found primarily in the knee, ankle, and elbow joints. Since osteochondrosis of the elbow primarily involves capitellum, few papers involving osteonecrosis of the trochlea have been reported. This paper discusses a pre-adolescent boy with clinical and radiographic signs consistent with unilateral osteochondral lesion of the trochlea humeri, with no history of recent trauma. The patient had insidious onset of right elbow pain during daily activities for the last 3 weeks. After usage of long arm splint for 2 weeks, persistence of the symptoms necessitated MRI of the affected elbow. After the diagnosis, non-operative management was achieved. Care should be taken for the affected children to recognize any residual deformity and to treat it properly at follow up.

  9. Osteochondrosis dissecans of the elbow.

    Science.gov (United States)

    Van Sonhoven, F; Geusens, E; Nijs, S

    2009-01-01

    This case shows a typical presentation of an osteochondrosis dissecans lesion on the capitellum, with associated intra-articular loose bodie(s), diagnosed on plain film. Osteochondrosis dissecans (OCD) is a rather common entity. Mostly the knee joint is involved. Only 5% of OCD lesions occur in the elbow joint. Possible causes of osteochondrosis dissecans include (repetitive) trauma (e.g. in throwing sports or gymnastics), ischemia, ossification defects, and genetic factors. Conventional radiography mostly has a low sensitivity to detect OCD lesions, and is often normal in early stages. CT is more sensitive to detect intra-articular loose bodies. MRI detects very early stages of OCD and radiographically occult lesions that may not be evident on CT.

  10. Elbow arthroscopy: valgus extension overload.

    Science.gov (United States)

    Ahmad, Christopher S; Conway, John E

    2011-01-01

    Valgus torque combined with deceleration produces high compression and shear forces acting on the posteromedial olecranon and the posteromedial trochlea. This valgus extension overload process may cause posteromedial trochlea chondromalacia, chondral flap formation, osteochondrosis, subchondral erosion, a subchondral insufficiency fracture, and marginal exostosis formation. Olecranon pathologies include proximal stress reaction, a posteromedial tip stress fracture, a transverse proximal process stress fracture, exostosis formation, exostosis fragmentation, and intra-articular loose bodies. Symptoms include posteromedial elbow pain during the deceleration phase of the throwing motion. The extension impingement test reproduces posterior or posteromedial pain similar to that experienced while throwing. Special radiographic techniques and CT scans can show loose bodies and osteophyte fragmentation. Surgical treatment is indicated when symptoms persist despite nonsurgical management. Based on clinical and basic science research, all patients with valgus extension overload should be comprehensively evaluated for medial ulnar collateral ligament insufficiency. Surgical treatment is limited to the resection of osteophytes only; normal olecranon should not be resected.

  11. Elbow joint rehabilitation equipment actuated by pneumatic muscles

    Directory of Open Access Journals (Sweden)

    Vetrice Georgiana

    2017-01-01

    Full Text Available The mobility of the limbs is an essential prerequisite for the individual’s physical autonomy. For persons suffering from post-traumatic affections of the elbow joint such limited mobility results in barriers in fulfilling personal or professional tasks. Passive motion has certain specific advantages and beneficial effects, thus being highly recommended for the recovery of injured joints. The paper presents a model of rehabilitation equipment that induces continuous passive motion of the elbow, as part of a recovery programme. The equipment is actuated by pneumatic muscles, using compressed air as the source of energy that generates force and motion. The main benefits of the pneumatic actuation system compared to other driving systems are its low cost, simple and robust construction and swift response to commands. Its constructive simplicity and reduced cost adds to the system’s eligibility for deployment in medical units.

  12. Clinical anatomy of the elbow and shoulder.

    Science.gov (United States)

    Villaseñor-Ovies, Pablo; Vargas, Angélica; Chiapas-Gasca, Karla; Canoso, Juan J; Hernández-Díaz, Cristina; Saavedra, Miguel Ángel; Navarro-Zarza, José Eduardo; Kalish, Robert A

    The elbow patients herein discussed feature common soft tissue conditions such as tennis elbow, golfers' elbow and olecranon bursitis. Relevant anatomical structures for these conditions can easily be identified and demonstrated by cross examination by instructors and participants. Patients usually present rotator cuff tendinopathy, frozen shoulder, axillary neuropathy and suprascapular neuropathy. The structures involved in tendinopathy and frozen shoulder can be easily identified and demonstrated under normal conditions. The axillary and the suprascapular nerves have surface landmarks but cannot be palpated. In neuropathy however, physical findings in both neuropathies are pathognomonic and will be discussed. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  13. Influence of elbow curvature on flow structure at elbow outlet under high Reynolds number condition

    Energy Technology Data Exchange (ETDEWEB)

    Ono, A., E-mail: ono.ayako@jaea.go.jp [Oarai Research and Development Center, Japan Atomic Energy Agency, Narita 4002, Oarai, Ibaraki 311-1393 (Japan); Kimura, N.; Kamide, H.; Tobita, A. [Oarai Research and Development Center, Japan Atomic Energy Agency, Narita 4002, Oarai, Ibaraki 311-1393 (Japan)

    2011-11-15

    In the design of Japan Sodium-cooled Fast Reactor (JSFR), coolant velocity is beyond 9 m/s in the primary hot leg pipe of 1.27 m diameter. The Reynolds number in the piping reaches 4.2 Multiplication-Sign 10{sup 7}. Moreover, a short-elbow is adopted in the hot leg pipe in order to achieve compact plant layout and to reduce plant construction cost. Therefore, the flow-induced vibration (FIV) arising from the piping geometry may occur in the short-elbow pipe. The FIV is due to the excitation source which is caused by the pressure fluctuation in the pipe. The pressure fluctuation in the pipe is closely related with the velocity fluctuation. As the first step of clarification of the FIV mechanism, it is important to grasp the mechanism of flow fluctuation in the elbow. In this study, water experiments with two types of elbows with different curvature ratios were conducted in order to investigate the interaction between flow separation and the secondary flow due to the elbow curvature. The experiments were conducted with the short-elbow and the long-elbow under Re = 1.8 Multiplication-Sign 10{sup 5} and 5.4 Multiplication-Sign 10{sup 5} conditions. The velocity fields in the elbows were measured using a high-speed Particle Image Velocimetry (PIV). The time-series of axial velocity fields and the cross-section velocity fields obtained by the high-speed PIV measurements revealed the unsteady and complex flow structure in the elbow. The flow separation always occurred in the short-elbow while the flow separation occurred intermittently in the long-elbow case. The circumferential secondary flows in clockwise and counterclockwise directions flowed forward downstream of reattachment point alternately in both elbows.

  14. Management of tennis elbow by Agnikarma

    Directory of Open Access Journals (Sweden)

    Vyasadeva Mahanta

    2013-01-01

    Full Text Available Tennis elbow is a painful condition and causes restricted movement of forearm which requires treatment for long period. Till date only symptomatic treatments are available like use of anti-inflammatory analgesic drugs, steroids injection, physiotherapy, exercise etc. But none of these provide satisfactory result. Long term use of anti-inflammatory, analgesic drugs and steroids injection is also not free from the adverse effects. Usually, ′wait-and-see policy′ of treatment guideline is recommended in most of medical texts. According to Ayurveda, snayugata vata can be correlated with the condition of tennis elbow. Sushruta has advised Agnikarma for disorders of snayu (ligaments and tendons, asthi (bone, siddhi (joints etc. Hence, in this study a case of tennis elbow (snayugata vata was treated by Agnikarma, along with administration of powder of Ashwagandha and Navajivana Rasa orally, for a period of 03 weeks. This combination therapy provided considerable relief in pain and movement of the elbow joint.

  15. Management of tennis elbow by Agnikarma.

    Science.gov (United States)

    Mahanta, Vyasadeva; Dudhamal, Tukaram S; Gupta, Sanjay Kumar

    2013-01-01

    Tennis elbow is a painful condition and causes restricted movement of forearm which requires treatment for long period. Till date only symptomatic treatments are available like use of anti-inflammatory analgesic drugs, steroids injection, physiotherapy, exercise etc. But none of these provide satisfactory result. Long term use of anti-inflammatory, analgesic drugs and steroids injection is also not free from the adverse effects. Usually, 'wait-and-see policy' of treatment guideline is recommended in most of medical texts. According to Ayurveda, snayugata vata can be correlated with the condition of tennis elbow. Sushruta has advised Agnikarma for disorders of snayu (ligaments and tendons), asthi (bone), siddhi (joints) etc. Hence, in this study a case of tennis elbow (snayugata vata) was treated by Agnikarma, along with administration of powder of Ashwagandha and Navajivana Rasa orally, for a period of 03 weeks. This combination therapy provided considerable relief in pain and movement of the elbow joint.

  16. Irreducible lateral dislocation of the elbow.

    Directory of Open Access Journals (Sweden)

    Chhaparwal M

    1997-01-01

    Full Text Available A rare case of an irreducible post-traumatic lateral dislocation of elbow is presented. The mechanism of injury was fall on a flexed elbow with trauma on its medial aspect resulting in pronation of the forearm. At open reduction, the brachialis muscle was in the form of a tight band which prevented reduction. The ulnar nerve was entrapped in the joint.

  17. Total elbow arthroplasty: a radiographic outcome study

    Energy Technology Data Exchange (ETDEWEB)

    Bai, Xue Susan [University of Washington, Department of Radiology, Box 357115, Seattle, WA (United States); Petscavage-Thomas, Jonelle M. [Penn State Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Ha, Alice S. [University of Washington, Department of Radiology, Box 354755, Seattle, WA (United States)

    2016-06-15

    Total elbow arthroplasty (TEA) is becoming a popular alternative to arthrodesis for patients with end-stage elbow arthrosis and comminuted distal humeral fractures. Prior outcome studies have primarily focused on surgical findings. Our purpose is to determine the radiographic outcome of TEA and to correlate with clinical symptoms such as pain. This is an IRB-approved retrospective review from 2005 to 2015 of all patients with semiconstrained TEA. All available elbow radiographs and clinical data were reviewed. Data analysis included descriptive statistics and Kaplan-Meier survival curves for radiographic and clinical survival. A total of 104 total elbow arthroplasties in 102 patients were reviewed; 75 % were in women and the mean patient age was 63.1 years. Mean radiographic follow-up was 826 days with average of four radiographs per patient. Seventy TEAs (67 %) developed radiographic complications, including heterotopic ossification (48 %), perihardware lucency (27 %), periprosthetic fracture (23 %), hardware subluxation/dislocation (7 %), polyethylene wear (3 %), and hardware fracture/dislodgement (3 %); 56 patients (55 %) developed symptoms of elbow pain or instability and 30 patients (30 %) underwent at least one reoperation. In patients with radiographic complications, 66 % developed elbow pain, compared to 19 % of patients with no radiologic complications (p = 0.001). Of the patients with radiographic complications, 39 % had at least one additional surgery compared to 0 % of patients without radiographic complications (p = 0.056). Radiographic complications are common in patients after total elbow arthroplasty. There is a strong positive association between post-operative radiographic findings and clinical outcome. Knowledge of common postoperative radiographic findings is important for the practicing radiologist. (orig.)

  18. Decreased Brain Neurokinin-1 Receptor Availability in Chronic Tennis Elbow.

    Science.gov (United States)

    Linnman, Clas; Catana, Ciprian; Svärdsudd, Kurt; Appel, Lieuwe; Engler, Henry; Långström, Bengt; Sörensen, Jens; Furmark, Tomas; Fredrikson, Mats; Borsook, David; Peterson, Magnus

    Substance P is released in painful and inflammatory conditions, affecting both peripheral processes and the central nervous system neurokinin 1 (NK1) receptor. There is a paucity of data on human brain alterations in NK1 expression, how this system may be affected by treatment, and interactions between central and peripheral tissue alterations. Ten subjects with chronic tennis elbow (lateral epicondylosis) were selected out of a larger (n = 120) randomized controlled trial evaluating graded exercise as a treatment for chronic tennis elbow (lateral epicondylosis). These ten subjects were examined by positron emission tomography (PET) with the NK1-specific radioligand 11C-GR205171 before, and eight patients were followed up after treatment with graded exercise. Brain binding in the ten patients before treatment, reflecting NK1-receptor availability (NK1-RA), was compared to that of 18 healthy subjects and, longitudinally, to the eight of the original ten patients that agreed to a second PET examination after treatment. Before treatment, patients had significantly lower NK1-RA in the insula, vmPFC, postcentral gyrus, anterior cingulate, caudate, putamen, amygdala and the midbrain but not the thalamus and cerebellum, with the largest difference in the insula contralateral to the injured elbow. No significant correlations between brain NK1-RA and pain, functional severity, or peripheral NK1-RA in the affected limb were observed. In the eight patients examined after treatment, pain ratings decreased in everyone, but there were no significant changes in NK1-RA. These findings indicate a role for the substance P (SP) / NK1 receptor system in musculoskeletal pain and tissue healing. As neither clinical parameters nor successful treatment response was reflected in brain NK1-RA after treatment, this may reflect the diverse function of the SP/NK1 system in CNS and peripheral tissue, or a change too small or slow to capture over the three-month treatment.

  19. Decreased Brain Neurokinin-1 Receptor Availability in Chronic Tennis Elbow.

    Directory of Open Access Journals (Sweden)

    Clas Linnman

    Full Text Available Substance P is released in painful and inflammatory conditions, affecting both peripheral processes and the central nervous system neurokinin 1 (NK1 receptor. There is a paucity of data on human brain alterations in NK1 expression, how this system may be affected by treatment, and interactions between central and peripheral tissue alterations. Ten subjects with chronic tennis elbow (lateral epicondylosis were selected out of a larger (n = 120 randomized controlled trial evaluating graded exercise as a treatment for chronic tennis elbow (lateral epicondylosis. These ten subjects were examined by positron emission tomography (PET with the NK1-specific radioligand 11C-GR205171 before, and eight patients were followed up after treatment with graded exercise. Brain binding in the ten patients before treatment, reflecting NK1-receptor availability (NK1-RA, was compared to that of 18 healthy subjects and, longitudinally, to the eight of the original ten patients that agreed to a second PET examination after treatment. Before treatment, patients had significantly lower NK1-RA in the insula, vmPFC, postcentral gyrus, anterior cingulate, caudate, putamen, amygdala and the midbrain but not the thalamus and cerebellum, with the largest difference in the insula contralateral to the injured elbow. No significant correlations between brain NK1-RA and pain, functional severity, or peripheral NK1-RA in the affected limb were observed. In the eight patients examined after treatment, pain ratings decreased in everyone, but there were no significant changes in NK1-RA. These findings indicate a role for the substance P (SP / NK1 receptor system in musculoskeletal pain and tissue healing. As neither clinical parameters nor successful treatment response was reflected in brain NK1-RA after treatment, this may reflect the diverse function of the SP/NK1 system in CNS and peripheral tissue, or a change too small or slow to capture over the three-month treatment.

  20. Brachial artery injury due to closed posterior elbow dislocation: case report☆

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2016-04-01

    Full Text Available An association between closed posterior elbow dislocation and traumatic brachial artery injury is rare. Absence of radial pulse on palpation is an important warning sign and arteriography is the gold-standard diagnostic test. Early diagnosis is essential for appropriate treatment to be provided. This consists of joint reduction and immobilization, along with urgent surgical restoration of arterial flow. Here, a case (novel to the Brazilian literature of an association between these injuries (and the treatment implemented in a 27-year-old male patient is reported. These injuries were sustained through physical assault.

  1. MR tomography of the elbow joint

    Energy Technology Data Exchange (ETDEWEB)

    Zwaan, M.; Rinast, E.; Weiss, H.D.; Pressler, M.; Vogel, H.

    1989-03-01

    MR examinations of the elbow joint of three healthy subjects and a comparison with corresponding sections of anatomical preparations show that MR tomography enables not only an excellent differentiation of muscles, tendons and of the articular capsule, but will also visualise vessels and nerve tracts. MR tomography proved superior to the conventional methods in demonstration of separate fragments and inflammatory changes in the bone on examining 11 pathological elbow joints: congenital malformation, osteochondritis dissecans, ostitis, ulnar and radial nerve lesions, completely healed radius fracture and epicondylitis of the radial and ulnar humerus. Epicondylitis could not be demonstrated by MR. Magnetic resonance tomography seems to be the only method that enables direct visualisation of the nerve paths at the elbow joint.

  2. Capitellocondylar total elbow replacement in late-stage rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ovesen, Janne; Olsen, Bo Sanderhoff; Johannsen, Hans Viggo

    2012-01-01

    of instability. Other complications included 2 maltracking elbows, 2 triceps tendon ruptures, 2 cases of operative olecranon bursitis, and 2 ulnar nerve palsies. One elbow showed radiolucent lines of more than 1 mm in the circumference of the ulnar component; none of the other elbows showed any signs...

  3. Static analysis of a piping system with elbows

    International Nuclear Information System (INIS)

    Bryan, B.J.

    1994-01-01

    Vibration tests of elbows to failure were performed in Japan in the early 1970s. The piping system included two elbows and an eccentric mass. Tests were run both pressurized and unpressurized. This report documents a static analysis of the piping system in which the elbows are subjected to out of plane bending. The effects of internal pressure and material plasticity are investigated

  4. Temporary presence of myofibroblasts in human elbow capsule after trauma

    NARCIS (Netherlands)

    Doornberg, Job N.; Bosse, Tjalling; Cohen, Mark S.; Jupiter, Jesse B.; Ring, David; Kloen, Peter

    2014-01-01

    Elbow stiffness is a common complication after elbow trauma. The elbow capsule is often thickened, fibrotic, and contracted at the time of surgical release. The limited studies available suggest that the capsule is contracted because of fibroblast-to-myofibroblast differentiation. We hypothesize

  5. Assessment of medial elbow laxity by gravity stress radiography: comparison of valgus stress radiography with gravity and a Telos stress device.

    Science.gov (United States)

    Harada, Mikio; Takahara, Masatoshi; Maruyama, Masahiro; Nemoto, Tadanobu; Koseki, Kazuhiko; Kato, Yoshihiro

    2014-04-01

    Valgus instability was reported to be higher with the elbow in 60° of flexion, rather than in 30° of flexion, although there are no studies using valgus stress radiography by gravity (gravity radiography) with the elbow in 60° of flexion. Fifty-seven patients with medial elbow pain participated. For both elbows, valgus stress radiography by use of a Telos device (Telos radiography) and gravity radiography, with the elbow in 60° of flexion, were performed for the assessment of medial elbow laxity. In both radiographs, the medial elbow joint space (MJS) on the affected side was compared with that on the opposite side, and the increase in the MJS on the affected side was assessed. For the Telos radiographs, the mean MJS was 4.7 mm on the affected side and 4.0 mm on the opposite side, with the mean increase in the MJS on the affected side being 0.7 mm. For the gravity radiographs, the mean MJS was 5.0 mm on the affected side and 4.2 mm on the opposite side, with the mean increase in the MJS on the affected side being 0.8 mm. There were significant correlations between the Telos and gravity radiographs in the MJS on the affected side, the MJS on the opposite side, and the increase in the MJS on the affected side (respectively, P gravity radiographs. Gravity radiography is useful for assessment of medial elbow laxity, similar to Telos radiography. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  6. Predisposing Effect of Elbow Alignment on the Elbow Fracture Type in Children.

    Science.gov (United States)

    Kang, Seungcheol; Park, Soo-Sung

    2015-08-01

    Under the hypothesis that the elbow alignment, namely the carrying angle, could predispose individuals to a specific type of pediatric elbow fracture after a fall onto an outstretched arm, we investigated the relationship between radiographic carrying angle and elbow fracture type in children. Retrospective case-control study. Level I pediatric trauma center. We reviewed 374 children who were diagnosed with supracondylar fracture (SCF, n = 208), lateral condylar fracture (LCF, n = 132), and radial neck fracture (RNF, n = 34). The association between the radiographic carrying angle and the fracture type was investigated. To adjust for bias, 2 statistical methods were used: multivariate analysis using a baseline-category logistic model and a case-matching method using propensity score analysis. In the multivariate analysis, with SCF patients set as the baseline category, a more valgus-deviated elbow (increased carrying angle, P = 0.011) predisposed individuals to RNF, whereas a more varus-deviated elbow (decreased carrying angle, P predisposed them to LCF. In the case-matched analysis, there were also significant differences in carrying angles between RNF and case-matched SCF patients (14.3 vs. 11.4 degrees, P = 0.013) and between LCF and case-matched SCF patients (7.7 vs. 11.7 degrees, P fall onto an outstretched elbow, could be a predisposing factor for specific types of pediatric elbow fracture. The results provide the additional information about the injury mechanisms of pediatric elbow fracture and may deepen our understanding of the fractures. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

  7. Biceps Tendon Lengthening Surgery for Failed Serial Casting Patients With Elbow Flexion Contractures Following Brachial Plexus Birth Injury.

    Science.gov (United States)

    Nath, Rahul K; Somasundaram, Chandra

    2016-01-01

    Assessment of surgical outcomes of biceps tendon lengthening (BTL) surgery in obstetric brachial plexus injury (OBPI) patients with elbow flexion contractures, who had unsuccessful serial casting. Serial casting and splinting have been shown to be effective in correcting elbow flexion contractures in OBPI. However, the possibilities of radial head dislocations and other complications have been reported in serial casting and splinting. Literature indicates surgical intervention when such nonoperative techniques and range-of-motion exercises fail. Here, we demonstrated a significant reduction of the contractures of the affected elbow and improvement in arm length to more normal after BTL in these patients, who had unsuccessful serial casting. Ten OBPI patients (6 girls and 4 boys) with an average age of 11.2 years (4-17.7 years) had BTL surgery after unsuccessful serial casting. Mean elbow flexion contracture was 40° before and 37° (average) after serial casting. Mean elbow flexion contracture was reduced to 8° (0°-20°) post-BTL surgical procedure with an average follow-up of 11 months. This was 75% improvement and statistically significant (P casting. These OBPI patients in our study had 75% significant reduction in elbow flexion contractures and achieved an improved and more normal length of the affected arm after the BTL surgery when compared to only 7% insignificant reduction and no improvement in arm length after serial casting.

  8. Stress-deformation analysis of elbow articulation

    Czech Academy of Sciences Publication Activity Database

    Hlavoň, Pavel; Florian, Z.

    2005-01-01

    Roč. 12, č. 5 (2005), s. 331-337 ISSN 1802-1484. [Mechatronics, Robotics and Biomechanics 2005. Třešť, 26.09.2005-29.09.2005] R&D Projects: GA ČR(CZ) GA101/05/0136 Institutional research plan: CEZ:AV0Z20760514 Keywords : elbow joint * radial head replacement * radio-humeral alloplasty Subject RIV: BO - Biophysics

  9. Major Peripheral Nerve Injuries After Elbow Arthroscopy.

    Science.gov (United States)

    Desai, Mihir J; Mithani, Suhail K; Lodha, Sameer J; Richard, Marc J; Leversedge, Fraser J; Ruch, David S

    2016-06-01

    To survey the American Society for Surgery of the Hand membership to determine the nature and distribution of nerve injuries treated after elbow arthroscopy. An online survey was sent to all members of the American Society for Surgery of the Hand under an institutional review board-approved protocol. Collected data included the number of nerve injuries observed over a 5-year period, the nature of treatment required for the injuries, and the outcomes observed after any intervention. Responses were anonymous, and results were securely compiled. We obtained 372 responses. A total of 222 nerve injuries were reported. The most injured nerves reported were ulnar, radial, and posterior interosseous (38%, 22%, and 19%, respectively). Nearly half of all patients with injuries required operative intervention, including nerve graft, tendon transfer, nerve repair, or nerve transfer. Of the patients who sustained major injuries, those requiring intervention, 77% had partial or no motor recovery. All minor injuries resolved completely. Our results suggest that major nerve injuries after elbow arthroscopy are not rare occurrences and the risk of these injuries is likely under-reported in the literature. Furthermore, patients should be counseled on this risk because most nerve injuries show only partial or no functional recovery. With the more widespread practice of elbow arthroscopy, understanding the nature and sequelae of significant complications is critically important in ensuring patient safety and improving outcomes. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  10. Natural course in tennis elbow--lateral epicondylitis after all?

    Science.gov (United States)

    Zeisig, Eva

    2012-12-01

    Tennis elbow is a common and difficult-to-treat condition largely because of lack of evidence. The natural history is unknown, but the condition is described as self-limiting. The objective of this case report is to describe the natural course of two control participants (pain free), who later developed tennis elbow, patient history, clinical findings, and ultrasound and colour Doppler examination before, during and after a period of tennis elbow.

  11. [The elbow joint - a diagnostic challenge : anatomy, biomechanics, and pathology].

    Science.gov (United States)

    Schueller-Weidekamm, C; Kainberger, F

    2008-12-01

    The elbow is one of the most commonly injured joints in sports activities. In particular, weight lifters, golfers, tennis players, and pitchers are affected. Injuries in sports involving overhead throwing are commonly based on the pathophysiologic model of valgus extension overload syndrome. The injuries are commonly complex and demand a good knowledge of the symptoms, the exact anatomy, and the biomechanics to arrive at a precise radiologic diagnosis. The characteristic patterns of injury that occur in specific sports activities are related to a combination of increased varus or valgus and extension or flexion overload that results in tensile forces and/or compression and shear stress. Acute symptoms are frequently based on chronic degeneration of the tendons and ligamentous structures due to repetitive microtrauma from overuse syndrome.

  12. Immobilization of Mortierella vinacea cells by radiation polymerization

    International Nuclear Information System (INIS)

    Kumakura, M.; Kaetsu, I.

    1983-01-01

    Immobilization of Mortierella vinacea cells, which contain active α-galactosidase, by radiation polymerization at low temperatures was studied. The durability of the enzymatic activity of the immobilized cells obtained with hydrophilic monomers was affected by the concentrations of the cells and monomer in which optimum conditions were observed. The enzymatic activity of the immobilized cells obtained with hydrophilic monomers was compared to that of hydrophobic monomers. Michaelis constants of the immobilized cells varied with monomer concentration. The effect of addition of porous solid substances on the immobilization of the cells was studied

  13. Nirschl surgical technique for concomitant lateral and medial elbow tendinosis: a retrospective review of 53 elbows with a mean follow-up of 11.7 years.

    Science.gov (United States)

    Schipper, Oliver N; Dunn, Jonathan H; Ochiai, Derek H; Donovan, J Skye; Nirschl, Robert P

    2011-05-01

    Combined lateral elbow tendinosis (tennis elbow) and medial elbow tendinosis (golfer's elbow) can be a disabling condition that, if unresponsive to nonoperative treatments, may be effectively treated surgically. The authors are not aware of any study that reports the outcome of a combined operation for lateral and medial elbow tendinosis (country club elbow) performed in the same operative setting. Combined surgical treatment of country club elbow in the same operative setting has similar outcomes to those seen in the literature for single operative procedures. Case series; Level of evidence 4. Outcome measurements included the Numeric Pain Intensity Scale, the Nirschl tennis elbow scoring system, and the American Shoulder and Elbow Surgeons elbow form. Forty-eight patients (53 clinical elbows) were available by telephone, with a minimum time to follow-up of 5 years (range, 5-19 years; mean, 11.7 years). The average Nirschl tennis elbow score improved from 16.7 preoperatively to 70.8 postoperatively (P Elbow Surgeons elbow score improved from 45.2 to 90.4 (P tennis elbow score, results were rated excellent in 38 elbows, good in 7 elbows, fair in 5 elbows, and poor in 3 elbows, with 85% (45 of 53) good to excellent results. Patient satisfaction with the surgery averaged 8.7 out of 10. Of the 46 patients who played sports, 44 (96%) reported returning to their sports. When nonoperative treatment of lateral and medial elbow tendinosis fails, combined surgical intervention via the Nirschl operative techniques for country club elbow is highly effective, with results similar to those of single-sided intervention.

  14. Tennis elbow: role of local steroid injection.

    Science.gov (United States)

    Ahmed, Gulzar Saeed; Ali, Muhammad; Trago, Imtiaz Ahmed

    2012-01-01

    Tennis elbow is a condition, characterised by pain and tenderness over the lateral epicondyle of the humerus, and pain on resisted dorsiflexion of the wrist, middle finger, or both. The aim of this randomised controlled trial was to investigate the short term efficacy of local steroid injection compared with oral and topical NSAIDs. Sixty patients (45 male and 15 female) were included in the study. The mean age was 42 years for men and 40 years for women. They were placed in group A and B (30 cases each). Group A received local steroid injection (triamcinolone 20 mg mixed with lignocaine 2% 1 cc) and topical NSAID cream application (diclofenac diethylammonium) twice a day, tab. diclofenac sodium 50 mg twice a day for 3 weeks. Group B received tab diclofenac 50 mg twice a day and, topical NSAID cream application twice a day for 3 weeks. Assessment of patients was made 3 times; first at the start of the study, 2nd time after 6 weeks, and 3rd time after 12 weeks. A blinded assessor rated the elbow complaints of the patients at resisted dorsiflexion of wrist using VAS (0 = no severity, 1-3 mild, 4-6 moderate, 7-9 sever, 10 = maximum severity). At six weeks, 22 (73.33%) patient in group A had no pain as compared to 7 (23.33%) patients in group B who were pain free (p < 0.0001, chi2 = 38.75). At 12 weeks 27 (90%) patients in group A were pain free compared to group B in which 7 (23.33%) patients were pain free (p < 0.0001, chi2 = 27.56). In patients with tennis elbow, the use of local steroid injection in combination with topical and oral NSAIDs is superior to the use of combination of topical and oral NSAIDs. Better results with combination therapy using local steroid injection may be limited to the short term.

  15. Shoulder-elbow exoskeleton as rehabilitation exerciser

    Science.gov (United States)

    Ianoşi, A.; Dimitrova, A.; Noveanu, S.; Tătar, O. M.; Mândru, D. S.

    2016-08-01

    This paper presents a 2 degree of freedom exoskeleton designed for the rehabilitation of the shoulder and elbow movement in the sagittal plane; a semi-portable design strategy was chosen, which enables an easy attachment to a standard medical chair as well as the patient upper limb. A dedicated driver enables the control from a graphical user interface, which also provides the option of customized rehabilitation exercises. The potential of future improvements is assessed, and recommendations of research direction are made in order to broaden the usability of the proposed device.

  16. It's time to change perspective! New diagnostic tools for lateral elbow pain.

    Science.gov (United States)

    Arrigoni, P; Cucchi, D; Menon, A; Randelli, P

    2017-12-01

    The presence of intra-articular findings that may complement the extra-articular pathology in lateral epicondilytis has been suggested, and a role for minor instability of the elbow as part of the causative process of this disease has been postulated. This study was designed to describe two new clinical tests, aimed at detecting intra-articular pathology in patients affected by recalcitrant lateral epicondylitis and investigate their diagnostic performance. Ten patients suffering of atraumatic lateral elbow pain unresponsive to conservative treatment were considered in this study. Two clinical tests were developed and administrated prior to arthroscopy: Supination and Antero-Lateral pain Test (SALT); Posterior Elbow Pain by Palpation-Extension of the Radiocapitellar joint (PEPPER). Sensitivity, specificity, predictive values and accuracy of SALT and PEPPER as diagnostic tests for seven intra-articular findings were calculated. In 90% of the patients, at least one test was positive. All patients with signs of lateral ligamentous patholaxity or intra-articular abnormal findings had a positive response to at least one of the two tests. SALT proved to have a high sensitivity but a low specificity and is accurate in detecting the presence of intra-articular abnormal findings, especially synovitis. PEPPER test was sensible, specific and accurate in the detection of radial head chondropathy. Two new diagnostic tests (SALT and PEPPER) were specifically designed to evoke pain from intra-articular structures. These tests could be a valid support in the diagnostic algorithm of recalcitrant lateral elbow pain. Positive findings may be indicative of a minor instability of the lateral elbow condition. Diagnostic study, development of diagnostic criteria on basis of consecutive patients, level II.

  17. Immobilized enzymes and cells

    Energy Technology Data Exchange (ETDEWEB)

    Bucke, C; Wiseman, A

    1981-04-04

    This article reviews the current state of the art of enzyme and cell immobilization and suggests advances which might be made during the 1980's. Current uses of immobilized enzymes include the use of glucoamylase in the production of glucose syrups from starch and glucose isomerase in the production of high fructose corn syrup. Possibilities for future uses of immobilized enzymes and cells include the utilization of whey and the production of ethanol.

  18. Orthotic devices for the treatment of tennis elbow

    NARCIS (Netherlands)

    Struijs, P. A. A.; Smidt, N.; Arola, H.; Dijk, van C. N.; Buchbinder, R.; Assendelft, W. J. J.

    2002-01-01

    BACKGROUND: Lateral epicondylitis (tennis elbow) is a frequently reported condition. A wide variety of treatment strategies has been described. As of yet, no optimal strategy has been identified. OBJECTIVES: To assess the effectiveness of orthotic devices for the treatment of tennis elbow. SEARCH

  19. Orthotic devices for tennis elbow: a systematic review

    NARCIS (Netherlands)

    Struijs, P. A.; Smidt, N.; Arola, H.; van Dijk, C. N.; Buchbinder, R.; Assendelft, W. J.

    2001-01-01

    Lateral epicondylitis (tennis elbow) is af requently reported condition. A wide variety of treatment strategies has been described. Asy et, no optimal strategy has been identified. The aim of this review was to assess the effectiveness of orthotic devices for treatment of tennis elbow. An electronic

  20. Biomechanics of the elbow joint in tennis players.

    NARCIS (Netherlands)

    Eygendaal, D.; Rahussen, F.T.; Diercks, R.L.

    2007-01-01

    Elbow injuries constitute a sizeable percentage of tennis injuries. A basic understanding of biomechanics of tennis and analysis of forces, loads and motions of the elbow during tennis can will improve the understanding of the pathophysiology of these injuries. All different strokes in tennis have a

  1. MR imaging of the elbow in baseball pitchers

    Energy Technology Data Exchange (ETDEWEB)

    Ouellette, Hugue; Bredella, Miriam; Palmer, William E.; Torriani, Martin [Massachusetts General Hospital, Division of Musculoskeletal Radiology, Boston, MA (United States); Labis, John [Methodist Hospital, Houston, TX (United States)

    2008-02-15

    Baseball pitcher throwing biomechanics are important to understanding the pathophysiology and magnetic resonance (MR) imaging appearances of injuries in baseball pitchers. Baseball pitchers experience repetitive excessive valgus forces at the elbow. Typical injuries are secondary to medial joint distraction, lateral joint compression, and rotatory forces at the olecranon. MR imaging is useful for evaluation of the elbow in baseball pitchers. (orig.)

  2. ERRORS AT RESTORATIVE TREATMENT OF CHILDREN WITH ELBOW INJURIES

    Directory of Open Access Journals (Sweden)

    N. A. Ovsyankin

    2010-01-01

    Full Text Available Presented analysis based on a large clinical material of reconstructive management of children with posttraumatic contractures of the elbow joint. In reconstructive management of children a plenty of errors are committed, and most of them are through undervaluation of displacements that have not been eliminated after bone fractures at the elbow joint.

  3. The treatment of recurrent posterolateral instability of the elbow

    DEFF Research Database (Denmark)

    Olsen, Bo Sanderhoff; Søjbjerg, Jens Ole

    2003-01-01

    This study describes the surgical technique used for reconstruction and reinforcement of the lateral collateral ligament complex in patients with posterolateral instability of the elbow and the results. A triceps tendon graft from the ipsilateral elbow which was inserted through bone tunnels...

  4. Assessment of induction elbows for an ASME Code application

    International Nuclear Information System (INIS)

    Panesar, J.S.; Soliman, M.

    1991-01-01

    The ASME Nuclear Codes impose some specific requirements on the wall thickness uniformity and the out-of-roundness of cross sections of the elbows for Nuclear Power Plant applications. Due to some of these requirements, manufacturing and installation of these elbows can be time consuming and quite expensive. This paper explores the feasibility of using induction elbows for nuclear application from the stress analysis point of view. To this end, three different sizes of 90deg elbows have been analyzed based on the geometry of an 'ASME Code' elbow and an elbow formed by induction bending. The analysis is carried out for internal pressure, in-plane and out-of-plane loads. Based on the results of these three carbon steel elbows, the use of induction elbows in some of the CANDU-PHW (CANadian Deuterium Uranium-Pressurized Heavy Water) power plant applications seems encouraging. However, before the feasibility can be fully confirmed analysis and induction bending tests over a wider range of geometries, loading conditions, and materials are required. (author)

  5. Tips to avoid nerve injury in elbow arthroscopy

    NARCIS (Netherlands)

    Hilgersom, Nick F. J.; Oh, Luke S.; Flipsen, Mark; Eygendaal, Denise; van den Bekerom, Michel P. J.

    2017-01-01

    Elbow arthroscopy is a technical challenging surgical procedure because of close proximity of neurovascular structures and the limited articular working space. With the rising number of elbow arthroscopies being performed nowadays due to an increasing number of surgeons performing this procedure and

  6. Kinematics of the lateral ligamentous constraints of the elbow joint

    DEFF Research Database (Denmark)

    Olsen, Bo Sanderhoff; Søjbjerg, Jens Ole; Dalstra, Michel

    1996-01-01

    preventer of elbow joint laxity. The LCLC was observed to be a complex structure of ligamentous fibers rather than discreet bands. The LCLC forms a ligamentous constraint between the lateral humeral epicondyle and the ulna, stabilizing the elbow joint and forming a base for radial head stability...

  7. Validation of the Danish version of the Oxford Elbow Score

    DEFF Research Database (Denmark)

    Plaschke, Hans Christian; Jørgensen, Andreas Møller; Thillemann, Theis Muncholm

    2013-01-01

    The Oxford Elbow Score (OES) is a patient-related outcome measure quantifying quality of life in relation to elbow disorders. This 12-item patient-administered English questionnaire comprises three domains: function, social-psychological status and pain. The purpose of this study was to examine...

  8. Experimental analysis of ratchetting in elbows

    International Nuclear Information System (INIS)

    Acker, D.; Touboul, F.; Brouard, D.

    1991-01-01

    Despite of their apparent simplicity, elbows or curved tubes are one of the most tested and analyzed structures to the last years when a large effort has been done by CEA in the framework of the European Structural Integrity Working Group in order to reassess the RCC-MR (1985) piping design rules for elbows and straight parts (TOUBOUL (1988-1989)). It is impossible to mention all the authors and an extensive bibliography has been done by BENDJEDIDIA (1987). But nobody in our knowledge has taken care in experimental validation of design rules against ratcheting. With such objectives, an experimental test program has been performed at CEA, in order to appraise the design methods based on shakedown model like 3 S m rule used by ASME section III (1989) in USA or RCC-M (1988) in FRANCE, or based on the efficiency Diagram used by the french design code for Fast Breeder reactors RCC-MR (1985). The first results were published by M. BENDJEDIDIA (1987). They have been completed by additional tests and improved by a better material characterisation

  9. Early to mid-term outcomes of patients with complex elbow dislocations following internal fixation

    Directory of Open Access Journals (Sweden)

    Yunus Guzel

    2015-08-01

    Results: In 19 of 29 patients evaluated in the emergency department, related fractures were detected. According to the Roberts criteria, the results were excellent in 6 patients (31.5%, good in 7 patients (36.8%, fair in 5 patients (26%, and poor in 1 patient (5%. Younger age and lack of ligament lesions were associated with good results. Ligament and cartilage lesions, older age and a longer period of immobilization were associated with worse results. Conclusions: The primary goal of surgery is to restore stability to initiate early range of motion, which is the key factor for a successful outcome. The patient's age and the presence of ligament and cartilage injury have prognostic value. Pure dislocation is uncommon, so it is recommended that radiographs are evaluated carefully for associated fractures around the elbow, especially on first presentation in the emergency department. [Hand Microsurg 2015; 4(2.000: 32-38

  10. EFFICACY OF LOCAL INFILTRATION OF AUTOLOGOUS BLOOD VERSUS LOCAL CORTICOSTEROID INJECTION- THE TREATMENT OF CHRONIC TENNIS ELBOW

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar Roy

    2017-05-01

    Full Text Available BACKGROUND Chronic painful tendon disorders are common in both sport persons and common individuals. 1,2 Lateral epicondylitis (tennis elbow is relatively more common among active individuals in the general population. 3 Typical signs and symptoms include pain and tenderness over the lateral epicondyle, exacerbated by resisted wrist extension and passive wrist flexion and impaired grip strength. The aim of the study is to find whether autologous blood provides comparable functional outcome over local steroids and hence whether it can replace steroids in treatment of tennis elbow. MATERIALS AND METHODS Patients with nontraumatic elbow pain attending the Orthopaedics Outpatient Department of Nalanda Medical College Hospital from January 2016 to August 2016. The participating subjects were randomly grouped into two groups (steroid (Group A and autologous blood (Group B. Pain in the subject’s affected elbow was measured using Visual Analogue Score (VAS. RESULTS Initially, both the groups had comparable initial VAS scores. At 1 month follow up, steroid group showed a significantly greater improvement in mean VAS scores when compared to autologous blood group. However, at 6 months follow up, steroid group showed no statistically significant difference in mean VAS scores when compared to autologous blood group. CONCLUSION From the current study, we concluded that both local corticosteroid and autologous blood were equally efficacious in the treatment of chronic lateral epicondylitis of elbow.

  11. The role of arthroscopy in chronic elbow instability.

    Science.gov (United States)

    Goodwin, David; Dynin, Maria; Macdonnell, J Ryan; Kessler, Michael W

    2013-12-01

    Elbow arthroscopy has had an emerging role in the management of many disorders of the elbow. In patients with chronic elbow instability, several arthroscopic techniques have been described in the diagnosis and management of posterolateral rotatory instability and valgus instability. We performed a systematic review investigating the role of arthroscopy in posterolateral rotatory instability and valgus instability in the elbow using the PubMed and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases, and the Cochrane Database of Systematic Reviews, consisting of articles from peer-reviewed journals published in the English language after January 1, 1991. Search criteria initially identified 249 articles. Twenty-five articles met criteria for inclusion. This included 17 review articles, 4 cadaveric studies, 3 retrospective studies, and 1 prospective study. Two of the retrospective studies compared arthroscopic and open techniques. Articles included in this systematic review concluded that arthroscopy is an accurate adjunct to physical examination and imaging in the diagnosis of chronic elbow instability and affords an exceptional view of the joint with the ability to address intra-articular pathologic conditions. Arthroscopic surgical techniques have shown equivalent clinical outcomes in a comparison of arthroscopic and open techniques. Elbow arthroscopy is a valuable tool in the diagnosis and management of chronic elbow instability. Patients treated arthroscopically benefit from additional diagnostic techniques, improved visualization of the elbow joint, the ability to address coexisting intra-articular pathologic conditions, and minimal soft tissue injury with no clinical consequences in outcomes. With such significant advantages, the use of elbow arthroscopy is likely to expand in the management of chronic elbow instability. Level IV, systematic review. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc

  12. Chronic elbow dislocation: a rare complication of tennis elbow surgery. Successful treatment by open reduction and external fixator.

    Science.gov (United States)

    Degreef, I; De Smet, L

    2007-06-01

    A case is presented of chronic dislocation of the elbow after tennis elbow surgery combined with posterior interosseous nerve (PIN) release. An open reduction with repair of the collateral ligaments was performed. Postoperative rehabilitation involved the use of an articulated external fixator and there was a successful outcome. Possible causes of the dislocation are discussed.

  13. Immobilized waste leaching

    International Nuclear Information System (INIS)

    Suarez, A.A.

    1989-01-01

    The main mechanism by which the immobilized radioactive materials can return to biosphere is the leaching due to the intrusion of water into the repositories. Some mathematical models and experiments utilized to evaluate the leaching rates in different immobilization matrices are described. (author) [pt

  14. Sonographic measurements of the ulnar nerve at the elbow with different degrees of elbow flexion.

    Science.gov (United States)

    Patel, Prutha; Norbury, John W; Fang, Xiangming

    2014-05-01

    To determine whether there were differences in the cross-sectional area (CSA) and the flattening ratio of the normative ulnar nerve as it passes between the medial epicondyle and the olecranon at 30° of elbow flexion versus 90° of elbow flexion. Bilateral upper extremities of normal healthy adult volunteers were evaluated with ultrasound. The CSA and the flattening ratio of the ulnar nerve at the elbow as it passes between the medial epicondyle and the olecranon were measured, with the elbow flexed at 30° and at 90°, by 2 operators with varying ultrasound scanning experience by using ellipse and direct tracing methods. The results from the 2 different angles of elbow flexion were compared for each individual operator. Finally, intraclass correlations for absolute agreement and consistency between the 2 raters were calculated. An outpatient clinic room at a regional rehabilitation center. Twenty-five normal healthy adult volunteers. The mean CSA and the mean flattening ratio of the ulnar nerve at 30° of elbow flexion and at 90° of elbow flexion. First, for the ellipse method, the mean CSA of the ulnar nerve at 90° (9.93 mm(2)) was slightly larger than at 30° (9.77 mm(2)) for rater 1. However, for rater 2, the mean CSA of the ulnar nerve at 90° (6.80 mm(2)) was slightly smaller than at 30° (7.08 mm(2)). This was found to be statistically insignificant when using a matched pairs t test and the Wilcoxon signed-rank test, with a significance level of .05. Similarly, the difference between the right side and the left side was not statistically significant. The intraclass correlations for absolute agreement between the 2 raters were not very high due to different measurement locations, but the intraclass correlations for consistency were high. Second, for the direct tracing method, the mean CSA at 90° (7.26 mm(2)) was slightly lower than at 30° (7.48 mm(2)). This was found to be statistically nonsignificant when using the matched pairs t test and the

  15. Lateral collateral ligament of the elbow joint

    DEFF Research Database (Denmark)

    Olsen, Bo Sanderhoff; Vaesel, M T; Søjbjerg, Jens Ole

    1996-01-01

    The structure and kinematics of the lateral collateral ligament of the elbow joint were investigated in 10 cadaveric specimens. The lateral collateral ligament was observed to be a distinct part of the lateral collateral ligament complex. It contains posterior fibers that pass through the annular....... Division of the posterolateral capsule caused no further laxity. Cutting the lateral collateral ligament induced a maximum laxity of 11.8 degrees at 110 degrees of flexion in forced varus and a maximum laxity of 20.6 degrees at 110 degrees of flexion in forced external rotation. The corresponding maximal...... posterior radial head translation was observed at 80 degrees to 100 degrees of flexion and was 5.7 mm in forced varus and 8.1 mm in forced external rotation. This study suggests the lateral collateral ligament to be an important stabilizer of the humeroulnar joint and the radial head in forced varus...

  16. Application of CT three-dimensional reconstruction in elbow injury

    International Nuclear Information System (INIS)

    Liang Wenhua; Qian Li

    2009-01-01

    Objective: To investigate the application of multi-slice spiral CT in fracture of elbow, and to study the value of different methods of the reconstruction. Methods: Thin line cross-section spiral CT scan was carried out in 13 cases with elbow injury, three-dimensional reconstruction was completed later. Several reconstructed image quality to display f the elbow fracture and dislocation were analyzed and compared. Results: 13 cases (17) elbow trauma included humeral media epicondyle fracture, humeral external epicondyle fracture, intercondylar fracture, olecranal fracture and radial head fracture. Among them, X-ray film showed negative in three sites, showed suspect fractures in 2 cases, and only showed single fracture in 2 cases. MPR reconstruction image could not only identify the diagnosis of fracture, but also provide further multi-angle display on fracture line and the extent of articular surface involvement. Surface reconstruction technology could exclude the impact of passive elbow flexion and display elbow injury more intuitively. Conclusion The elbow fracture dislocation could be showed clearly in multi-slice spiral CT, especially for complex fractures, with unmatched advantages compared to X-ray for clinical diagnosis and treatment determination. (authors)

  17. Risk factors for persistent elbow, forearm and hand pain among computer workers

    DEFF Research Database (Denmark)

    Lassen, C. F.; Mikkelsen, S.; Kryger, Ann Isabel

    2005-01-01

    to elbow, forearm, or wrist-hand pain during the 12 months preceding the baseline questionnaire. Pain status (recovery versus persistence) at follow-up was examined in relation to computer work aspects and ergonomic, psychosocial, and personal factors by questionnaire. In addition, data on objectively......, and type-A behavior, the prognosis seemed independent of psychosocial workplace factors and personal factors. A few cases with severe pain were affected at a level which could be compared to clinical pain conditions. CONCLUSIONS: Our results do not support the hypothesis that computer work activity......OBJECTIVES: This study examined the influence of work-related and personal factors on the prognosis of "severe" elbow, forearm, and wrist-hand pain among computer users. METHODS: In a 1-year follow-up study of 6943 computer users, 673 (10%) participants reported "quite a lot" or more trouble due...

  18. [External stability of the elbow after surgical treatment of epicondylitis. Presentation of a case].

    Science.gov (United States)

    Llop-Corbacho, A; Romero-Ruiz, J; Denia-Alarcón, N

    2014-01-01

    Elbow instability is a difficult to diagnose condition in certain cases, and could lead to some problems that limit daily functioning, such as joint blocks, bumps, projections, muscle weakness, and persistent pain. A case is presented of a patient with a clinical picture of epicondylitis, with a previous history of a fall on the affected arm. As there was no improvement after performing conventional non-aggressive treatment, surgery was performed on the affected tendon. The outcome of this was persistent pain and clinical instability of the elbow that ended up requiring surgery to reconstruct the ligament over the external complex. In follow-up 6 months after the operation, the clinical instability had disappeared, but there was still external discomfort and a 30° extension deficit. When faced with a picture of epicondylitis with a previous injury that does not respond to conventional therapies, it is important to take into account the possibility of an underlying elbow instability, ruling this out with a correct physical examination and, where necessary, with the appropriate complementary tests. Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.

  19. Affect

    NARCIS (Netherlands)

    Cetinic, M.; Diamanti, J.; Szeman, I.; Blacker, S.; Sully, J.

    2017-01-01

    This chapter historicizes four divergent but historically contemporaneous genres of affect theory – romantic, realist, speculative, and materialist. While critics credited with the turn to affect in the 1990s wrote largely in the wake of poststructuralism from the perspective of gender and queer

  20. Sensory Barrage Stimulation in the Treatment of Elbow Spasticity: A Crossover Double Blind Randomized Pilot Trial.

    Science.gov (United States)

    Slovak, Martin; Chindo, Joseph; Nair, Krishnan Padmakumari Sivaraman; Reeves, Mark L; Heller, Ben; Barker, Anthony T

    2016-02-01

    To assess the feasibility of using a novel form of multichannel electrical stimulation, termed Sensory Barrage Stimulation (SBS) for the treatment of spasticity affecting the elbow flexor muscles and to compare this with conventional single-channel TENS stimulation. Altogether ten participants with spasticity of the flexor muscles of the elbow of Grade 2 or above on the Modified Ashworth Scale (MAS) were recruited to this crossover double blind randomized trial. The participants received two intervention sessions (SBS and TENS), one week apart in a randomized order. Both interventions were applied over the triceps brachii on the affected arm for a duration of 60 minutes. Spasticity was measured using the MAS. Secondary outcome measures were self-reported change in spasticity, measured on a visual analog scale (VAS, 0-100), and therapist-rated strength of elbow extension and strength of elbow flexion. Measurements were taken immediately before each intervention was applied, immediately after the intervention, and one hour after the intervention. Immediately after stimulation spasticity showed a significant reduction for both TENS and SBS groups assessed by MAS -0.9 ± 0.2 vs. -1.1 ± 0.2 and by VAS -15 ± 3 vs. -31 ± 8. For SBS this improvement in MAS was still present at one hour after the stimulation, but not for TENS. Altogether seven SBS responders and four TENS responders were identified. This study demonstrates the feasibility and practicality of applying the new concept of SBS. Promising results indicate it causes a reduction in spasticity. © 2015 International Neuromodulation Society.

  1. Reliability testing of two classification systems for osteoarthritis and post-traumatic arthritis of the elbow.

    Science.gov (United States)

    Amini, Michael H; Sykes, Joshua B; Olson, Stephen T; Smith, Richard A; Mauck, Benjamin M; Azar, Frederick M; Throckmorton, Thomas W

    2015-03-01

    The severity of elbow arthritis is one of many factors that surgeons must evaluate when considering treatment options for a given patient. Elbow surgeons have historically used the Broberg and Morrey (BM) and Hastings and Rettig (HR) classification systems to radiographically stage the severity of post-traumatic arthritis (PTA) and primary osteoarthritis (OA). We proposed to compare the intraobserver and interobserver reliability between systems for patients with either PTA or OA. The radiographs of 45 patients were evaluated at least 2 weeks apart by 6 evaluators of different levels of training. Intraobserver and interobserver reliability were calculated by Spearman correlation coefficients with 95% confidence intervals. Agreement was considered almost perfect for coefficients >0.80 and substantial for coefficients of 0.61 to 0.80. In patients with both PTA and OA, intraobserver reliability and interobserver reliability were substantial, with no difference between classification systems. There were no significant differences in intraobserver or interobserver reliability between attending physicians and trainees for either classification system (all P > .10). The presence of fracture implants did not affect reliability in the BM system but did substantially worsen reliability in the HR system (intraobserver P = .04 and interobserver P = .001). The BM and HR classifications both showed substantial intraobserver and interobserver reliability for PTA and OA. Training level differences did not affect reliability for either system. Both trainees and fellowship-trained surgeons may easily and reliably apply each classification system to the evaluation of primary elbow OA and PTA, although the HR system was less reliable in the presence of fracture implants. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  2. Long-term sequel of posterolateral rotatory instability of the elbow: a case report

    Directory of Open Access Journals (Sweden)

    Cheng Chun-Ying

    2010-01-01

    Full Text Available Abstract The natural course of untreated posterior lateral rotatory instability of the elbow is unclear. A case of elbow arthrosis with progressing deformity and flexion contracture after an episode of elbow dislocation about 20 years ago presented the possibility the long term outcome of untreated posterior lateral rotatory instability of the elbow.

  3. Plutonium Disposition by Immobilization

    International Nuclear Information System (INIS)

    Gould, T.; DiSabatino, A.; Mitchell, M.

    2000-01-01

    The ultimate goal of the Department of Energy (DOE) Immobilization Project is to develop, construct, and operate facilities that will immobilize between 17 to 50 tonnes (MT) of U.S. surplus weapons-usable plutonium materials in waste forms that meet the ''spent fuel'' standard and are acceptable for disposal in a geologic repository. Using the ceramic can-in-canister technology selected for immobilization, surplus plutonium materials will be chemically combined into ceramic forms which will be encapsulated within large canisters of high level waste (HLW) glass. Deployment of the immobilization capability should occur by 2008 and be completed within 10 years. In support of this goal, the DOE Office of Fissile Materials Disposition (MD) is conducting development and testing (D and T) activities at four DOE laboratories under the technical leadership of Lawrence Livermore National Laboratory (LLNL). The Savannah River Site has been selected as the site for the planned Plutonium Immobilization Plant (PIP). The D and T effort, now in its third year, will establish the technical bases for the design, construction, and operation of the U. S. capability to immobilize surplus plutonium in a suitable and cost-effective manner. Based on the D and T effort and on the development of a conceptual design of the PIP, automation is expected to play a key role in the design and operation of the Immobilization Plant. Automation and remote handling are needed to achieve required dose reduction and to enhance operational efficiency

  4. A comparative study to evaluate the efficacy of platelet-rich plasma and triamcinolone to treat tennis elbow.

    Science.gov (United States)

    Seetharamaiah, Vanamali B; Gantaguru, Amrit; Basavarajanna, Sunil

    2017-01-01

    Lateral elbow pain is common with a population prevalence of 1%-3%. The study was a comparative trial to validate the efficacy of single injection of platelet-rich plasma (PRP) for tennis elbow as compared with single injections of triamcinolone and placebo (normal saline) over a short term period. Comparative trial with 3- and 6-month followup evaluated with visual analog scale (VAS) and facial pain scale (FPS). Our study included a total of eighty patients with unilateral or bilateral tennis elbows. The study population included patients between 20 and 40 years age group belonging to either sex with seventy unilateral and ten bilateral affections for more than 3-month duration. Patients suffering from elbow pain due to other problems or those who have received any form of injection were excluded from the study. One milliliter of 2% Xylocaine injection was given before injecting the proposed formulation under trial. VAS and FPS were used for scoring pain. Kruskal-Wallis test and Mann-Whitney U-tests were used for statistical analyses at 12 and 24 weeks. Overall, 49 females and 31 males were included with thirty elbows in each group. Both the PRP and triamcinolone groups had better pain relief at 3 and 6 months as compared to normal saline group ( P < 0.05), but at 6 months followup, the PRP group had statistically significant better pain relief than triamcinolone group. In the triamcinolone group, 13 patients had injection site hypopigmentation and 3 patients had subdermal atrophy. Over a short term period, PRP gives better pain relief than triamcinolone or normal saline in tennis elbow which needs to be validated over long term period by further studies.

  5. Acute and overuse elbow trauma: radio-orthopaedics overview.

    Science.gov (United States)

    Nocerino, Elisabetta Antonia; Cucchi, Davide; Arrigoni, Paolo; Brioschi, Marco; Fusi, Cristiano; Genovese, Eugenio A; Messina, Carmelo; Randelli, Pietro; Masciocchi, Carlo; Aliprandi, Alberto

    2018-01-19

    The correct management of acute, subacute and overuse-related elbow pathologies represents a challenging diagnostic and therapeutic problem. While major trauma frequently requires a rapid surgical intervention, subluxation and minor trauma allow taking more time for diagnostics and planning the correct elective treatment after careful clinical and radiological investigation. In these conditions, communication between orthopaedic surgeon and radiologist allow to create a detailed radiology report, tailored to the patient's and surgeon's needs and optimal to plan proper management. Imaging technique as X-Ray, CT, US, MRI, CTA and MRA all belong to the radiologist's portfolio in elbow diagnostics. Detailed knowledge of elbow pathology and its classification and of the possibilities and limits of each imaging technique is of crucial importance to reach the correct diagnosis efficiently. The aim of this review is to present the most frequent elbow pathologies and suggest a suitable diagnostic approach for each of them.

  6. Golf Injuries to the Hand, Wrist, or Elbow

    Science.gov (United States)

    ... Therapist? Media Find a Hand Surgeon Home Anatomy Golf Injuries to the Hand, Wrist or Elbow Email ... enjoyment of the game injury free. Types of Golf Injuries Golf injuries can include tendonitis, sprains or ...

  7. Dry Arthroscopy of the Elbow and Basic Hip Arthroscopy Positioning.

    Science.gov (United States)

    Lubowitz, James H

    2015-08-01

    In Arthroscopy Techniques, dry arthroscopy of the elbow is well-illustrated, and hip arthroscopy patient positioning including fluoroscopic examination under anesthesia is critically reviewed. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  8. Diagnosing ulnar neuropathy at the elbow using magnetic resonance neurography

    International Nuclear Information System (INIS)

    Keen, Nayela N.; Chin, Cynthia T.; Saloner, David; Steinbach, Lynne S.; Engstrom, John W.

    2012-01-01

    Early diagnosis of ulnar neuropathy at the elbow is important. Magnetic resonance neurography (MRN) images peripheral nerves. We evaluated the usefulness of elbow MRN in diagnosing ulnar neuropathy at the elbow. The MR neurograms of 21 patients with ulnar neuropathy were reviewed retrospectively. MRN was performed prospectively on 10 normal volunteers. The MR neurograms included axial T1 and axial T2 fat-saturated and/or axial STIR sequences. The sensitivity and specificity of MRN in detecting ulnar neuropathy were determined. The mean ulnar nerve size in the symptomatic and normal groups was 0.12 and 0.06 cm 2 (P 2 , sensitivity was 95% and specificity was 80%. Ulnar nerve size and signal intensity were greater in patients with ulnar neuropathy. MRN is a useful test in evaluating ulnar neuropathy at the elbow. (orig.)

  9. Elbow joint stability in relation to forced external rotation

    DEFF Research Database (Denmark)

    Deutch, S.R.; Jensen, S.L.; Olsen, B.S.

    2003-01-01

    The objective of this study was to evaluate the osseous constraint related to forced forearm external rotation as the initial stage in a posterior elbow dislocation. Six joint specimens without soft tissues were examined in a joint analysis system developed for simulation of dislocation. The osse......The objective of this study was to evaluate the osseous constraint related to forced forearm external rotation as the initial stage in a posterior elbow dislocation. Six joint specimens without soft tissues were examined in a joint analysis system developed for simulation of dislocation...... external forearm rotation until the point of maximal torque decreased from a maximum in full extension to a minimum at 30 degrees of elbow flexion (P =.03). The elbow in a slightly flexed position, varus stress, and forearm external rotation trauma might be the important biomechanical factors...

  10. Preparation of immobilized growing cells and enzymatic hydrolysis of sawdust

    International Nuclear Information System (INIS)

    Kumakura, M.; Kaetsu, I.

    1984-01-01

    Trichoderma reesei cells were immobilized by radiation polymerization using porous materials such as non-woven material and sawdust, and the enzymatic hydrolysis of sawdust with the enzyme solution from the immobilized growing cells was studied. The filter paper activity, which shows the magnitude of cellulase production in the immobilized cells, was comparable with that in the intact cells. The filter paper activity was affected by addition concentration of monomer and porous materials. The cells in the immobilized cells grew to be adhered on the surface of the fibrous polymers. Sawdust, which was pretreated by irradiation technique, was effectively hydrolyzed with the enzyme solution resulting from the culture of the immobilized cells, in which the glucose yield increased increasing the culture time of the immobilized cells. (author)

  11. Insulin action in human thighs after one-legged immobilization

    DEFF Research Database (Denmark)

    Richter, Erik; Kiens, Bente; Mizuno, M.

    1989-01-01

    Insulin action was assessed in thighs of five healthy young males who had one knee immobilized for 7 days by a splint. The splint was not worn in bed. Subjects also used crutches to prevent weight bearing of the immobilized leg. Immobilization decreased the activity of citrate synthase and 3-OH......-acyl-CoA-dehydrogenase in the vastus lateralis muscle by 9 and 14%, respectively, and thigh volume by 5%. After 7 days of immobilization, a two-step euglycemic hyperinsulinemic clamp procedure combined with arterial and bilateral femoral venous catheterization was performed. Insulin action on glucose uptake and tyrosine release...... of the thighs at mean plasma insulin concentrations of 67 (clamp step I) and 447 microU/ml (clamp step II) was decreased by immobilization, whereas immobilization did not affect insulin action on thigh exchange of free fatty acids, glycerol, O2, or potassium. Before and during the clamp step I, lactate release...

  12. A review of epidemiology of paediatric elbow injuries in sports.

    Science.gov (United States)

    Magra, Merzesh; Caine, Dennis; Maffulli, Nicola

    2007-01-01

    The elbow is a common site of orthopaedic injury in the paediatric population. The number of these injuries continues to rise following increased levels of participation in paediatric recreational and competitive sport. Injuries to the paediatric elbow can be classified as either overuse or acute. Delineating injury patterns to the elbow in children can be challenging, given the cartilaginous composition of the distal humerus and the multiple secondary ossification centres that appear and unite with the epiphysis at defined ages. Pitching in baseball, serving in tennis, spiking in volleyball, passing in American football and launching in javelin-throwing can all produce elbow pathology by forceful valgus stress, with medial stretching, lateral compression and posterior impingement. In children and adolescents, the epiphyseal plate is weaker than the surrounding ligaments, predisposing them to epiphyseal plate injuries. On the other hand, post-pubescent or skeletally mature athletes are more prone to tendinous or ligamentous injury. Injuries may cause significant impact on the athlete, parents and healthcare system. With the exception of baseball, there are few prospective cohort studies on the epidemiological trends of childhood elbow injuries in other sports. This paper aims to describe the epidemiological trends in paediatric elbow injuries related to sports, suggests prevention strategies and discusses the scope for further research. A web-based search of existing articles pertaining to paediatric elbow injuries in sports was performed. The implications of acute and overuse injuries and the possibility of permanent damage should be understood by parents, coaches and the athletes. Proper understanding of the intrinsic and extrinsic risk factors that could lead to elbow injuries is thus required. Measures to prevent elbow injuries should include proper coaching, warm-up, officiation, legislation, medical expertise and protective gear. There are still many

  13. End effects on elbows subjected to moment loadings

    International Nuclear Information System (INIS)

    Rodabaugh, E.C.; Iskander, S.K.; Moore, S.E.

    1978-03-01

    End effects on elbows subjected to moment loading are investigated using the finite element program EPACA. Relatively simple but more accurate (than present Code) equations are developed and recommendation for an alternative Code method using these equations is presented. Data from EPACA on stresses at welds (elbow-to-pipe juncture) are presented. A simple equation is given for estimating the maximum stresses at the welds

  14. The medial collateral ligament of the elbow joint

    DEFF Research Database (Denmark)

    Floris, S; Olsen, Bo Sanderhoff; Dalstra, Michel

    1998-01-01

    Eighteen osteoligamentous elbow joint specimens were included in a study of the medial collateral ligament complex (MCL). The morphologic characteristics of the MCL were examined, and three-dimensional kinematic measurements were taken after selective ligament dissections were performed. On morph......Eighteen osteoligamentous elbow joint specimens were included in a study of the medial collateral ligament complex (MCL). The morphologic characteristics of the MCL were examined, and three-dimensional kinematic measurements were taken after selective ligament dissections were performed...

  15. Energy transformation and flow topology in an elbow draft tube

    Directory of Open Access Journals (Sweden)

    Štefan D.

    2012-06-01

    Full Text Available Paper presents a computational study of energy transformation in two geometrical configurations of Kaplan turbine elbow draft tube. Pressure recovery, hydraulic efficiency and loss coefficient are evaluated for a series of flow rates and swirl numbers corresponding to operating regimes of the turbine. These integral characteristics are then correlated with local flow field properties identified by extraction of topological features. Main focus is to find the reasons for hydraulic efficiency drop of the elbow draft tube.

  16. Elbow joint fatigue and bench-press training.

    Science.gov (United States)

    Huang, Yen-Po; Chou, You-Li; Chen, Feng-Chun; Wang, Rong-Tyai; Huang, Ming-Jer; Chou, Paul Pei-Hsi

    2014-01-01

    Bench-press exercises are among the most common form of training exercise for the upper extremity because they yield a notable improvement in both muscle strength and muscle endurance. The literature contains various investigations into the effects of different bench-press positions on the degree of muscle activation. However, the effects of fatigue on the muscular performance and kinetics of the elbow joint are not understood fully. To investigate the effects of fatigue on the kinetics and myodynamic performance of the elbow joint in bench-press training. Controlled laboratory study. Motion research laboratory. A total of 18 physically healthy male students (age = 19.6 ± 0.8 years, height = 168.7 ± 5.5 cm, mass = 69.6 ± 8.6 kg) participated in the investigation. All participants were right-hand dominant, and none had a history of upper extremity injuries or disorders. Participants performed bench-press training until fatigued. Maximal possible number of repetitions, cycle time, myodynamic decline rate, elbow-joint force, and elbow-joint moment. We observed a difference in cycle time in the initial (2.1 ± 0.42 seconds) and fatigue (2.58 ± 0.46 seconds) stages of the bench-press exercise (P = .04). As the participants fatigued, we observed an increase in the medial-lateral force (P = .03) and internal-external moment (P ≤ .04) acting on the elbow joint. Moreover, a reduction in the elbow muscle strength was observed in the elbow extension-flexion (P ≤ .003) and forearm supination-pronation (P ≤ .001) conditions. The results suggest that performing bench-press exercises to the point of fatigue increases elbow-joint loading and may further increase the risk of injury. Therefore, when clinicians design bench-press exercise regimens for general athletic training, muscle strengthening, or physical rehabilitation, they should control carefully the maximal number of repetitions.

  17. Regional Variation Is Present in Elbow Capsules after Injury

    OpenAIRE

    Germscheid, Niccole M.; Hildebrand, Kevin A.

    2006-01-01

    Myofibroblast numbers and α-smooth muscle actin expression are increased in anterior joint capsules of patients with posttraumatic elbow contractures. The purpose of our study was to determine whether these changes occur regionally or throughout the entire joint capsule. We hypothesized that the α-smooth muscle actin mRNA expression and the myofibroblast numbers in posterior joint capsules would be elevated in elbows obtained from patients with posttraumatic joint contractures compared with j...

  18. Deliberate utilization of interaction torques brakes elbow extension in a fast throwing motion.

    Science.gov (United States)

    Hore, Jon; Debicki, Derek B; Gribble, Paul L; Watts, Sherry

    2011-05-01

    We tested the hypothesis that in fast arm movements the CNS deliberately utilizes interaction torques to decelerate (brake) joint rotations. Twelve subjects performed fast 2-D overarm throws in which large elbow extension velocities occurred. Joint motions were computed from recordings made with search coils; joint torques were calculated using inverse dynamics. After ball release, a large follow-through shoulder extension acceleration occurred that was initiated by shoulder extensor muscle torque. This shoulder acceleration produced a flexor interaction torque at the elbow that initiated elbow deceleration (braking). An instantaneous mechanical interaction of passive torques then occurred between elbow and shoulder, i.e., elbow extension deceleration produced a large shoulder extensor interaction torque that contributed to the shoulder extension acceleration which, simultaneously, produced a large elbow flexor interaction torque that contributed to elbow extension deceleration, and so on. Late elbow flexor muscle torque also contributed to elbow deceleration. The interaction of passive torques between shoulder and elbow was braked by shoulder flexor muscle torque. In this mechanism, shoulder musculature contributed to braking elbow extension in two ways: shoulder extensors initiated the mechanical interaction of passive torques between shoulder and elbow and shoulder flexors dissipated kinetic energy from elbow braking. It is concluded that, in fast 2-D throws, the CNS deliberately utilizes powerful interaction torques between shoulder and elbow to brake motion at the elbow.

  19. A randomized, double-blind sham-controlled trial on the efficacy of arthroscopic tennis elbow release for the management of chronic lateral epicondylitis.

    Science.gov (United States)

    Matache, Bogdan A; Berdusco, Randa; Momoli, Franco; Lapner, Peter L C; Pollock, J W

    2016-06-01

    Tennis elbow is a common elbow pathology typically affecting middle-aged individuals that can lead to significant disability. Most cases resolve within 2 years of symptom onset, but a subset of patients will develop persistent symptoms despite appropriate conservative management. There are several surgical approaches used to treat chronic tennis elbow, with arthroscopic surgery becoming an increasingly popular approach to address this pathology in North America. This procedure involves the arthroscopic release of the extensor carpi radialis brevis tendon (ECRB) origin at the elbow. The potential benefit of arthroscopic treatment of this condition is improved patient outcomes and shorter recovery time following surgery. The results of this technique have been reported only in the context of case series, which have shown positive results. However, in order to justify its widespread use and growing popularity, a high level of evidence study is required. The purpose of this prospective, randomized sham-controlled trial is to determine whether arthroscopic tennis elbow release is effective at treating chronic lateral epicondylitis. We will conduct a prospective single center, double-blind, randomized sham-controlled parallel arm trial evaluating the efficacy of arthroscopic tennis elbow release in adult patients with symptoms for at least 6 months. Patients will undergo intraoperative randomization after diagnostic arthroscopy of the elbow to receive either ECRB release (through the creation of a lateral portal) or a sham lateral portal and no ECRB release. The primary outcome will be the Mayo Elbow Performance Score (MEPS) at 1 year follow-up. Secondary outcomes will be the abbreviated Disability of the Shoulder and Hand (DASH) score, American Shoulder and Elbow Surgeons elbow (ASES-e) score and grip strength at 3, 6, 12 and 24 months as well as return-to-work time, ability to return to full duty and adverse outcomes. Results of this study will provide empirical

  20. Case report 471: Hemophilic pseudotumors (presumptive diagnosis) and hemophilic arthropathy of elbow

    International Nuclear Information System (INIS)

    Hermann, G.; Gilbert, M.

    1988-01-01

    A case has been presented of a 72-year-old man on whom an excretory urogram showed the incidental findings of two soft tissue masses in the abdomen containing considerable deposits of calcium. The history was interesting in that the patient was classic hemophiliac with Factor VIII level less than 1%, who first developed symptoms and signs of multiple hemarthroses affecting the knees, ankles, elbows, and shoulders at the age of nine years. Secondary hemophilic arthropathy followed, particularly advanced in the right elbow. Total knee replacements were performed within the last 10 years. A mass within the muscles of the right chest wall, superficial to the ribs, was surgically removed. The abdominal masses in this case were studied with CT and showed considerable calcification with a fibrous wall. Surgical removal of pseudotumors is usually undertaken following diagnosis because the natural history includes continuous enlargement and destruction of the adjacent tissues. Because of the age of the patient and the significant cardiac history, it was considered inappropriate to undertake surgery for the masses in the abdomen which were considered presumptively to be pseudotumors. The clinical, radiological, and pathological aspects of pseudotumor of hemophilia were reviewed. In this case, besides the masses in the abdomen, hemophilic arthropathy of an elbow was illustrated and a soft tissue mass in the right chest wall was demonstrated radiologically and the pathological specimen shown after surgical excision. (orig.)

  1. Outcome of Boyd-McLeod procedure for recalcitrant lateral epicondylitis of elbow.

    Science.gov (United States)

    Reddy, V R M; Satheesan, K S; Bayliss, N

    2011-08-01

    Various surgical procedures including percutaneous and open release and arthroscopic procedures have been described to treat recalcitrant tennis elbow. We present the outcome of Boyd-McLeod surgical procedure for tennis elbow resistant to non-operative treatment in twenty-seven patients (twenty-nine limbs). Boyd McLeod procedure involves excision of the proximal portion of the annular ligament, release of the origin of the extensor muscles, excision of the bursa if present, and excision of the synovial fringe. The average time interval from the onset of symptoms of tennis elbow until surgery was 28 months (range 8-72 months). Of those patients, 91% reported complete relief of symptoms with return to full normal activities including sports. Average post-operative time for return to professional/recreational activity was 5 weeks. One case developed pain secondary to ectopic bone formation after surgery, which settled after excision, and in another there was no pain relief with Boyd McLeod procedure. Two patients had scar tenderness that did not affect the final outcome. We conclude that Boyd-McLeod procedure is an effective treatment option in patients with resistant lateral epicondylitis.

  2. Sex comparisons of non-local muscle fatigue in human elbow flexors and knee extensors

    Science.gov (United States)

    Ye, Xin; Beck, Travis W.; Wages, Nathan P.; Carr, Joshua C.

    2018-01-01

    Objectives: To examine non-local muscle fatigue (NLMF) in both contralateral homologous and non-related heterogonous muscles for both sexes. Methods: Ten men and nine women participated in this study. After the familiarization visit, subjects completed four separate randomly sequenced experimental visits, during which the fatiguing interventions (six sets of 30-second maximal isometric contractions) were performed on either their right elbow flexors or knee extensors. Before (Pre-) and after (Post-) the fatiguing interventions, the isometric strength and the corresponding surface electromyographic (EMG) amplitude were measured for the non-exercised left elbow flexors or knee extensors. Results: For the non-exercised elbow flexors, the isometric strength decreased for both sexes (sex combined mean±SE: Pre vs. Post=339.67±18.02 N vs. 314.41±16.37 N; pisometric knee extension strength for men (Pre vs. Post =845.02±66.26 N vs. 817.39±67.64 N; p=0.019), but not for women. Conclusions: The presence of NMLF can be affected by factors such as sex and muscle being tested. Women are less likely to demonstrate NLMF in lower body muscle groups. PMID:29504584

  3. Case report 471: Hemophilic pseudotumors (presumptive diagnosis) and hemophilic arthropathy of elbow

    Energy Technology Data Exchange (ETDEWEB)

    Hermann, G.; Gilbert, M.

    1988-03-01

    A case has been presented of a 72-year-old man on whom an excretory urogram showed the incidental findings of two soft tissue masses in the abdomen containing considerable deposits of calcium. The history was interesting in that the patient was classic hemophiliac with Factor VIII level less than 1%, who first developed symptoms and signs of multiple hemarthroses affecting the knees, ankles, elbows, and shoulders at the age of nine years. Secondary hemophilic arthropathy followed, particularly advanced in the right elbow. Total knee replacements were performed within the last 10 years. A mass within the muscles of the right chest wall, superficial to the ribs, was surgically removed. The abdominal masses in this case were studied with CT and showed considerable calcification with a fibrous wall. Surgical removal of pseudotumors is usually undertaken following diagnosis because the natural history includes continuous enlargement and destruction of the adjacent tissues. Because of the age of the patient and the significant cardiac history, it was considered inappropriate to undertake surgery for the masses in the abdomen which were considered presumptively to be pseudotumors. The clinical, radiological, and pathological aspects of pseudotumor of hemophilia were reviewed. In this case, besides the masses in the abdomen, hemophilic arthropathy of an elbow was illustrated and a soft tissue mass in the right chest wall was demonstrated radiologically and the pathological specimen shown after surgical excision.

  4. Anatomic factors related to the cause of tennis elbow.

    Science.gov (United States)

    Bunata, Robert E; Brown, David S; Capelo, Roderick

    2007-09-01

    The pathogenesis of lateral epicondylitis remains unclear. Our purpose was to study the anatomy of the lateral aspect of the elbow under static and dynamic conditions in order to identify bone-to-tendon and tendon-to-tendon contact or rubbing that might cause abrasion of the tissues. Eighty-five cadaveric elbows were examined to determine details related to the bone structure and musculotendinous origins. We identified the relative positions of the musculotendinous units and the underlying bone when the elbow was in different degrees of flexion. We also recorded the contact between the extensor carpi radialis brevis and the lateral edge of the capitellum as elbow motion occurred, and we sought to identify the areas of the capitellum and extensor carpi radialis brevis where contact occurs. The average site of origin of the extensor carpi radialis brevis on the humerus lay slightly medial and superior to the outer edge of the capitellum. As the elbow was extended, the undersurface of the extensor carpi radialis brevis rubbed against the lateral edge of the capitellum while the extensor carpi radialis longus compressed the brevis against the underlying bone. The extensor carpi radialis brevis tendon has a unique anatomic location that makes its undersurface vulnerable to contact and abrasion against the lateral edge of the capitellum during elbow motion.

  5. Elbow joint position sense after neuromuscular training with handheld vibration.

    Science.gov (United States)

    Tripp, Brady L; Faust, Donald; Jacobs, Patrick

    2009-01-01

    Clinicians use neuromuscular control exercises to enhance joint position sense (JPS); however, because standardizing such exercises is difficult, validations of their use are limited. To evaluate the acute effects of a neuromuscular training exercise with a handheld vibrating dumbbell on elbow JPS acuity. Crossover study. University athletic training research laboratory. Thirty-one healthy, college-aged volunteers (16 men, 15 women, age = 23 + or - 3 years, height = 173 + or - 8 cm, mass = 76 + or - 14 kg). We measured and trained elbow JPS using an electromagnetic tracking device that provided auditory and visual biofeedback. For JPS testing, participants held a dumbbell and actively identified the target elbow flexion angle (90 degrees ) using the software-generated biofeedback, followed by 3 repositioning trials without feedback. Each neuromuscular training protocol included 3 exercises during which participants held a 2.55-kg dumbbell vibrating at 15, 5, or 0 Hz and used software-generated biofeedback to locate and maintain the target elbow flexion angle for 15 seconds. We calculated absolute (accuracy) and variable (variability) errors using the differences between target and reproduced angles. Training protocols using 15-Hz vibration enhanced accuracy and decreased variability of elbow JPS (P or = .200). Our results suggest these neuromuscular control exercises, which included low-magnitude, low-frequency handheld vibration, may enhance elbow JPS. Future researchers should examine vibration of various durations and frequencies, should include injured participants and functional multijoint and multiplanar measures, and should examine long-term effects of training protocols on JPS and injury.

  6. Sonography of injury of the ulnar collateral ligament of the elbow - initial experience

    International Nuclear Information System (INIS)

    Miller, Theodore T.; Adler, Ronald S.; Friedman, Lawrence

    2004-01-01

    The purpose of this study is to describe the sonographic appearance of injuries of the ulnar collateral ligament (UCL) of the elbow. Eight non-professional male baseball pitchers, ages 13-35 years, with medial elbow pain and clinical suspicion of ulnar collateral ligament injury, were referred for imaging. All eight underwent sonography of the affected and contralateral asymptomatic elbow, and six also underwent MR imaging. Neither valgus stress nor power Doppler was used during the sonographic examinations. Time from onset of symptoms to imaging was 1.5 weeks to 6 months. Three patients had surgical confirmation of their injuries, with time from imaging to surgery of 2 days to 9 months. In four patients, the UCL was ruptured, manifest sonographically in three cases as discontinuity of the normally hyperechoic ligament with anechoic fluid in the gap and in one case as non-visualization of the ligament with heterogeneous echogenicity in the expected location of the ligament. Two adolescent patients had avulsions of the UCL from the medial epicondyle, with sonographic demonstration of the avulsed echogenic bony fragment in both cases. One patient had a mild sprain, manifest as mild thickening and decreased echogenicity of the ligament sonographically compared with the contralateral normal elbow, with mild surrounding hypoechoic edema. The eighth patient had a small partial tear of the deep surface of the distal aspect of the ligament, visualized as a hypoechoic focus between the deep surface of the ligament and its ulnar attachment. Tears of the ulnar collateral ligament are manifested sonographically as non-visualization of the ligament or alteration of the normal morphology. (orig.)

  7. Hemophilic Chronic Synovitis: Therapy of Hemarthrosis using Endovascular Embolization of Knee and Elbow Arteries

    International Nuclear Information System (INIS)

    Galli, E.; Baques, A.; Moretti, N.; Candela, M.; Caviglia, H.

    2013-01-01

    PurposeCongenital hemophilia is a hereditary bleeding disorder that affects 1 in 5,000 males and is characterized by repetitive musculoskeletal bleeding episodes. Selective embolization of the knee and elbow arteries can prevent bleeding episodes. To evaluate the long-term efficacy of these procedures, we assessed the outcomes of 30 procedures performed in our center.MethodsWe performed 30 procedures in 27 hemophilic patients, including 23 knee, and 7 elbow procedures. To evaluate the efficacy of selective embolization of knee and elbow arteries in people with hemophilia, we analyzed the number of bleeding episodes during 12 months before the procedure compared with the amount of episodes that occurred 3, 6, and 12 months after embolization.ResultsTwenty-nine of 30 procedures were classified as successful. The median of 1.25 episodes per month (range 0–3) observed before the procedure was reduced to 0 (range 0–1.67; p < 0.001) at 3 months, 0.17 (range 0–1.67; p < 0.001) at 6 months, and 0.33 (range 0–1.67; p = 0.024) at 12 months. Three patients remained free of bleeding events for more than 6 months. Additionally, after the procedure there was a significant reduction in factor FVIII usage that sustained up to 12 months after the procedures. No serious adverse events were observed.ConclusionsSelective angiographic embolization of knee and elbow arteries is a feasible procedure that can prevent repetitive bleedings, which would translate in better joint outcomes for these patients

  8. Hemophilic Chronic Synovitis: Therapy of Hemarthrosis using Endovascular Embolization of Knee and Elbow Arteries

    Energy Technology Data Exchange (ETDEWEB)

    Galli, E., E-mail: emgalli1@yahoo.com.ar [CABA, Hospital de Agudos ' Juan A. Fernandez' (Argentina); Baques, A.; Moretti, N.; Candela, M. [CABA, Fundacion de la Hemofilia de Buenos Aires (Argentina); Caviglia, H. [CABA, Hospital de Agudos ' Juan A. Fernandez' (Argentina)

    2013-08-01

    PurposeCongenital hemophilia is a hereditary bleeding disorder that affects 1 in 5,000 males and is characterized by repetitive musculoskeletal bleeding episodes. Selective embolization of the knee and elbow arteries can prevent bleeding episodes. To evaluate the long-term efficacy of these procedures, we assessed the outcomes of 30 procedures performed in our center.MethodsWe performed 30 procedures in 27 hemophilic patients, including 23 knee, and 7 elbow procedures. To evaluate the efficacy of selective embolization of knee and elbow arteries in people with hemophilia, we analyzed the number of bleeding episodes during 12 months before the procedure compared with the amount of episodes that occurred 3, 6, and 12 months after embolization.ResultsTwenty-nine of 30 procedures were classified as successful. The median of 1.25 episodes per month (range 0-3) observed before the procedure was reduced to 0 (range 0-1.67; p < 0.001) at 3 months, 0.17 (range 0-1.67; p < 0.001) at 6 months, and 0.33 (range 0-1.67; p = 0.024) at 12 months. Three patients remained free of bleeding events for more than 6 months. Additionally, after the procedure there was a significant reduction in factor FVIII usage that sustained up to 12 months after the procedures. No serious adverse events were observed.ConclusionsSelective angiographic embolization of knee and elbow arteries is a feasible procedure that can prevent repetitive bleedings, which would translate in better joint outcomes for these patients.

  9. Hybrid external fixation in high-energy elbow fractures: a modular system with a promising future.

    Science.gov (United States)

    Lerner, A; Stahl, S; Stein, H

    2000-12-01

    Severe, high-energy, periarticular elbow injuries producing a "floating joint" are a major surgical challenge. Their reconstruction and rehabilitation are not well documented. Therefore, the following reports our experience with treating such injuries caused by war wounds. Seven adults with compound open peri- and intra-articular elbow fractures were treated in hybrid ring tubular fixation frames. After debridement, bone stabilization, and neurovascular reconstructions, early controlled daily movements were started in the affected joint. These seven patients had together seven humeral, five radial, and six ulnar fractures. All fractures united at a median time of 180 days. No deep infection developed. The functional end results assessed by the Khalfayan functional score were excellent in two, good in one, and fair in four of these severely mangled upper extremities. None was amputated. The Mangled Extremity Severity Score has been shown to be unable to provide a reliable assessment for severe high-energy limb injuries surgically managed with the modular hybrid thin wire tubular external fixation system. This hybrid system is a very useful addition to the surgical armamentarium of orthopedic trauma surgeons. It both allows complex surgical reconstructions and reduces the incidence of deep infections in these heavily contaminated injuries. The hybrid circular (thin wire) external fixation system is very modular and may provide secure skeletal stabilization even in cases of severely comminuted juxta-articular fractures on both sides of the elbow joint (floating elbow) with severe damage to soft tissues. This fixation system allows individual fixation of forearm bone fractures, thus allowing the preservation of pronation-supination movements.

  10. The Reasons of Steam Pipeline Elbow Rupture

    Directory of Open Access Journals (Sweden)

    Mesjasz A.

    2016-09-01

    Full Text Available In the paper the reasons for steam pipeline’s elbow material rupture, made of steel 13CrMo4-5 (15HM that is being used in the energetics. Based on the mechanical properties in the ambient temperature (Rm, Rp0,2 and elongation A5 and in the increased temperature (Rp0,2t it was found, that the pipeline elbow’s material sampled from the ruptured area has lower Rp0,2 i Rp0,2t by around 2% than it is a requirement for 13CrMo4-5 steel in it’s base state. The damage appeared as a result of complex stress state, that substantially exceeded the admissible tensions, what was the consequence of considerable structure degradation level. As a result of the microstructure tests on HITACHI S4200 microscope, the considerable development of the creeping process associates were found. Also the advances progress of the microstructure degradation was observed, which is substantial decomposition of bainite and multiple, with varied secretion size, and in most cases forming the micro cracks chains. With the use of lateral micro sections the creeping voids were observed, that creates at some places the shrinkage porosities clusters and micro pores.

  11. Use of the Liverpool Elbow Score as a postal questionnaire for the assessment of outcome after total elbow arthroplasty.

    Science.gov (United States)

    Ashmore, Alexander M; Gozzard, Charles; Blewitt, Neil

    2007-01-01

    The Liverpool Elbow Score (LES) is a newly developed, validated elbow-specific score. It consists of a patient-answered questionnaire (PAQ) and a clinical assessment. The purpose of this study was to determine whether the PAQ portion of the LES could be used independently as a postal questionnaire for the assessment of outcome after total elbow arthroplasty and to correlate the LES and the Mayo Elbow Performance Score (MEPS). A series of 51 total elbow replacements were reviewed by postal questionnaire. Patients then attended the clinic for assessment by use of both the LES and the MEPS. There was an excellent response rate to the postal questionnaire (98%), and 44 elbows were available for clinical review. Good correlation was shown between the LES and the MEPS (Spearman correlation coefficient, 0.84; P PAQ portion of the LES and the MEPS (Spearman correlation coefficient, 0.76; P PAQ component and the MEPS, suggesting that outcome assessment is possible by postal questionnaire.

  12. Current evidence for effectiveness of interventions for cubital tunnel syndrome, radial tunnel syndrome, instability, or bursitis of the elbow: a systematic review.

    Science.gov (United States)

    Rinkel, Willem D; Schreuders, Ton A R; Koes, Bart W; Huisstede, Bionka M A

    2013-12-01

    To provide an evidence-based overview of the effectiveness of interventions for 4 nontraumatic painful disorders sharing the anatomic region of the elbow: cubital tunnel syndrome, radial tunnel syndrome, elbow instability, and olecranon bursitis. The Cochrane Library, PubMed, Embase, PEDro, and CINAHL were searched to identify relevant reviews and randomized clinical trials (RCTs). Two reviewers independently extracted data and assessed the quality of the methodology. A best-evidence synthesis was used to summarize the results. One systematic review and 6 RCTs were included. For the surgical treatment of cubital tunnel syndrome (1 review, 3 RCTs), comparing simple decompression with anterior ulnar nerve transposition, no evidence was found in favor of either one of these. Limited evidence was found in favor of medial epicondylectomy versus anterior transposition and for early postoperative therapy versus immobilization. No evidence was found for the effect of local steroid injection in addition to splinting. No RCTs were found for radial tunnel syndrome. For olecranon bursitis (1 RCT), limited evidence for effectiveness was found for methylprednisolone acetate injection plus naproxen. Concerning elbow instability, including 2 RCTs, one showed that nonsurgical treatment resulted in similar results compared with surgery, whereas the other found limited evidence for the effectiveness in favor of early mobilization versus 3 weeks of immobilization after surgery. In this review no, or at best, limited evidence was found for the effectiveness of nonsurgical and surgical interventions to treat painful cubital tunnel syndrome, radial tunnel syndrome, elbow instability, or olecranon bursitis. Well-designed and well-conducted RCTs are clearly needed in this field.

  13. Immobilization of Trichoderma reesei by radiation polymerization

    International Nuclear Information System (INIS)

    Zhou Ruimin; Ma Zueteh; Kaetus, Isao; Kumakura, Minoro

    1993-01-01

    Immobilization of Trichoderma reesei was carried out by radiation polymerization. It was found that the activity of fixed cells increased with increasing surface area of the carrier and was affected by the concentration of monomer tetraethylenglycol dimethacrylate and the shape of the substrate composition and structure of cotton textile fabrics. (author)

  14. MR arthrography of elbow: evaluation of the ulnar collateral ligament of elbow

    International Nuclear Information System (INIS)

    Nakanishi, Katsunuki; Masatomi, Takashi; Ochi, Takahiro; Ishida, Takeshi; Hori, Shinichi; Ikezoe, Junpei; Nakamura, Hironobu

    1996-01-01

    Objective. The purpose of this study was to evaluate ulnar collateral ligament (UCL) injury of the elbow in throwing athletes by MRI and MR arthrography. Design. Ten elbows of throwing athletes were examined on both plain MRI and MR saline arthrography and the injuries subsequently surgically proven. Spin-echo (SE) T1-weighted and fast SE T2-weighted coronal images were obtained. Results. The UCL was unclear in all ten cases on T1-weighted MRI. In five cases an avulsion fracture was also found on T1-weighted MRI. On T2-weighted MRI, abnormal high-intensity areas were identified in or around the UCL. On T2-weighted MR arthrography images, extracapsular high-intensity areas, which represent extracapsular leakage, were found in four of five cases with avulsion fracture. At surgery, all these four cases showed avulsion fractures with instability; the other case had a fracture but it was stable and adherent to the humerus. On T2-weighted MR arthrography images, an extracapsular high-intensity area was found in one of the five cases without avulsion fracture. At surgery this patient had a complete tear of the UCL itself. Conclusion. MR arthrography provided additional information for evaluating the degree of UCL injury. (orig.). With 5 figs., 1 tab

  15. Elbow Reconstruction Using Island Flap for Burn Patients

    Directory of Open Access Journals (Sweden)

    Gi Yeun Hur

    2012-11-01

    Full Text Available BackgroundDeep burns of the elbow lead to soft tissue necrosis and infection, with exposure of deep structures. Adequate wound coverage of this area requires thin, pliable, and durable tissue, while optimal functional recovery requires early coverage and functional rehabilitation. We have found 3 types of island flaps that provide reliable coverage for the elbow.MethodsA retrospective study was performed on all patients who underwent flap coverage of an elbow defect at our hospital. The patients' data including age, sex, cause of injury, wound dimensions, timing of flap coverage, postoperative elbow motion, and complications were investigated.ResultsBetween 2001 and 2012, 16 patients were treated at our hospital. The mean age was 53.3 years. Three kinds of flaps were performed: 9 latissimus dorsi flaps, 4 lateral arm flaps, and 4 radial forearm flaps. The average defect size was 183.5 cm2 (range, 28 to 670 cm2. Wound coverage was performed at mean duration of 45.9 days (range, 14 to 91 days. The mean postoperative active elbow flexion was 98° (range, 85° to 115°. Partial flap failure occurred in 1 latissimus dorsi flap. Minor complications included partial flap loss (11.8%, hematoma (23.5%, seroma (35.3%, and wound infection (5.9%.ConclusionsFlap selection for elbow reconstruction is determined by the defect size and the extent of the adjacent tissue injury. Elbow reconstruction using an island flap is a single-staged, reliable, and relatively simple procedure that permits initiation of early rehabilitation, thereby improving a patient's functional outcome.

  16. Elbow Reconstruction Using Island Flap for Burn Patients

    Directory of Open Access Journals (Sweden)

    Gi Yeun Hur

    2012-11-01

    Full Text Available Background Deep burns of the elbow lead to soft tissue necrosis and infection, with exposureof deep structures. Adequate wound coverage of this area requires thin, pliable, and durabletissue, while optimal functional recovery requires early coverage and functional rehabilitation.We have found 3 types of island flaps that provide reliable coverage for the elbow.Methods A retrospective study was performed on all patients who underwent flap coverageof an elbow defect at our hospital. The patients’ data including age, sex, cause of injury, wounddimensions, timing of flap coverage, postoperative elbow motion, and complications wereinvestigated.Results Between 2001 and 2012, 16 patients were treated at our hospital. The mean agewas 53.3 years. Three kinds of flaps were performed: 9 latissimus dorsi flaps, 4 lateral armflaps, and 4 radial forearm flaps. The average defect size was 183.5 cm2 (range, 28 to 670cm2. Wound coverage was performed at mean duration of 45.9 days (range, 14 to 91 days.The mean postoperative active elbow flexion was 98° (range, 85° to 115°. Partial flap failureoccurred in 1 latissimus dorsi flap. Minor complications included partial flap loss (11.8%,hematoma (23.5%, seroma (35.3%, and wound infection (5.9%.Conclusions Flap selection for elbow reconstruction is determined by the defect size andthe extent of the adjacent tissue injury. Elbow reconstruction using an island flap is a singlestaged,reliable, and relatively simple procedure that permits initiation of early rehabilitation,thereby improving a patient’s functional outcome.

  17. Inverted 'V' osteotomy excision arthroplasty for bony ankylosed elbows

    Directory of Open Access Journals (Sweden)

    Rex Chadrabose

    2011-12-01

    Full Text Available Abstract Background Bony ankylosis of elbow is challenging and difficult problem to treat. The options are excision arthroplasty and total elbow replacement. We report our midterm results on nine patients, who underwent inverted 'V' osteotomy excision arthroplasty in our hospital with good functional results. Materials Our case series includes 9 patients (seven males and two females with the mean age of 34 years (13-56 years. Five patients had trauma, two had pyogenic arthritis, one had tuberculous arthritis, and one had pyogenic arthritis following surgical fixation. Results The average duration of follow up is 65 months (45 months-80 months. The mean Mayo's elbow performance score (MEPS preoperatively was 48 (35-70. The MEPS at final follow up was 80 (60-95. With no movement at elbow and fixed in various degrees of either flexion or extension preoperatively, the mean preoperative position of elbow was 64°(30°to 100°. The mean post operative range of motion at final follow up was 27°of extension (20-500, 116°of flexion (1100-1300, and the arc of motion was 88°(800-1000. One patient had ulnar nerve neuropraxia and another patient developed median nerve neuropraxia, and both recovered completely in six weeks. No patient had symptomatic instability of the elbow. All patients were asymptomatic except one patient, who had pain mainly on heavy activities. Conclusion We conclude that inverted 'V' osteotomy excision arthroplasty is a viable option in the treatment of bony ankylosis of the elbow in young patients.

  18. THE EFFECTS OF RACKET INERTIA TENSOR ON ELBOW LOADINGS AND RACKET BEHAVIOR FOR CENTRAL AND ECCENTRIC IMPACTS

    Directory of Open Access Journals (Sweden)

    Steven M. Nesbit

    2006-06-01

    Full Text Available This paper discusses the inertia tensors of tennis rackets and their influence on the elbow swing torques in a forehand motion, the loadings transmitted to the elbow from central and eccentric impacts, and the racket acceleration responses from central and eccentric impacts. Inertia tensors of various rackets with similar mass and mass center location were determined by an inertia pendulum and were found to vary considerably in all three orthogonal directions. Tennis swing mechanics and impact analyses were performed using a computer model comprised of a full-body model of a human, a parametric model of the racket, and an impact function. The swing mechanics analysis of a forehand motion determined that inertia values had a moderate linear effect on the pronation-supination elbow torques required to twist the racket, and a minor effect on the flexion-extension and valgus-varus torques. The impact analysis found that mass center inertia values had a considerable effect on the transmitted torques for both longitudinal and latitudinal eccentric impacts and significantly affected all elbow torque components. Racket acceleration responses to central and eccentric impacts were measured experimentally and found to be notably sensitive to impact location and mass center inertia values

  19. Pathology of articular cartilage and synovial membrane from elbow joints with and without degenerative joint disease in domestic cats.

    Science.gov (United States)

    Freire, M; Meuten, D; Lascelles, D

    2014-09-01

    The elbow joint is one of the feline appendicular joints most commonly and severely affected by degenerative joint disease. The macroscopic and histopathological lesions of the elbow joints of 30 adult cats were evaluated immediately after euthanasia. Macroscopic evidence of degenerative joint disease was found in 22 of 30 cats (39 elbow joints) (73.33% cats; 65% elbow joints), and macroscopic cartilage erosion ranged from mild fibrillation to complete ulceration of the hyaline cartilage with exposure of the subchondral bone. Distribution of the lesions in the cartilage indicated the presence of medial compartment joint disease (most severe lesions located in the medial coronoid process of the ulna and medial humeral epicondyle). Synovitis scores were mild overall and correlated only weakly with macroscopic cartilage damage. Intra-articular osteochondral fragments either free or attached to the synovium were found in 10 joints. Macroscopic or histologic evidence of a fragmented coronoid process was not found even in those cases with intra-articular osteochondral fragments. Lesions observed in these animals are most consistent with synovial osteochondromatosis secondary to degenerative joint disease. The pathogenesis for the medial compartmentalization of these lesions has not been established, but a fragmented medial coronoid process or osteochondritis dissecans does not appear to play a role. © The Author(s) 2014.

  20. Astym treatment vs. eccentric exercise for lateral elbow tendinopathy: a randomized controlled clinical trial

    Science.gov (United States)

    Stegink-Jansen, Caroline W.

    2015-01-01

    Introduction. Patients with chronic lateral elbow (LE) tendinopathy, commonly known as tennis elbow, often experience prolonged symptoms and frequent relapses. Astym treatment, evidenced in animal studies to promote the healing and regeneration of soft tissues, is hypothesized to improve outcomes in LE tendinopathy patients. This study had two objectives: (1) to compare the efficacy of Astym treatment to an evidence-based eccentric exercise program (EE) for patients with chronic LE tendinopathy, and (2) to quantify outcomes of subjects non-responsive to EE who were subsequently treated with Astym treatment. Study Design. Prospective, two group, parallel, randomized controlled trial completed at a large orthopedic center in Indiana. Inclusion criteria: age range of 18–65 years old, with clinical indications of LE tendinopathy greater than 12 weeks, with no recent corticosteriod injection or disease altering comorbidities. Methods. Subjects with chronic LE tendinopathy (107 subjects with 113 affected elbows) were randomly assigned using computer-generated random number tables to 4 weeks of Astym treatment (57 elbows) or EE treatment (56 elbows). Data collected at baseline, 4, 8, 12 weeks, 6 and 12 months. Primary outcome measure: DASH; secondary outcome measures: pain with activity, maximum grip strength and function. The treating physicians and the rater were blinded; subjects and treating clinicians could not be blinded due to the nature of the treatments. Results. Resolution response rates were 78.3% for the Astym group and 40.9% for the EE group. Astym subjects showed greater gains in DASH scores (p = 0.047) and in maximum grip strength (p = 0.008) than EE subjects. Astym therapy also resolved 20/21 (95.7%) of the EE non-responders, who showed improvements in DASH scores (p effects were reported. Conclusion. This study suggests Astym therapy is an effective treatment option for patients with LE tendinopathy, as an initial treatment, and after an eccentric

  1. EFFECT OF TRAINING WITH NEUROMUSCULAR ELECTRICAL STIMULATION ON ELBOW FLEXION STRENGTH

    Directory of Open Access Journals (Sweden)

    William R. Holcomb

    2006-06-01

    Full Text Available Neuromuscular electrical stimulation (NMES may be used to prevent strength loss associated with post-surgical immobilization. Most studies testing the effectiveness of NMES have trained the knee extensors. The purpose of this investigation was to test the effectiveness of NMES when training the elbow flexors. Twenty-four students were randomly assigned to one of three groups: NMES training, isometric training or control. Testing and training were completed using a Biodex™ dynamometer. After a standard warm-up, subjects were positioned on the Biodex™ with left shoulder in anatomical neutral, elbow flexed to 90o and forearm supinated. Subjects performed three maximum isometric contractions of 5 seconds duration, with 1 min rest between repetitions. Average peak torque during three repetitions was calculated. Subjects trained on three days per week for four weeks. Training included 15 maximum contractions of 15 seconds duration with 45 seconds recovery between repetitions. Russian current was delivered by a Forte™ 400 Combo via electrodes placed over ends of biceps brachii. A maximum tolerable ramped intensity was delivered with frequency of 90 bps and duty cycle of 15:45. After training, subjects were post-tested in a manner identical to pretest. Mean normalized strength data were analyzed using a 3 (Group x 2 (Test ANOVA. The Group x Test interaction was significant. Post-hoc analyses revealed that the voluntary training group (normalized means of 0.49 to 0.71 for the pretest and post-test, respectively had a significantly greater increase than the other two groups, which were not significantly different from each other. The lack of significant strength gains with NMES was likely due to low average training intensity, which was only 20.4% of MVIC. Based on these results, NMES training may not be an effective alternative to voluntary training in healthy subjects

  2. MR imaging of the major nerves about the elbow: cadaveric study examining the effect of flexion and extension of the elbow and pronation and supination of the forearm

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Sook; Yeh, Lee Ren; Trudell, D.; Resnick, D. [Department of Radiology (114), Veterans Administration Medical Center, San Diego, CA (United States)

    1998-08-01

    Magnetic resonance (MR) imaging provides useful information in the evaluation of peripheral nerves. Recent advances in MR imaging allow for detailed depiction of the soft tissue structures of the elbow joint. Three major nerves are present about the elbow. Six cadaveric elbows were imaged to depict the normal anatomy of these nerves and to determine the best plane and position of the elbow for optimal visualization of each nerve. Axial images of the elbow in full extension with the forearm in supination allow identification of all major nerves. Axial images with the elbow in full flexion allow accurate assessment of the cubital tunnel and the ulner nerve. Axial images of the elbow in full extension with the forearm in pronation are helpful for assessment of the median and radial nerves in the forearm. (orig.) With 11 figs., 20 refs.

  3. MR imaging of the major nerves about the elbow: cadaveric study examining the effect of flexion and extension of the elbow and pronation and supination of the forearm

    International Nuclear Information System (INIS)

    Kim, Young Sook; Yeh, Lee Ren; Trudell, D.; Resnick, D.

    1998-01-01

    Magnetic resonance (MR) imaging provides useful information in the evaluation of peripheral nerves. Recent advances in MR imaging allow for detailed depiction of the soft tissue structures of the elbow joint. Three major nerves are present about the elbow. Six cadaveric elbows were imaged to depict the normal anatomy of these nerves and to determine the best plane and position of the elbow for optimal visualization of each nerve. Axial images of the elbow in full extension with the forearm in supination allow identification of all major nerves. Axial images with the elbow in full flexion allow accurate assessment of the cubital tunnel and the ulner nerve. Axial images of the elbow in full extension with the forearm in pronation are helpful for assessment of the median and radial nerves in the forearm. (orig.)

  4. Incarcerated medial epicondyle fracture following pediatric elbow dislocation: 11 cases.

    Science.gov (United States)

    Dodds, Seth D; Flanagin, Brody A; Bohl, Daniel D; DeLuca, Peter A; Smith, Brian G

    2014-09-01

    To describe outcomes after surgical management of pediatric elbow dislocation with incarceration of the medial epicondyle. We conducted a retrospective case review of 11 consecutive children and adolescents with an incarcerated medial epicondyle fracture after elbow dislocation. All patients underwent open reduction internal fixation using a similar technique. We characterized outcomes at final follow-up. Average follow-up was 14 months (range, 4-56 mo). All patients had clinical and radiographic signs of healing at final follow-up. There was no radiographic evidence of loss of reduction at intervals or at final follow-up. There were no cases of residual deformity or valgus instability. Average final arc of elbow motion was 4° to 140°. All patients had forearm rotation from 90° supination to 90° pronation. Average Mayo elbow score was 99.5. Four of 11 patients had ulnar nerve symptoms postoperatively and 1 required a second operation for ulnar nerve symptoms. In addition, 1 required a second operation for flexion contracture release with excision of heterotopic ossification. Three patients had ulnar nerve symptoms at final follow-up. Two of these had mild paresthesia only and 1 had both mild paresthesia and weakness. Our results suggest that open reduction internal fixation of incarcerated medial epicondyle fractures after elbow dislocation leads to satisfactory motion and function; however, the injury carries a high risk for complications, particularly ulnar neuropathy. Therapeutic IV. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  5. The posterior transtriceps approach for elbow arthrography: a forgotten technique?

    International Nuclear Information System (INIS)

    Lohman, M.; Borrero, C.; Casagranda, B.; Rafiee, B.; Towers, J.

    2009-01-01

    To evaluate the technical feasibility of performing elbow MR arthrography via a posterior approach through the triceps. The images of 19 patients with elbow MR arthrography via a posterior transtriceps approach were retrospectively studied. The injections were performed by four musculoskeletal radiologists, using fluoroscopic guidance and a 22- or 25-gauge needle. The fluoroscopic and subsequent MR images were reviewed by two musculoskeletal radiologists and evaluated for adequacy of joint capsular distention, degree and location of contrast leakage, and presence of gas bubbles. The injection was diagnostic in all 19 patients, with a sufficient amount of contrast agent seen in the elbow joint. No significant contrast leakage occurred in 12 patients who received injections of 8 cc or less of contrast agent, but moderate contrast leakage occurred in 6/7 patients who received injections of greater than 8 cc. Contrast leakage generally occurred within the triceps myotendinous junction. No gas bubbles were identified in the injected joints. Patients often present for MR arthrography of the elbow with medial or lateral elbow pain. Contrast leakage during a radiocapitellar approach may complicate evaluation of the lateral collateral ligament or the common extensor tendon origin. Transtriceps MR arthrography offers an alternative to the more commonly used radiocapitellar approach. With injected volumes not exceeding 8 cc, the risk of significant contrast leakage is small. An advantage of the transtriceps injection is that contrast leakage through the posterior needle tract does not interfere with evaluation of the lateral structures. (orig.)

  6. Hydroforming Process for an Ultrasmall Bending Radius Elbow

    Directory of Open Access Journals (Sweden)

    Shangwen Ruan

    2018-01-01

    Full Text Available Bent pipes are widely used in automotive, aviation, and aerospace industries for delivering fluids. Parts having small relative bending radiuses are called elbows. However, fabricating a thin-walled elbow part using the simple bending process poses many challenges. One possible way to manufacture elbows is with the stamping-welding process. The major drawbacks of this method include the decline in sealing performance and the addition in weight attributed to the lap welding process. Tube hydroforming (THF is considered as a feasible solution to these problems. However, the forming process could be quite complex, and multistep forming is necessary. This study investigates the effects of preliminary processes on elbow forming such as bending, partition forming, and heat treatment and presents a high-performance optimized process design to achieve an ultrasmall radius elbow. The effects of multistep forming on the thickness distribution and the heat treatment on the microstructure have been evaluated. The results obtained from simulations show a reasonable agreement with those from the experiments.

  7. Immobilization of microorganisms. Part 1. Preparation of immobilized Lactobacillus bulgaricus

    Energy Technology Data Exchange (ETDEWEB)

    Lee, K H

    1981-01-01

    The immobilization of Lactobacillus bulgaricus on polyacrylamide and on alginate beads was investigated. The most active immobilized cells were obtained by entrapment in Ca alginate beads. These immobilized microbial cells, when introduced into 4.5% lactose solution and whey solution showed maximum relative activity of 28% for lactose and 18% for whey compared to free cells.

  8. End effects on elbows subjected to moment loadings

    International Nuclear Information System (INIS)

    Rodabaugh, E.C.; Moore, S.E.

    1982-01-01

    So-called end effects for moment loadings on short-radius and long-radius butt welding elbows of various arc lengths are investigated with a view toward providing more accurate design formulas for critical piping systems. Data developed in this study, along with published information, were used to develop relatively simple design equations for elbows attached at both ends to long sections of straight pipe. These formulas are the basis for an alternate ASME Code procedure for evaluating the bending moment stresses in Class 1 nuclear piping (ASME Code Case N-319). The more complicated problems of elbows with other end conditions, e.g., flanges at one or both ends, are also considered. Comparisons of recently published experimental and theoretical studies with current industrial code design rules for these situations indicate that these rules also need to be improved

  9. Experimental study of plastic responses of pipe elbows

    International Nuclear Information System (INIS)

    Greenstreet, W.L.

    1978-01-01

    Load-deflection responses were determined experimentally for sixteen 152.4-mm (6-in.) (nominal) commercial carbon steel pipe elbows and four 152.4-mm (6-in.) stainless steel elbows. Each specimen was loaded with an external force of sufficient magnitude to produce predominantly plastic response. The influences of bend radius and wall thickness were studied, as well as the effect of internal prssure on load-deflection behavior. Comparisons of results from stainless steel and from carbon steel elbows indicate differences in responses attributable to material differences. The results were interpreted in terms of limit analysis concepts, and collapse loads were determined. Trends given by the collapse loads are identified and discussed

  10. The Unilateral Below Elbow Test: a function test for children with unilateral congenital below elbow deficiency.

    Science.gov (United States)

    Bagley, Anita M; Molitor, Fred; Wagner, Lisa V; Tomhave, Wendy; James, Michelle A

    2006-07-01

    The Unilateral Below Elbow Test (UBET) was developed to evaluate function in bimanual activities for both the prosthesis wearer and non-wearer. Nine tasks were chosen for each of four age-specific categories defined by development stages of hand function (2-4y, 5-7y, 8-10y, and 11-21y). Two scales, Completion of Task and Method of Use, were designed to rate performance. To measure reliability, four occupational therapists scored samples of videotaped UBET performances. For Completion of Task, an interval scale, agreement in scoring was measured with interclass correlation coefficients (ICC; n=9; five females, four males). For Method of Use, a nominal scale, chance-adjusted association was calculated with Cohen's kappa coefficients (interobserver n=198; 111 females, 87 males; intraobserver n=93; 56 females, 37 males). For Completion of Task, the average ICC was 0.87 for the prosthesis-on condition, and 0.85 for the prosthesis-off condition. ICCs exceeded 0.80 for eight out of nine tasks for the two older age groups, but for only five out of nine tasks in the younger age groups. Higher inter- and intraobserver kappa coefficients for Method of Use resulted when scoring children with their prostheses on versus off. The oldest age group had lower kappa values than the other three groups. The UBET is recommended for the functional evaluation of Completion of Task in children with unilateral congenital below elbow deficiency with and without their prostheses. Method of Use scoring can evaluate individuals for directed therapy interventions or prosthetic training.

  11. Membranes suited for immobilizing biomolecules

    NARCIS (Netherlands)

    2009-01-01

    The present invention relates to flow-through membranes suitable for the immobilization of biomols., methods for the prepn. of such membranes and the use of such membranes for the immobilization of biomols. and subsequent detection of immobilized biomols. The invention concerns a flow-through

  12. Static progressive versus dynamic splinting for posttraumatic elbow stiffness: a systematic review of 232 patients

    NARCIS (Netherlands)

    Veltman, Ewout S.; Doornberg, Job N.; Eygendaal, Denise; van den Bekerom, Michel P. J.

    2015-01-01

    The elbow is prone to stiffness after trauma. To regain functional elbow motion, several conservative and surgical treatment options are available. Nonoperative treatment includes physical therapy, intra-articular injections with corticosteroids, and a static progressive or dynamic splinting

  13. Romantic Resonances in the Rhetoric of Peter Elbow's "Writing Without Teachers."

    Science.gov (United States)

    Yager, Kristi

    1996-01-01

    Seeks to uncover the historical roots within English Romanticism of Peter Elbow's thinking in order to show the depth and complexity of his assumptions about writing. Implicitly refutes charges questioning the intellectual credibility of Elbow's work. (TB)

  14. 78 FR 68907 - Agency Information Collection (Elbow and Forearm Conditions Disability Benefits Questionnaire...

    Science.gov (United States)

    2013-11-15

    ... Forearm Conditions Disability Benefits Questionnaire) Under OMB Review AGENCY: Veterans Benefits... Control No. 2900- NEW (Elbow and Forearm Conditions Disability Benefits Questionnaire)'' in any... Benefits Questionnaire)''. SUPPLEMENTARY INFORMATION: Title: Elbow and Forearm Conditions Disability...

  15. Failure Behavior of Elbows with Local Wall Thinning

    Science.gov (United States)

    Lee, Sung-Ho; Lee, Jeong-Keun; Park, Jai-Hak

    Wall thinning defect due to corrosion is one of major aging phenomena in carbon steel pipes in most plant industries, and it results in reducing load carrying capacity of the piping components. A failure test system was set up for real scale elbows containing various simulated wall thinning defects, and monotonic in-plane bending tests were performed under internal pressure to find out the failure behavior of them. The failure behavior of wall-thinned elbows was characterized by the circumferential angle of thinned region and the loading conditions to the piping system.

  16. Immobilization Patterns and Dynamics of Acetate-Utilizing Methanogens Immobilized in Sterile Granular Sludge in Upflow Anaerobic Sludge Blanket Reactors

    Science.gov (United States)

    Schmidt, Jens Ejbye; Ahring, Birgitte Kjær

    1999-01-01

    Sterile granular sludge was inoculated with either Methanosarcina mazeii S-6, Methanosaeta concilii GP-6, or both species in acetate-fed upflow anaerobic sludge blanket (UASB) reactors to investigate the immobilization patterns and dynamics of aceticlastic methanogens in granular sludge. After several months of reactor operation, the methanogens were immobilized, either separately or together. The fastest immobilization was observed in the reactor containing M. mazeii S-6. The highest effluent concentration of acetate was observed in the reactor with only M. mazeii S-6 immobilized, while the lowest effluent concentration of acetate was observed in the reactor where both types of methanogens were immobilized together. No changes were observed in the kinetic parameters (Ks and μmax) of immobilized M. concilii GP-6 or M. mazeii S-6 compared with suspended cultures, indicating that immobilization does not affect the growth kinetics of these methanogens. An enzyme-linked immunosorbent assay using polyclonal antibodies against either M. concilii GP-6 or M. mazeii S-6 showed significant variations in the two methanogenic populations in the different reactors. Polyclonal antibodies were further used to study the spatial distribution of the two methanogens. M. concilii GP-6 was immobilized only on existing support material without any specific pattern. M. mazeii S-6, however, showed a different immobilization pattern: large clumps were formed when the concentration of acetate was high, but where the acetate concentration was low this strain was immobilized on support material as single cells or small clumps. The data clearly show that the two aceticlastic methanogens immobilize differently in UASB systems, depending on the conditions found throughout the UASB reactor. PMID:10049862

  17. Correlation between the elbow flexion and the hand and wrist flexion after neurotization of the fascicles of the ulnar nerve to the motor branch to the biceps

    Directory of Open Access Journals (Sweden)

    Ricardo Boso Escudero

    Full Text Available ABSTRACT OBJECTIVE: Gain in elbow flexion in patients with brachial plexus injury is extremely important. The transfer of a fascicle from the ulnar nerve to the motor branch of the musculocutaneous nerve (Oberlin surgery is a treatment option. However, in some patients, gain in elbow flexion is associated with wrist and finger flexion. This study aimed to assess the frequency of this association and the functional behavior of the limb. METHODS: Case-control study of 18 patients who underwent the Oberlin surgery. Group 1 included patients without disassociation of range of elbow flexion and that of the fingers and wrist; Group 2 included patients in whom this disassociation was present. In the functional evaluation, the Sollerman and DASH tests were used. RESULTS: It was observed that 38.89% of the patients did not present disassociation of elbow flexion with flexion of the wrist and fingers. Despite the existence of a favorable difference in the group with disassociation of the movement, when the Sollerman protocol was applied to the comparison between both groups, this difference was not statistically significant. With the DASH test, however, there was a statistically significant difference in favor of the group of patients who managed to disassociate the movement. CONCLUSION: The association of elbow flexion with flexion of the wrist and fingers, in the group studied, was shown to be a frequent event, which influenced the functional result of the affected limb.

  18. Evaluation of shoulder and elbow functions after treatment of humeral shaft fractures: a 20-132-month follow-up study.

    Science.gov (United States)

    Fırat, Ahmet; Deveci, Alper; Güler, Ferhat; Oçgüder, Ali; Oğuz, Temel; Bozkurt, Murat

    2012-01-01

    The aim of this study was to evaluate the long-term results of shoulder and elbow functions in humeral shaft fractures treated with functional brace, plate and screw osteosynthesis or intramedullary nailing. The study included 128 patients treated for humeral shaft fracture. The patients were divided into three groups according to treatment method: Group 1 (n=62) received functional brace, Group 2 (n=36) plate and screw osteosynthesis and Group 3 (n=30) intramedullary nailing. Coronal and sagittal humeral angulations were measured radiologically during the final follow-up. Shoulder and elbow functions were evaluated using the Constant shoulder score, the Mayo Elbow Performance Scoring and range of movement measurements. The mean follow-up time was 74 (range: 20 to 132) months. Mean Constant shoulder scores were 92.4 in Group 1, 85.6 in Group 2 and 74 in Group 3. A statistically significant difference was detected between the Constant shoulder scores of Groups 2 and 3 (p0.05). In the statistical evaluation of the Constant shoulder scores, a statistically significant difference was detected between the Constant scores of patients with a varus angulation greater than 20° and those with neutral alignment. Functional results of humeral shaft fractures treated with functional brace appear to be satisfactory. Varus and antecurvatum may affect shoulder and elbow function. In the presence of surgical indications, plate and screw fixation technique is the most effective method in terms of shoulder and elbow functions.

  19. The American Society of Shoulder and Elbow Therapists' consensus statement on rehabilitation following arthroscopic rotator cuff repair.

    Science.gov (United States)

    Thigpen, Charles A; Shaffer, Michael A; Gaunt, Bryce W; Leggin, Brian G; Williams, Gerald R; Wilcox, Reg B

    2016-04-01

    This is a consensus statement on rehabilitation developed by the American Society of Shoulder and Elbow Therapists. The purpose of this statement is to aid clinical decision making during the rehabilitation of patients after arthroscopic rotator cuff repair. The overarching philosophy of rehabilitation is centered on the principle of the gradual application of controlled stresses to the healing rotator cuff repair with consideration of rotator cuff tear size, tissue quality, and patient variables. This statement describes a rehabilitation framework that includes a 2-week period of strict immobilization and a staged introduction of protected, passive range of motion during weeks 2-6 postoperatively, followed by restoration of active range of motion, and then progressive strengthening beginning at postoperative week 12. When appropriate, rehabilitation continues with a functional progression for return to athletic or demanding work activities. This document represents the first consensus rehabilitation statement developed by a multidisciplinary society of international rehabilitation professionals specifically for the postoperative care of patients after arthroscopic rotator cuff repair. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  20. Clinical application of advances in elbow and forearm anatomy and biomechanics.

    Science.gov (United States)

    Zimmerman, Neal B

    2002-02-01

    The static and dynamic stabilizers of the elbow and forearm axis are closely interrelated in elbow and forearm unit motion and load handling. An [figure: see text] understanding of elbow and forearm anatomy is crucial to the surgeon evaluating and treating complex pathologies resulting from acute or remote trauma.

  1. Incidence and risk factors for the development of radiographic arthrosis after traumatic elbow injuries

    NARCIS (Netherlands)

    Guitton, Thierry G.; Zurakowski, David; van Dijk, Niek C.; Ring, David

    2010-01-01

    Radiographic arthrosis is a common sequela of elbow trauma. Few studies have addressed risk factors for radiographic arthrosis after elbow injury, especially in the long term. Data from multiple long-term follow-up studies of patients with surgically treated elbow fractures provided us with an

  2. Rehabilitation of the Overhead Athlete’s Elbow

    Science.gov (United States)

    Wilk, Kevin E.; Macrina, Leonard C.; Cain, E. Lyle; Dugas, Jeffrey R.; Andrews, James R.

    2012-01-01

    The activities required during overhead sports, particularly during baseball pitching, produce large forces at the elbow joint. Injuries to the elbow joint frequently occur in the overhead athlete because of the large amount of forces observed during the act of throwing, playing tennis, or playing golf. Injuries may result because of repetitive overuse, leading to tissue failure. Rehabilitation following injury or surgery to the throwing elbow is vital to fully restore normal function and return the athlete to competition as quickly and safely as possible. Rehabilitation of the elbow, whether following injury or postsurgical, must follow a progressive and sequential order, building on the previous phase, to ensure that healing tissues are not compromised. Emphasis is placed on restoring full motion, muscular strength, and neuromuscular control while gradually applying loads to healing tissue. In addition, when one is creating a rehabilitation plan for athletes, it is imperative to treat the entire upper extremity, core, and legs to create and dissipate the forces generated at each joint. PMID:23016113

  3. A review of national shoulder and elbow joint replacement registries

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe V; Olsen, Bo S; Fevang, Bjørg-Tilde S

    2012-01-01

    The aim was to review the funding, organization, data handling, outcome measurements, and findings from existing national shoulder and elbow joint replacement registries; to consider the possibility of pooling data between registries; and to consider wether a pan european registry might be feasible....

  4. The role of total elbow arthroplasty in traumatology.

    Science.gov (United States)

    Mansat, P; Bonnevialle, N; Rongières, M; Bonnevialle, P

    2014-10-01

    Fractures of the distal humerus account for 5% of osteoporotic fractures in subjects older than 60 years. A history of osteoporosis, co-morbidities, and joint comminution make their management difficult. The therapeutic options are limited to functional treatments, osteosynthesis, or either partial or total arthroplasty. Functional treatment of distal humerus fractures in the elderly subject provide inconsistent results, often with persistence of pain with a stiff or unstable elbow. Osteosynthesis remains the reference treatment for these fractures, following the principle of stable and rigid osteosynthesis allowing early mobilization. However, joint comminution and a history of osteoporosis occasionally make it impossible to meet this objective, with a considerable rate of complications and surgical revisions. Total elbow arthroplasty remains an alternative to osteosynthesis with very satisfactory immediate results restoring a painless, stable, and functional elbow. These results seem reproducible and sustainable over time. The complication rate is not uncommon with an approximately 10% surgical revision rate. Elbow hemiarthroplasty remains to be validated in this indication. V. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. Elbow joint stability following experimental osteoligamentous injury and reconstruction

    DEFF Research Database (Denmark)

    Deutch, Søren R; Jensen, Steen Lund; Tyrdal, Stein

    2003-01-01

    Elbow joint dislocation was simulated in cadaveric specimens to quantify laxity induced by radial head and coronoid process lesions, either alone or in combination with collateral ligament insufficiency. The effects of lateral ligament reconstruction and radial head prosthesis replacement were also...

  6. Radiographic and tomographic study of the elbow joint in dogs

    International Nuclear Information System (INIS)

    Sendyk-Grunkraut, Alessandra; Martin, Claudia M.; Souza, Alexandre N.A.; Patricio, Geni Cristina F.; Lorigados, Carla A.B.; Matera, Julia M.; Fonseca-Pinto, Ana C.B.C.

    2017-01-01

    Elbow dysplasia disease includes an united anconeal process, fragmented medial coronoid process, osteochondrosis of humeral trochlea, articular incongruity and degenerative joint disease. The aim of this study was to present detailed morphologic and morphometric aspects of the elbow joint in dog in clinical and correlate with radiographic and tomographic (CT) exam. Inter-observer variation for articular incongruity measurements by CT, comparative analysis in the radiographic exam, angle in ulnar notch and its comparative analysis between radiographic and tomographic agreement examination in 44 elbow of dogs with different ages were evaluated. The statistics analyses included the kappa coefficient and interclass correlation and Fischer's test and McNemar's test. It was evidenced that individual performance of each radiographic incidence had poor agreement with the tomographic exam, suggesting that the accomplishment of more than two radiograph views are needed. There was no agreement between the three evaluators in the ulnar notch angle at radiographic and tomographic exams. However, there was good/moderate agreement for articular incongruity measurement in the sagittal plane between evaluators. It was possible to conclude that none of the five radiographic incidences was better than the others for radiographic analysis because each incidence had a better identification of a particular elbow compartment; measurements at the tomographic exam to evaluate radioulnar incongruity had no reproductiveness in the frontal plane, but in sagittal plan had a good/moderate agreement between observers and the angle in ulnar notch presented no repeatability at radiographic exam and no reproductiveness at tomographic exam. (author)

  7. Static Progressive Orthoses for Elbow Contracture: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Bin Chen

    2017-01-01

    Full Text Available Background. As one of the most common musculoskeletal complications following trauma, elbow contracture is a frequent source of disabled daily activities. Conventional interventions are inadequate to provide favorable outcome. The static progressive orthoses are getting popular in the treatment of this problem. Objective. The purpose of this review was to assess the effectiveness of static progressive orthoses for elbow contracture. Methods. Literatures when written in English published during 1 January 1997 and 31 January 2017 were searched in the following databases: Web of Science, Cochrane Library, PubMed, and EBSCOhost. Articles are quality-assessed by two assessors, each article was summarized in evidence tables, and a narrative synthesis was also performed. Results. Ten clinical trials were included. The study design and outcome measures used varied. Significant immediate improvement in the range of motion was reported by all studies, and those effects were still significant at follow-up. No significant difference was shown between static progressive and dynamic orthoses for elbow contracture in one randomized control trial. Conclusions. Current low-quality evidence suggested that static progressive orthoses provided assistance for elbow contracture through improving range of motion. Further research is recommended using high-quality randomized controlled trials.

  8. Diagnosing ulnar neuropathy at the elbow using magnetic resonance neurography

    Energy Technology Data Exchange (ETDEWEB)

    Keen, Nayela N.; Chin, Cynthia T.; Saloner, David; Steinbach, Lynne S. [University of California San Francisco, Dept of Radiology and Biomedical Imaging, San Francisco, CA (United States); Engstrom, John W. [University of California San Francisco, Department of Neurology, San Francisco, CA (United States)

    2012-04-15

    Early diagnosis of ulnar neuropathy at the elbow is important. Magnetic resonance neurography (MRN) images peripheral nerves. We evaluated the usefulness of elbow MRN in diagnosing ulnar neuropathy at the elbow. The MR neurograms of 21 patients with ulnar neuropathy were reviewed retrospectively. MRN was performed prospectively on 10 normal volunteers. The MR neurograms included axial T1 and axial T2 fat-saturated and/or axial STIR sequences. The sensitivity and specificity of MRN in detecting ulnar neuropathy were determined. The mean ulnar nerve size in the symptomatic and normal groups was 0.12 and 0.06 cm{sup 2} (P < 0.001). The mean relative signal intensity in the symptomatic and normal groups was 2.7 and 1.4 (P < 0.01). When using a size of 0.08 cm{sup 2}, sensitivity was 95% and specificity was 80%. Ulnar nerve size and signal intensity were greater in patients with ulnar neuropathy. MRN is a useful test in evaluating ulnar neuropathy at the elbow. (orig.)

  9. Nontyphoidal Salmonella Septic arthritis of the elbow in a healthy ...

    African Journals Online (AJOL)

    A case of rarely encountered nontyphoidal Salmonella septic arthritis of the elbow in an infant with no preexisting disease is reported. Salmonella etiology was not suspected in this case, and the diagnosis was made only after bacterial isolation. Aspiration of the infected joint with radiological guidance initially failed to give a ...

  10. Comparison of two classification protocols in the evaluation of elbow dysplasia in the dog

    International Nuclear Information System (INIS)

    Lang, J.; Busato, A.; Baumgartner, D.; Fluckiger, M.; Weber, U.T.

    1998-01-01

    The incidence of elbow disease based solely on arthrosis (ARTH) score was compared with a protocol using a combination of ARTH score plus a score for primary lesions (ED score). The population of dogs studied included 425 Bernese mountain dogs and 22 dogs of other breeds. The overall agreement between the two systems was high. However, 12 per cent of ARTH-score negative cases were positive using the ED score. This difference was statistically significant (P < 0.005). The female:male ratio of the dogs missed using the ARTH score was 2:1. The proportion of dogs affected with arthrosis increased with age, male dogs being affected more frequently. The development of arthrosis depends not only on age and breed, but probably also on gender. Thus, screening for elbow dysplasia should be based on at least two radiographic projections, including arthrosis and primary lesions. As the vast majority of dogs in this study were Bernese mountain dogs, conclusions are valid only for this breed

  11. A Study on the Effect of Applying Cast Splints in Treatment of Tennis Elbow

    Directory of Open Access Journals (Sweden)

    A Zarezadeh

    2004-02-01

    Full Text Available Background: Tennis elbow is a common orthopedic disease affecting elbow in middle aged people. Ninety percent of patients are cured using conservative treatments. In the past, emphasis was placed on the use of long arm splints for its treatment; however, recent studies put doubt on the use of this method of treatment for the complications arising from the application of splints. The results of using long arm splints for the treatment of Methods: This was a case series non randomized clinical trial involving 25 patients treated with long arm castsplints, and 25 patients treated without the use of splint. Local corticosteroid injections and oral NSAIDs were administered for all patients. The two groups were compared in the third week, third month and sixth month of their treatment for the presence of local tenderness and pain in passive flexion test of wrist and fingers against resistance. Using SPSS 9.0, data were analyzed via repeated measurements test of ANOVA Results: Patients in case and control groups had mean ages 43.6 ± 7.2 and 43.6 ± 6 years, respectively. Prior to any treatments, all patients in this study suffered from pain and tenderness in the origin of forearm extensor muscles. Their pain exacerbated upon passive flexion of wrist and fingers against resistance. No significant difference was seen in third week, third month and sixth month (P value =0.32, and no significant difference was seen in the results of our tests regarding the presence of local tenderness and pain in passive flexion of wrist and fingers against resistance between the two groups Conclusions: After a follow-up period of six months, this study demonstrated no statistically significant difference between the two groups treated with and without long arm splints. Keywords: Tennis elbow, Conservative treatment, Laterals epicondylitis, Cast splint

  12. Combined hyperextension and supination of the elbow joint induces lateral ligament lesions. An experimental study of the pathoanatomy and kinematics in elbow ligament injuries

    DEFF Research Database (Denmark)

    Tyrdal, Stein; Olsen, Bo Sanderhoff

    1998-01-01

    An epidemiological study suggested that the injury mechanism of 'handball goalie's elbow' may be hyperextension. The pathomechanics of hyperextension combined with supination was studied in ten macroscopically normal, male, cadaveric elbow joint specimens. The age of the donors was 28.8 years...... rupture of the lateral collateral ligament. The lesions indicate that combined hyperextension and supination represent a possible mechanism leading to 'handball goalie's elbow'....

  13. The Elbow Self-Assessment Score (ESAS): development and validation of a new patient-reported outcome measurement tool for elbow disorders.

    Science.gov (United States)

    Beirer, Marc; Friese, Henrik; Lenich, Andreas; Crönlein, Moritz; Sandmann, Gunther H; Biberthaler, Peter; Kirchhoff, Chlodwig; Siebenlist, Sebastian

    2017-07-01

    To develop and validate an elbow self-assessment score considering subjective as well as objective parameters. Each scale of the American Shoulder and Elbow Surgeons-Elbow Score, the Broberg and Morrey rating system (BMS), the Patient-Rated Elbow Evaluation (PREE) Questionnaire, the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES) and the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) was analysed, and after matching of the general topics, the dedicated items underwent a fusion to the final ESAS's item and a score containing 22 items was created. In a prospective clinical study, validity, reliability and responsiveness in physically active patients with traumatic as well as degenerative elbow disorders were evaluated. Validation study included 103 patients (48 women, 55 men; mean age 43 years). A high test-retest reliability was found with intraclass correlation coefficients of at least 0.71. Construct validity and responsiveness were confirmed by correlation coefficients of -0.80 to -0.84 and 0.72-0.84 (p Self-Assessment Score (ESAS), a valid and reliable instrument for a qualitative self-assessment of subjective and objective parameters (e.g. range of motion) of the elbow joint is demonstrated. Quantitative measurement of elbow function may not longer be limited to specific elbow disorders or patient groups. The ESAS seems to allow for a broad application in clinical research studying elbow patients and may facilitate the comparison of treatment results in elbow disorders. The treatment efficacy can be easily evaluated, and treatment concepts could be reviewed and revised. Diagnostic study, Level III.

  14. Immobilization in external rotation combined with abduction reduces the risk of recurrence after primary anterior shoulder dislocation.

    Science.gov (United States)

    Heidari, Kamran; Asadollahi, Shadi; Vafaee, Reza; Barfehei, Abbas; Kamalifar, Hossein; Chaboksavar, Zein Alabedin; Sabbaghi, Mohammad

    2014-06-01

    We aimed to compare the effectiveness of immobilization in abduction and external rotation vs immobilization in adduction and internal rotation after primary anterior dislocation of the shoulder. The study randomized 102 patients (age range, 15-55 years) with the diagnosis of primary anterior dislocation of the shoulder to receive immobilization in adduction and internal rotation (AdIR, n = 51) using sling and swathe bandage or immobilization in abduction and external rotation (AbER, n = 51) with a stabilizer brace. Patients received a rehabilitation program 3 weeks after the intervention. After a 24-month follow-up, 33.3% in the AdIR group and 3.9% in the AbER group had recurrence (P patients in the AbER group (19.6%) and 3 in the AdIR group (5.8%) discontinued shoulder immobilization before 3 weeks (P = .03). In patients without recurrence, the anterior apprehension test was positive in 6 of 34 in the AdIR group (17.6%) and in 4 of 49 in the AbER group (8.1%, P = .19). Immobilization with the shoulder joint in abduction and external rotation is an effective method to reduce the risk of recurrence after primary anterior shoulder dislocations and should be preferred to the traditional method of immobilization in adduction and internal rotation in clinical practice. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  15. Analysis of results of surgical treatment of posttraumatic stiff elbow

    Directory of Open Access Journals (Sweden)

    Rex Chandrabose

    2008-01-01

    Full Text Available Background: Surgical management of posttraumatic elbow stiffness has been reported with poor outcome following treatment. Sequential release in earlier stages of stiffness yielded much better results. The goal of our study was to assess the outcome in improvement of the range of motion of the elbow after surgical release and to analyze a tailor-made approach according to individual needs to yield good result. Materials and Methods: A prospective study was conducted in 47 cases of elbow stiffness due to various types of injuries. All the cases were treated with sequential release if there was no progress after adequate supervised conservative management except in unreduced dislocations. All the cases were followed up for a minimum period of 24 months. Overall outcome was rated with the functional scoring system by Mayo Clinic Performance Index. Results: Twenty-five (44.68% out of 47 patients had excellent results with a mean preoperative range of motion of 33.9° and postoperative range of motion of 105° with net gain in range of motion of 71.1° (′ t ′ test value is 19.27, P < 0.01. None of the patients had elbow instability. Patients not having heterotopic ossification, who underwent surgery from three to six months post injury had a mean gain of 73.5°. In patients who waited for more than six months had mean gain of 66.8°. However, the results in cases having heterotopic ossification followed a slightly different pattern. In cases where release was performed from three months to six months had mean gain of 77.5°. Cases in which release was performed after six months had gain of 57.1°. Conclusions: In cases of posttraumatic elbow stiffness after a failed initial conservative treatment, early arthrolysis with sequential surgical soft tissue release yields good result than delayed surgery.

  16. Early results of surgical intervention for elbow deformity in cerebral palsy based on degree of contracture.

    Science.gov (United States)

    Carlson, Michelle G; Hearns, Krystle A; Inkellis, Elizabeth; Leach, Michelle E

    2012-08-01

    Elbow flexion posture, caused by spasticity of the muscles on the anterior surface of the elbow, is the most common elbow deformity seen in patients with cerebral palsy. This study retrospectively evaluated early results of 2 surgical interventions for elbow flexion deformities based on degree of contracture. We hypothesized that by guiding surgical treatment to degree of preoperative contracture, elbow extension and flexion posture angle at ambulation could be improved while preserving maximum flexion. Eighty-six patients (90 elbows) were treated for elbow spasticity due to cerebral palsy. Seventy-one patients (74 elbows) were available for follow-up. Fifty-seven patients with fixed elbow contractures less than 45° were surgically treated with a partial elbow muscle lengthening, which included partial lengthening of the biceps and brachialis and proximal release of the brachioradialis. Fourteen patients (17 elbows) with fixed elbow contractures ≥ 45° had a more extensive full elbow release, with biceps z-lengthening, partial brachialis myotomy, and brachioradialis proximal release. Age at surgery averaged 10 years (range, 3-20 y) for partial lengthening and 14 years (range, 5-20 y) for full elbow release. Follow-up averaged 22 months (range, 7-144 mo) for partial lengthening and 18 months (range, 6-51 mo) for full elbow release. Both groups achieved meaningful improvement in flexion posture angle at ambulation, active and passive extension, and total range of motion. Elbow flexion posture angle at ambulation improved by 57° and active extension increased 17° in the partial lengthening group, with a 4° loss of active flexion. In the full elbow release group, elbow flexion posture angle at ambulation improved 51° and active extension improved 38°, with a loss of 19° of active flexion. Surgical treatment of spastic elbow flexion in cerebral palsy can improve deformity. We obtained excellent results by guiding the surgical intervention by the amount of

  17. On the Efficacy of Isolating Shoulder and Elbow Movements with a Soft, Portable, and Wearable Robotic Device

    Science.gov (United States)

    Kadivar, Zahra; Beck, Christopher E.; Rovekamp, Roger N.; O'Malley, Marcia K.; Joyce, Charles A.

    2016-01-01

    Treatment intensity has a profound effect on motor recovery following neurological injury. The use of robotics has potential to automate these labor-intensive therapy procedures that are typically performed by physical therapists. Further, the use of wearable robotics offers an aspect of portability that may allow for rehabilitation outside the clinic. The authors have developed a soft, portable, lightweight upper extremity wearable robotic device to provide motor rehabilitation of patients with affected upper limbs due to traumatic brain injury (TBI). A key feature of the device demonstrated in this paper is the isolation of shoulder and elbow movements necessary for effective rehabilitation interventions. Herein is presented a feasibility study with one subject and demonstration of the device's ability to provide safe, comfortable, and controlled upper extremity movements. Moreover, it is shown that by decoupling shoulder and elbow motions, desired isolated joint actuation can be achieved.

  18. Focused and Radial Shock Wave Therapy in the Treatment of Tennis Elbow: A Pilot Randomised Controlled Study

    Directory of Open Access Journals (Sweden)

    Król Piotr

    2015-09-01

    Full Text Available The purpose of this article was to evaluate and compare the efficacy of radial and focused shock wave therapies applied to treat tennis elbow. Patients with tennis elbow were randomized into two comparative groups: focused shock wave therapy (FSWT; n=25 and radial shock wave therapy (RSWT; n=25. Subjects in the FSWT and RSWT groups were applied with a focused shock wave (3 sessions, 2000 shocks, 4 Hz, 0.2 mJ/mm2 and a radial shock wave (3 sessions, 2000 + 2000 shocks, 8 Hz, 2.5 bar, respectively. The primary study endpoints were pain relief and functional improvement (muscle strength one week after therapy. The secondary endpoint consisted of the results of the follow-up observation (3, 6 and 12 weeks after the study. Successive measurements showed that the amount of pain patients felt decreased in both groups. At the same time grip strength as well as strength of wrist extensors and flexors of the affected extremity improved significantly. Both focused and radial shock wave therapies can comparably and gradually reduce pain in subjects with tennis elbow. This process is accompanied by steadily improved strength of the affected extremity.

  19. The Snapping Elbow Syndrome as a Reason for Chronic Elbow Neuralgia in a Tennis Player - MR, US and Sonoelastography Evaluation.

    Science.gov (United States)

    Łasecki, Mateusz; Olchowy, Cyprian; Pawluś, Aleksander; Zaleska-Dorobisz, Urszula

    2014-01-01

    Ulnar neuropathy is the second most common peripheral nerve neuropathy after median neuropathy, with an incidence of 25 cases per 100 000 men and 19 cases per 100 000 women each year. Skipping (snapping) elbow syndrome is an uncommon cause of pain in the posterior-medial elbow area, sometimes complicated by injury of the ulnar nerve. One of the reason is the dislocation of the abnormal insertion of the medial triceps head over the medial epicondyle during flexion and extension movements. Others are: lack of the Osboune fascia leading to ulnar nerve instability and focal soft tissue tumors (fibromas, lipomas, etc). Recurrent subluxation of the nerve at the elbow results in a tractional and frictional neuritis with classical symptoms of peripheral neuralgia. As far as we know snapping triceps syndrome had never been evaluated in sonoelastography. A 28yo semi-professional left handed tennis player was complaining about pain in posterior-medial elbow area. Initial US examination suggest golfers elbow syndrome which occurs quite commonly and has a prevalence of 0.3-0.6% in males and 0-3-1.1% in women and may be associated (approx. 50% of cases) with ulnar neuropathy. However subsequently made MRI revealed unusual distal triceps anatomy, moderate ulnar nerve swelling and lack of medial epicondylitis symptoms. Followed (second) US examination and sonoelastography have detected slipping of the both ulnar nerve and the additional band of the medial triceps head. Snapping elbow syndrome is a poorly known medical condition, sometimes misdiagnosed as the medial epicondylitis. It describes a broad range of pathologies and anatomical abnormalities. One of the most often reasons is the slipping of the ulnar nerve as the result of the Osborne fascia/anconeus epitrochlearis muscle absence. Simultaneously presence of two or more "snapping reasons" is rare but should be always taken under consideration. There are no sonoelastography studies describing golfers elbow syndrome

  20. Experimental measurement of flexion-extension movement in normal and corpse prosthetic elbow joint.

    Science.gov (United States)

    TarniŢă, Daniela; TarniŢă, DănuŢ Nicolae

    2016-01-01

    This paper presents a comparative experimental study of flexion-extension movement in healthy elbow and in the prosthetic elbow joint fixed on an original experimental bench. Measurements were carried out in order to validate the functional morphology and a new elbow prosthesis type ball head. The three-dimensional (3D) model and the physical prototype of our experimental bench used to test elbow endoprosthesis at flexion-extension and pronation-supination movements is presented. The measurements were carried out on a group of nine healthy subjects and on the prosthetic corpse elbow, the experimental data being obtained for flexion-extension movement cycles. Experimental data for the two different flexion-extension tests for the nine subjects and for the corpse prosthetic elbow were acquired using SimiMotion video system. Experimental data were processed statistically. The corresponding graphs were obtained for all subjects in the experimental group, and for corpse prosthetic elbow for both flexion-extension tests. The statistical analysis has proved that the flexion angles of healthy elbows were significantly close to the values measured at the prosthetic elbow fixed on the experimental bench. The studied elbow prosthesis manages to re-establish the mobility for the elbow joint as close to the normal one.

  1. Immobilized yeast in bioreactor for alcohol fermentation

    International Nuclear Information System (INIS)

    Handy, M.K.; Kim, K.

    1986-01-01

    Mutant of Saccharomyces cerevisiae was developed using a Co-60 source. Cells were immobilized onto sterile, channeled alumina beads and packed into bioreactor column under controlled temperature. Feedstocks containing substrate and nutrients were fed into the bioreactor at specific rates. Beads with greatest porosity and surface area produced the most ethanol. Factors affecting ethanol productivity included: temperature, pH, flow rate, nutrients and substrate in the feedstock

  2. Influence of Immobilization Time on Functional Outcome in Radial Neck Fractures in Children.

    Science.gov (United States)

    Badoi, Adina; Frech-Dörfler, Martina; Häcker, Frank-Martin; Mayr, Johannes

    2016-12-01

    Background  Radial neck fractures represent 20 to 30% of elbow fractures in children. Incorrect treatment can lead to significant permanent functional impairment. Posttraumatic avascular necrosis may cause a deformity of the radial head and neck. Deformation of the radial head and neck can be more severe after open rather than closed reduction or orthopedic treatment without reduction. The aim of our study was to analyze the influence of immobilization time on functional outcome. Patients and Methods  Retrospective, descriptive study of all children who had been treated for a radial neck fracture between 1999 and 2013 at the University Children's Hospital Basel. Patients were allocated to two groups (group 1: patients treated between 1999 and 2008, group 2: patients treated between 2009 and 2013). The fractures were classified according to the classification of Metaizeau. The primary endpoint was the percentage of patients who reached the full range of elbow motion at the end of the treatment period or the last follow-up. Secondary endpoints were immobilization time and number of patients with persistent physical restrictions of the elbow range of motion as well as the type of restrictions and subjective complaints. Results  A total of 67 patients treated for radial neck fracture were included in the first group (1999-2008). A total of 47 patients were allocated to the second group (2009-2013). Overall, 59 patients in group 1 and 39 patients in group 2 were treated nonoperatively. Average immobilization time was 22.7 days (range, 6-60 days) in group 1 and 13.2 days (range, 0-27 days) in group 2. Full range of motion was observed in 50 to 72.7% of patients in group 1 and in 71.4 to 92% of patients in group 2, depending on the grade of fracture displacement. Overall, 21 patients (31%) of group 1 showed a persistent functional restriction. In group 2, only six patients (12%) suffered from a persistent functional restriction of the elbow range of motion

  3. Magnetic resonance imaging of the elbow. Part I: Normal anatomy, imaging technique, and osseous abnormalities

    International Nuclear Information System (INIS)

    Kijowski, Richard; Tuite, Michael; Sanford, Matthew

    2004-01-01

    Part I of this comprehensive review on magnetic resonance imaging of the elbow discusses normal elbow anatomy and the technical factors involved in obtaining high-quality magnetic resonance images of the elbow. Part I also discusses the role of magnetic resonance imaging in evaluating patients with osseous abnormalities of the elbow. With proper patient positioning and imaging technique, magnetic resonance imaging can yield high-quality multiplanar images which are useful in evaluating the osseous structures of the elbow. Magnetic resonance imaging can detect early osteochondritis dissecans of the capitellum and can be used to evaluate the size, location, stability, and viability of the osteochondritis dissecans fragment. Magnetic resonance imaging can detect early stress injury to the proximal ulna in athletes. Magnetic resonance imaging can detect radiographically occult fractures of the elbow in both children and adults. Magnetic resonance imaging is also useful in children to further evaluate elbow fractures which are detected on plain-film radiographs. (orig.)

  4. Phase-II Clinical Validation of a Powered Exoskeleton for the Treatment of Elbow Spasticity.

    Science.gov (United States)

    Crea, Simona; Cempini, Marco; Mazzoleni, Stefano; Carrozza, Maria Chiara; Posteraro, Federico; Vitiello, Nicola

    2017-01-01

    Introduction: Spasticity is a typical motor disorder in patients affected by stroke. Typically post-stroke rehabilitation consists of repetition of mobilization exercises on impaired limbs, aimed to reduce muscle hypertonia and mitigate spastic reflexes. It is currently strongly debated if the treatment's effectiveness improves with the timeliness of its adoption; in particular, starting intensive rehabilitation as close as possible to the stroke event may counteract the growth and postpone the onset of spasticity. In this paper we present a phase-II clinical validation of a robotic exoskeleton in treating subacute post-stroke patients. Methods: Seventeen post-stroke patients participated in 10 daily rehabilitation sessions using the NEUROExos Elbow Module exoskeleton, each one lasting 45 min: the exercises consisted of isokinetic passive mobilization of the elbow, with torque threshold to detect excessive user's resistance to the movement. We investigated the safety by reporting possible adverse events, such as mechanical, electrical or software failures of the device or injuries or pain experienced by the patient. As regards the efficacy , the Modified Ashworth Scale, was identified as primary outcome measure and the NEEM metrics describing elbow joint resistance to passive extension (i.e., maximum extension torque and zero-torque angle) as secondary outcomes. Results: During the entire duration of the treatments no failures or adverse events for the patients were reported. No statistically significant differences were found in the Modified Ashworth Scale scores, between pre-treatment and post-treatment and between post-treatment and follow-up sessions, indicating the absence of spasticity increase throughout (14 days) and after (3-4 months follow-up) the treatment. Exoskeleton metrics confirmed the absence of significant difference in between pre- and post-treatment data, whereas intra-session data highlighted significant differences in the secondary outcomes

  5. Phase-II Clinical Validation of a Powered Exoskeleton for the Treatment of Elbow Spasticity

    Directory of Open Access Journals (Sweden)

    Simona Crea

    2017-05-01

    Full Text Available Introduction: Spasticity is a typical motor disorder in patients affected by stroke. Typically post-stroke rehabilitation consists of repetition of mobilization exercises on impaired limbs, aimed to reduce muscle hypertonia and mitigate spastic reflexes. It is currently strongly debated if the treatment's effectiveness improves with the timeliness of its adoption; in particular, starting intensive rehabilitation as close as possible to the stroke event may counteract the growth and postpone the onset of spasticity. In this paper we present a phase-II clinical validation of a robotic exoskeleton in treating subacute post-stroke patients.Methods: Seventeen post-stroke patients participated in 10 daily rehabilitation sessions using the NEUROExos Elbow Module exoskeleton, each one lasting 45 min: the exercises consisted of isokinetic passive mobilization of the elbow, with torque threshold to detect excessive user's resistance to the movement. We investigated the safety by reporting possible adverse events, such as mechanical, electrical or software failures of the device or injuries or pain experienced by the patient. As regards the efficacy, the Modified Ashworth Scale, was identified as primary outcome measure and the NEEM metrics describing elbow joint resistance to passive extension (i.e., maximum extension torque and zero-torque angle as secondary outcomes.Results: During the entire duration of the treatments no failures or adverse events for the patients were reported. No statistically significant differences were found in the Modified Ashworth Scale scores, between pre-treatment and post-treatment and between post-treatment and follow-up sessions, indicating the absence of spasticity increase throughout (14 days and after (3–4 months follow-up the treatment. Exoskeleton metrics confirmed the absence of significant difference in between pre- and post-treatment data, whereas intra-session data highlighted significant differences in the

  6. Uranium Immobilization in Wetland Soils

    Science.gov (United States)

    Jaffe, Peter R.; Koster van Groos, Paul G.; Li, Dien; Chang, Hyun-Shik; Seaman, John C.; Kaplan, Daniel I.; Peacock, Aaron D.; Scheckel, Kirk

    2014-05-01

    In wetlands, which are a major feature at the groundwater-surface water interface, plants deliver oxygen to the subsurface to keep root tissue aerobic. Some of this oxygen leaches into the rhizosphere where it will oxidize iron that typically precipitates on or near roots. Furthermore, plans provide carbon via root exudates and turnover, which in the presence of the iron oxides drives the activity of heterotrophic iron reducers in wetland soils. Oxidized iron is an important electron acceptor for many microbially-driven transformations, which can affect the fate and transport of several pollutants. It has been shown that heterotrophic iron reducing organisms, such as Geobacter sp., can reduce water soluble U(VI) to insoluble U(IV). The goal of this study was to determine if and how iron cycling in the wetland rhizosphere affects uranium dynamics. For this purpose, we operated a series of small-scale wetland mesocosms in a greenhouse to simulate the discharge of uranium-contaminated groundwater to surface waters. The mesocosms were operated with two different Fe(II) loading rates, two plant types, and unplanted controls. The mesocosms contained zones of root exclusion to differentiate between the direct presence and absence of roots in the planted mesocosms. The mesocosms were operated for several month to get fully established, after which a U(VI) solution was fed for 80 days. The mesocosms were then sacrificed and analyzed for solid-associated chemical species, microbiological characterization, micro-X-ray florescence (µ-XRF) mapping of Fe and U on the root surface, and U speciation via X-ray Absorption Near Edge Structure (XANES). Results showed that bacterial numbers including Geobacter sp., Fe(III), as well as total uranium, were highest on roots, followed by sediments near roots, and lowest in zones without much root influence. Results from the µ-XRF mapping on root surfaces indicated a strong spatial correlation between Fe and U. This correlation was

  7. Immobilization of enzymes by radiation

    International Nuclear Information System (INIS)

    Kaetsu, I.; Kumakura, M.; Yoshida, M.; Asano, M.; Himei, M.; Tamura, M.; Hayashi, K.

    1979-01-01

    Immobilization of various enzymes was performed by radiation-induced polymerization of glass-forming monomers at low temperatures. Alpha-amylase and glucoamylase were effectively immobilized in hydrophilic polymer carrier such as poly(2-hydroxyethyl methacrylate) and also in rather hydrophobic carrier such as poly(tetraethylene-glycol diacrylate). Immobilized human hemoglobin underwent the reversible oxygenation concomitantly with change of oxygen concentration outside of the matrices. (author)

  8. Effects of immobilization on spermiogenesis

    Science.gov (United States)

    Meitner, E. R.

    1980-01-01

    The influence of immobilization stress on spermiogenesis in rats was investigated. After 96 hour immobilization, histological changes began to manifest themselves in the form of practically complete disappearance of cell population of the wall of seminiferous tubule as well as a markedly increased number of cells with pathologic mitoses. Enzymological investigations showed various changes of activity (of acid and alkaline phosphatase and nonspecific esterase) in the 24, 48, and 96 hour immobilization groups.

  9. Does radiographic arthrosis correlate with cartilage pathology in Labrador Retrievers affected by medial coronoid process disease?

    Science.gov (United States)

    Farrell, Michael; Heller, Jane; Solano, Miguel; Fitzpatrick, Noel; Sparrow, Tim; Kowaleski, Mike

    2014-02-01

    To compare radiographic elbow arthrosis with arthroscopic cartilage pathology in Labrador retrievers with elbow osteoarthritis secondary to medial coronoid process (MCP) disease. Retrospective epidemiological study. Labrador retrievers (n = 317; 592 elbow joints). Data were collected retrospectively (June 2007-June 2011) to identify Labrador retrievers with thoracic limb lameness and elbow pain, a complete set of elbow radiographs, and a comprehensive arthroscopic surgery report. Each radiograph was scored for osteophytosis on the anconeal process and ulnar subtrochlear sclerosis using a modification of the International Elbow Working Group (IEWG) scoring system. Elbows affected by traumatic MCP fracture, humeral condylar osteochondrosis, or ununited anconeal process were excluded. The arthroscopic report was used to generate a composite cartilage score (CCS; 0 = normal, 1 = mild, 2 = moderate, 3 = severe) for each elbow joint. Ordinal regression analysis was performed to test the relationship between radiographic arthrosis score and CCS. There was a significant relationship between radiographic elbow arthrosis and CCS (P arthrosis can be used to predict the severity of arthroscopic cartilage pathology in Labrador retrievers affected by MCP disease. © Copyright 2014 by The American College of Veterinary Surgeons.

  10. A study of stress distribution in elbows mounted on stanchions

    International Nuclear Information System (INIS)

    Basavanhally, N.R.; Tonet, N.

    1983-01-01

    It is a common practice, both in the nuclear and power piping industry, to have integral attachments on piping to either form a restraint or an anchor. For small attachments, such as lugs, one can use the readily available methods (eg., ASME Code Case N-318) to evaluate the local stresses at these attachments. For elbows or curved pipes mounted on stanchions, the evaluation of local stresses is more complex. In the present analysis, a 3D finite element model was implemented to determine the stress intensification factor that can be applied to piping stress under internal pressure and in-plane bending type of loads. The analysis indicates that, for an internal pressure load, in-plane bending is generated. For such supports, a stress intensification factor should be used to account for the increased loads. The results also indicate that there is an optimum elbow to stanchion post radius ratio which should be used in designing such supports. (orig.)

  11. Bimanual elbow exoskeleton: Force based protocol and rehabilitation quantification.

    Science.gov (United States)

    Alavi, N; Herrnstadt, G; Randhawa, B K; Boyd, L A; Menon, C

    2015-08-01

    An aging population, along with the increase in cardiovascular disease incidence that accompanies this demographic shift, is likely to increase both the economic and medical burden associated with stroke in western societies. Rehabilitation, the standard treatment for stroke, can be expanded and augmented with state of the art technologies, such as robotic therapy. This paper expands upon a recent work involving a force-feedback master-slave bimanual exoskeleton for elbow rehabilitation, named a Bimanual Wearable Robotic Device (BWRD). Elbow force data acquired during the execution of custom tasks is analyzed to demonstrate the feasibility of tracking patient progress. Two training tasks that focus on applied forces are examined. The first is called "slave arm follow", which uses the absolute angular impulse as a metric; the second is called "conditional arm static", which uses the rise time to target as a metric, both presented here. The outcomes of these metrics are observed over three days.

  12. Portal placement in elbow arthroscopy by novice surgeons: cadaver study.

    Science.gov (United States)

    Claessen, Femke M A P; Kachooei, Amir R; Kolovich, Gregory P; Buijze, Geert A; Oh, Luke S; van den Bekerom, Michel P J; Doornberg, Job N

    2017-07-01

    In this anatomical cadaver study, the distance between major nerves and ligaments at risk for injury and portal sites created by trainees was measured. Trainees, inexperienced in elbow arthroscopy, have received a didactic lecture and cadaver instruction prior to portal placement. The incidence of iatrogenic injury from novice portal placement was also determined. Anterolateral, direct lateral, and anteromedial arthroscopic portals were created in ten cadavers by ten inexperienced trainees in elbow arthroscopy. After creating each portal, the trajectory of the portal was marked with a guide pin. Subsequently, the cadavers were dissected and the distances between the guide pin in the anterolateral, direct lateral, and anteromedial portals and important ligaments and nerves were measured. The difference between the distance of the direct lateral portal and the posterior antebrachial cutaneous nerve (PABCN) (22 mm, p cadaver instruction session alone. Level of evidence V.

  13. Comparison between two models of elbow rehabilitation equipment

    Directory of Open Access Journals (Sweden)

    Vetrice Georgiana

    2017-01-01

    Full Text Available International studies have revealed that using continuous passive motion (CPM equipment as part of a rehabilitation program improves the recovery period and also diminishes the rehabilitation costs by about 50%. This explains the need for conceiving elbow joint rehabilitation equipment to help persons suffering from posttraumatic disabilities. In order to create the best model to meet the patients’ requirements this paper presents two constructive solutions of such equipment and a comparison between their designs. Both achieve the desired movements of the elbow joint: flexion-extension and pronation-supination and are actuated by pneumatic muscles, due to the multiple advantages of pneumatic actuation: low cost, compliance and favorable response to commands.

  14. Biodegradation of chlorobenzene using immobilized crude extracts ...

    African Journals Online (AJOL)

    SERVER

    2007-10-04

    Oct 4, 2007 ... immobilized crude extracts were reused for all other experiments and found that immobilization .... India which are of analytical reagent grade. .... 9. 60. 3. 1. Figure 3. Degradation of chlorobenzene by immobilized crude.

  15. Supramolecular protein immobilization on lipid bilayers

    NARCIS (Netherlands)

    Bosmans, R.P.G.; Hendriksen, W.E.; Verheijden, Mark Lloyd; Eelkema, R.; Jonkheijm, Pascal; van Esch, J.H.; Brunsveld, Luc

    2015-01-01

    Protein immobilization on surfaces, and on lipid bilayers specifically, has great potential in biomolecular and biotechnological research. Of current special interest is the immobilization of proteins using supramolecular noncovalent interactions. This allows for a reversible immobilization and

  16. Iodine immobilization in apatites

    International Nuclear Information System (INIS)

    Audubert, F.; Lartigue, J.E.

    2000-01-01

    In the context of a scientific program on long-lived radionuclide conditioning, a matrix for iodine 129 immobilization has been studied. A lead vanado-phosphate apatite was prepared from the melt of lead vanado-phosphate Pb 3 (VO 4 ) 1.6 (PO 4 ) 0.4 and lead iodide PbI 2 in stoichiometric proportions by calcination at 700 deg. C during 3 hours. Natural sintering of this apatite is not possible because the product decomposition occurs at 400 deg. C. Reactive sintering is the solution. The principle depends on the coating of lead iodide with lead vanado-phosphate. Lead vanado-phosphate coating is used as iodo-apatite reactant and as dense covering to confine iodine during synthesis. So the best condition to immobilize iodine during iodo-apatite synthesis is a reactive sintering at 700 deg. C under 25 MPa. We obtained an iodo-apatite surrounded with dense lead vanadate. Leaching behaviour of the matrix synthesized by solid-solid reaction is under progress in order to determine chemical durability, basic mechanisms of the iodo-apatite alteration and kinetic rate law. Iodo-apatite dissolution rates were pH and temperature dependent. We obtained a rate of 2.5 10 -3 g.m -2 .d -1 at 90 deg. C in initially de-ionised water. (authors)

  17. Ligamentous and capsular restraints to experimental posterior elbow joint dislocation

    DEFF Research Database (Denmark)

    Deutch, S.R.; Olsen, B.S.; Jensen, S.L.

    2003-01-01

    the anterior capsule and the lateral collateral ligament complex (LCLC), whereas in the flexed elbow the anterior capsule did not have a stabilizing effect. In flexed joint positions, the LCLC seems to be the only immediate stabilizer against PEFR, and thereby against posterolateral instability and possibly...... against posterior dislocation. The medial collateral ligament did not have any immediate stabilizing effect, but it prevented the final step of the posterior dislocation....

  18. Myofibroblast Numbers are Elevated in Human Elbow Capsules After Trauma

    OpenAIRE

    Hildebrand, Kevin A.; Zhang, Mei; van Snellenberg, Wistara; King, Graham J. W.; Hart, David A.

    2004-01-01

    Elbow contractures, a frequent problem after injury, can be treated by excision of the joint capsule. However, the underlying changes in the joint capsule are poorly understood. Based on skin healing work, we examined the hypotheses that myofibroblast numbers and expression of a myofibroblast marker α-smooth muscle actin, are elevated in patients with posttraumatic joint contractures. Anterior capsules were obtained from six patients who had operative release of posttraumatic contractures gre...

  19. Stress indices and flexibility factors in thin elbows

    International Nuclear Information System (INIS)

    Berton, M.N.; Carbonnier, J.L.

    1983-01-01

    Usually piping calculations are done with a beam model. Ovalisation in elbows is taken into account by the means of flexibility factors and stress indices. This paper compares results from a beam model calculation with results from a 3 D shell model calculation. (codes TEDEL and TRICO from the CEA-SEMT System). The aim of this comparison is to study the validity of the stress indices and flexibility factors used in the beam model for several kinds of loading

  20. Inelastic analysis of Battelle-Columbus piping elbow creep test

    International Nuclear Information System (INIS)

    Dhalla, A.K.; Newman, S.Z.

    1979-01-01

    Analytical results are presented for room temperature and 593 deg. C creep bending deformation of a piping elbow structure tested at the Battelle-Columbus Laboratory. This analysis was performed in support of the International Piping Benchmark Problem Program being coordinated by ORNL. Results are presented for both simplified and refined structural models, and compared with test measurements reported by the Battelle-Columbus Laboratory. (author)

  1. Direct magnetic resonance arthrography of the canine elbow

    Directory of Open Access Journals (Sweden)

    Yauheni Zhalniarovich

    2017-01-01

    Full Text Available This study compares the effects of four dilutions of the gadolinium-containing contrast media (1:100; 1:400; 1:800; 1:1,200 administered to the elbow on the quality of magnetic resonance images. All the examined dilutions had a positive effect on image quality, and 1:800 was regarded as the optimal dilution of gadolinium for viewing the elbow because it imparted good contrast to the joint cavity without obliterating the contours of articular surfaces. Transverse, sagittal, and dorsal low-field magnetic resonance images were obtained in 24 canine cadaver front limbs. The musculus biceps brachii, m. triceps brachii, m. extensor carpi radialis, m. flexor carpi ulnaris, the articular surfaces, the medial coronoid process and the anconeal process of the ulna were well visualized by High Resolution Gradient Echo, XBONE T2 and Spin Echo T1 sequences in the sagittal plane. The biceps brachii, pronator teres, flexor carpi radialis, extensor digitorum communis, extensor carpi radialis, deltoid muscle and the articular surface of the medial condyle of the humerus were very well visualized by 3D SST1 and XBONE T2 sequences in the transverse plane. The triceps brachii muscle, extensor digitorum lateralis muscle, superficial digital flexor, deep digital flexor and the medial condyle of the humerus were very well visualized by the Spin Echo T1 sequence in the dorsal plane. This article describes for the first time the use of the gadolinium contrast agent administered to the canine elbow joint during magnetic resonance modality. Magnetic resonance arthrography can be a helpful visualization technique in treating canine soft tissue elbow injury.

  2. The effectiveness of diagnostic imaging methods for the assessment of soft tissue and articular disorders of the shoulder and elbow

    Energy Technology Data Exchange (ETDEWEB)

    Shahabpour, M. [Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels (Belgium)], E-mail: Maryam@shahabpour.uzbrussel; Kichouh, M.; Laridon, E. [Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels (Belgium); Gielen, J.L. [Department of Radiology, Universitair Ziekenhuis Antwerpen, Universiteit Antwerpen, Wilrijkstraat 10, 2650 Edegem (Belgium); De Mey, J. [Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels (Belgium)

    2008-02-15

    There are no clear guidelines for diagnostic imaging of articular and soft tissue pathologies of the shoulder and elbow. Several methods are used, including magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA) and ultrasound (US). Their cost-effectiveness is still unclear. We performed a meta-analysis of the relevant literature and discussed the role of MR imaging of the shoulder and elbow compared with other diagnostic imaging modalities. For the shoulder impingement syndrome and rotator cuff tears, MRI and US have a comparable accuracy for detection of full-thickness rotator cuff tears. MRA and US might be more accurate for the detection of partial-thickness tears than MRI. Given the large difference in cost of MR and US, ultrasound may be the most cost-effective diagnostic method for identification of full-thickness tears in a specialist hospital setting (Evidence level 3). Both MRA and CT arthrography (CTA) are effective methods for the detection of labrum tears. More recently, multidetector CTA has offered the advantages of thinner slices than with MRA in a shorter examination time. Still, MRA has the advantage towards CTA to directly visualize the affected structures with a better evaluation of extent and location and to detect associated capsuloligamentous injuries. For the elbow pathologies, plain MRI or MRA have the advantage towards CTA to detect occult bone injuries. CTA is better for the assessment of the thin cartilage of the elbow. Both US and MRI are reliable methods to detect chronic epicondylitis; US is more available and far more cost-effective (Evidence level 2). MRA can differentiate complete from partial tears of the medial collateral ligament. US or MRI can detect partial and complete biceps tendon tears and/or bursitis. MRI can provide important diagnostic information in lesions of the ulnar, radial, or median nerve.

  3. Uranium uptake by immobilized cells of Pseudomonas strain EPS 5028

    International Nuclear Information System (INIS)

    Pons, M.P.; Fuste, M.C.

    1993-01-01

    Polyacrylamide-gel-immobilized cells of Pseudomonas strain EPS 5028 were effective in the removal of uranium (U) from synthetic effluents. Metal accumulation was performed in an open system in columns filled with immobilized cells that were challenged with continuous flows containing U. Possible variable of the system were studied. Uranium uptake by the immobilized cells of this microorganism was affected by pH but not by temperature or flow rate. In addition, U binding could be interpreted in terms of the Freundlich adsorption isotherm indicating single-layer adsorption. The feasibility of reusing the immobilized cells was suggested after the recovery of U with a solution of 0.1 M sodium carbonate. (orig.)

  4. Immobilization of wet solid wastes at nuclear power plants

    International Nuclear Information System (INIS)

    Neilson, R.M. Jr.

    1977-01-01

    Wet solid wastes are classified into four basic types: spent resins, filter sludges, evaporator concentrates, and miscellaneous liquids. Although the immobilization of wet solid wastes is primarily concerned with the incorporation of the waste with a solidification agent, there are a number of other discrete operations or subsystems involved in the treatment of these wastes that may affect the immobilized waste product. The immobilization process may be broken down into five basic operations: waste collection, waste pretreatment, solidification agent handling, mixing/packaging, and waste package handling. The properties of the waste forms that are ultimately shipped from the reactor site are primarily influenced by the methods utilized during the waste collection, waste pretreatment and mixing/packaging operations. The mixing/packaging (solidification) operation is perhaps the most important stage of the immobilization process. The basic solidification agent types are: absorbants, hydraulic cement, urea-formaldehyde, bitumen, and other polymer systems

  5. Biosorption of americium-241 by immobilized Rhizopus arrihizus

    International Nuclear Information System (INIS)

    Liao Jiali; Yang Yuanyou; Luo Shunzhong; Liu Ning; Jin Jiannan; Zhang Taiming; Zhao Pengji

    2004-01-01

    Rhizopus arrihizus (R. arrihizus), a fungus, which in previous experiments had shown encouraging ability to remove 241 Am from solutions, was immobilized by calcium alginate and other reagents. The various factors affecting 241 Am biosorption by the immobilized R. arrihizus were investigated. The results showed that not only can immobilized R. arrihizus adsorb 241 Am as efficiently as free R. arrihizus, but that also can be used repeatedly or continuously. The biosorption equilibrium was achieved within 2 h, and more than 94% of 241 Am was removed from 241 Am solutions of 1.08 MBq/l by immobilized R. arrihizu in the pH range 1-7. Temperature did not affect the adsorption on immobilized R. arrihizus in the range 15-45 deg. C. After repeated adsorption for 8 times, the immobilized R. arrihizus still adsorbed more than 97% of 241 Am. At this time, the total adsorption of 241 Am was more than 88.6 KBq/g, and had not yet reached saturation. Ninety-five percent of the adsorbed 241 Am was desorbed by saturated EDTA solution and 98% by 2 mol/l HNO 3

  6. Excessive deformation and failure of straight parts and elbows

    International Nuclear Information System (INIS)

    Touboul, F.; Acker, D.

    1991-01-01

    The design rules for LMFBRs must cover the ranges of loading types and geometries wider than PWR Design Codes. Steam pipework does not differ between two reactor systems, but as far as sodium piping is concerned, usual PWR criteria may not be adequate. The LMFBR sodium piping is operated at high temperature and low pressure level. Moreover, these peculiar loadings require the geometrical characteristics completely different in the fact that the piping must be flexible but need not to be thick. For such piping components, the ultimate behavior depends much on the geometry. 170 experimental results on straight parts and 95 results on elbows were investigated. As for elbows, half of the tests were performed under in-plane closing moment. On the analysis of straight pipes and elbows, the experiments and the proposed expressions for the evaluation of collapse and instability moments are described, respectively. The application of the present study to the design rules and the criteria for various loading conditions are reported. It is difficult to experimentally distinguish between plastic instability and buckling. (K.I.)

  7. Total elbow arthroplasty for the treatment of distal humeral fractures.

    Science.gov (United States)

    Gallucci, G L; Larrondo Calderón, W; Boretto, J G; Castellaro Lantermo, J A; Terán, J; de Carli, P

    2016-01-01

    To report the clinical-functional outcomes of the treatment of humeral distal fractures with a total elbow prosthesis. This retrospective study was performed in two surgical centres. A total of 23patients were included, with a mean age of 79years, and of which 21 were women. The inclusion criteria were: patients with humeral distal fractures, operated on using a Coonrad-Morrey prosthesis, and with a follow-up of more than one year. According to AO classification, 15fractures were type C3, 7 C2 and 1 A2. All patients were operated on without de-insertion of the extensor mechanism. The mean follow-up was 40 months. Flexor-extension was 123-17°, with a total mobility arc of 106° (80% of the contralateral side). Pain, according to a visual analogue scale was 1. The Mayo Elbow Performance Index (MEPI) was 83 points. Excellent results were obtained in 8 patients, good in 13, medium in 1, and poor in 1. The mean DASH (disability) score was 24 points. Treatment of humeral distal fractures with total elbow arthroplasty could be a good treatment option, but indications must be limited to patients with complex fractures, poor bone quality, with osteoporosis and low functional demands. In younger patients, the use is limited to serious cases where there is no other treatment option. Level of Evidence IV. Copyright © 2016 SECOT. Published by Elsevier Espana. All rights reserved.

  8. Functional anatomy of the lateral collateral ligament of the elbow.

    Science.gov (United States)

    Hackl, M; Bercher, M; Wegmann, K; Müller, L P; Dargel, J

    2016-07-01

    The aim of this study was to analyze the functional anatomy of the lateral collateral ligament complex (LCLC) and the surrounding forearm extensors. Using 81 human cadaveric upper extremities, the anatomy of the forearm extensors-especially the anconeus, supinator and extensor carpi ulnaris (ECU)-was analyzed. After removal of aforementioned extensors the functional anatomy of the LCLC was analyzed. The origin of the LCLC was evaluated for isometry. The insertion types of the lateral ulnar collateral ligament (LUCL) were analyzed and classified. The ECU runs parallel to the RCL to dynamically preserve varus stability. The supinator and anconeus muscle fibers coalesce with the LCLC and lengthen during pronation. The anconeus fibers run parallel to the LUCL in full flexion. The LCLC consists of the annular ligament (AL) and the isometric radial collateral ligament (RCL). During elbow flexion, its posterior branches (LUCL) tighten while the anterior branches loosen. When performing a pivot shift test, the loosened LUCL fibers do not fully tighten in full extension. The LUCL inserts along with the AL at the supinator crest. Three different insertion types could be observed. The LUCL represents the posterior branch of the RCL rather than a distinct ligament. It is non-isometric and lengthens during elbow flexion. The RCL was found to be of vital importance for neutralization of posterolateral rotatory forces. Pronation of the forearm actively stabilizes the elbow joint as the supinator, anconeus and biceps muscle work in unison to increase posterolateral rotatory stability.

  9. Unreduced elbow dislocation treated by Ilizarov method: A case report

    Directory of Open Access Journals (Sweden)

    Jovanović Vesna

    2010-01-01

    Full Text Available Introduction. Unreduced elbow dislocation is every elbow dislocation older than one week. It may be treated non-operatively (with prereduction traction or surgically. The treatment goals are: to reduce pain, to establish joint stability and movements. There are a lot of techniques described in literature, series are relatively small, mostly case reports. Multicentric studies have not been done. That is why there are no precisely defined therapeutic protocols. Every contribution in the field is valuable. Case Outline. A 43-year-old patient was admitted for the treatment of a three-month old unreduced elbow dislocation. Treatment has been done by Ilizarov method, using the reduction mechanism. The reduction process lasted two weeks. The Ilizarov device was removed two months after the operation, then physical therapy was started. Normal anatomical and functional findings were established five months following the operation. Conclusion. The presented method of treatment has been found as very useful, having in mind that it may solve two problems: difficult reduction and redislocation. Reduction may be done without the joint opening, step by step; retention of the reduced joint may be easily done. Physical therapy may be started without Ilizarov device removal, movements of flexion and extension may be improved without any lateral instability. There is no iatrogenic intraarticular damage, so there are no secondary joint degeneration, pains and invalidity.

  10. Central uplift of custom immobilization radiotherapy patients with lower limb overhead sagittal laser affected without mobile; Elevacion central de inmovilizacion personalizada de pacientes radioterapicos con extremidades inferiores afectas sin laser sagital cenital movil

    Energy Technology Data Exchange (ETDEWEB)

    Velazquez Miranda, S.; Delgado Gil, M. M.; Ortiz Seidel, M.

    2011-07-01

    If you have a laser moving overhead sagittal or the location of tumors in the lower extremities is laborious, as to reference properly in the CT, is necessary before tattooing in the treatment table using their ability to relate the lateral midline with tattoos on the limb. For anatomical forms often happens that lasers are not displayed on the areas of our interest. The problem can be overcome if between the legs raise the bag or custom immobilizer above the height of the patient's abdomen, as this will have a central reference reliable and well designed lasers.

  11. Tennis elbow: a biomechanical and therapeutic approach.

    Science.gov (United States)

    Schnatz, P; Steiner, C

    1993-07-01

    Lateral epicondylitis, one of the most common lesions of the arm, affects some 50% of tennis players. This condition poses a problem in clinical management because treatment is dependent not only on proper medical therapy but also on correction of the improper on-court biomechanics. The most common flaw is a late contact on the backhand groundstroke, forcing the player to extend the wrist with the extensor muscles. This action predisposes to trauma of the tendon fibers at the lateral epicondyle. Understanding the biomechanics will better prepare the physician to advise the patient and to communicate with a tennis teaching professional to facilitate long-term relief.

  12. Does immobilization after arthroscopic rotator cuff repair increase tendon healing? A systematic review and meta-analysis.

    Science.gov (United States)

    Shen, Chong; Tang, Zhi-Hong; Hu, Jun-Zu; Zou, Guo-Yao; Xiao, Rong-Chi; Yan, Dong-Xue

    2014-09-01

    To determine whether immobilization after arthroscopic rotator cuff repair improved tendon healing compared with early passive motion. A systematic electronic literature search was conducted to identify randomized controlled trials (RCTs) comparing early passive motion with immobilization after arthroscopic rotator cuff repair. The primary outcome assessed was tendon healing in the repaired cuff. Secondary outcome measures were range of motion (ROM) and American Shoulder and Elbow Surgeons (ASES) shoulder scale, Simple Shoulder Test (SST), Constant, and visual analog scale (VAS) for pain scores. Pooled analyses were performed using a random effects model to obtain summary estimates of treatment effect with 95% confidence intervals. Heterogeneity among included studies was quantified. Three RCTs examining 265 patients were included. Meta-analysis revealed no significant difference in tendon healing in the repaired cuff between the early-motion and immobilization groups. A significant difference in external rotation at 6 months postoperatively favored early motion over immobilization, but no significant difference was observed at 1 year postoperatively. In one study, Constant scores were slightly higher in the early-motion group than in the immobilization group. Two studies found no significant difference in ASES, SST, or VAS score between groups. We found no evidence that immobilization after arthroscopic rotator cuff repair was superior to early-motion rehabilitation in terms of tendon healing or clinical outcome. Patients in the early-motion group may recover ROM more rapidly. Level II; systematic review of levels I and II studies.

  13. Assessing attitudes toward spinal immobilization.

    Science.gov (United States)

    Bouland, Andrew J; Jenkins, J Lee; Levy, Matthew J

    2013-10-01

    Prospective studies have improved knowledge of prehospital spinal immobilization. The opinion of Emergency Medical Services (EMS) providers regarding spinal immobilization is unknown, as is their knowledge of recent research advances. To examine the attitudes, knowledge, and comfort of prehospital and Emergency Department (ED) EMS providers regarding spinal immobilization performed under a non-selective protocol. An online survey was conducted from May to July of 2011. Participants were drawn from the Howard County Department of Fire and Rescue Services and the Howard County General Hospital ED. The survey included multiple choice questions and responses on a modified Likert scale. Correlation analysis and descriptive data were used to analyze results. Comfort using the Kendrick Extrication Device was low among ED providers. Experienced providers were more likely to indicate comfort using this device. Respondents often believed that spinal immobilization is appropriate in the management of penetrating trauma to the chest and abdomen. Reported use of padding decreased along with the frequency with which providers practice and encounter immobilized patients. Respondents often indicated that they perform spinal immobilization due solely to mechanism of injury. Providers who feel as if spinal immobilization is often performed unnecessarily were more likely to agree that immobilization causes an unnecessary delay in patient care. The results demonstrate the need for improved EMS education in the use of the Kendrick Extrication Device, backboard padding, and spinal immobilization in the management of penetrating trauma. The attitudes highlighted in this study are relevant to the implementation of a selective spinal immobilization protocol. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Clinical Evaluation of Percutaneous Vertebroplasty in a Patient with Paraplegia and Immobilization Syndrome: A Case Report

    OpenAIRE

    Masala, Salvatore; Calabria, Eros; Nezzo, Marco; De Vivo, Dominique; Neroni, Luca; Simonetti, Giovanni

    2013-01-01

    We will discuss a potential role of percutaneous vertebroplasty (PVP) in the management of a patient with immobilization syndrome due to paraplegia and vertebral osteoporotic fractures. While PVP is commonly used for the treatment of osteoporotic thoracolumbar vertebral compression fractures, its role in vertebral stabilization in patient with immobilization syndrome has not been reported in the literature. A 73-year-old woman affected by immobilization syndrome due to paraplegia and vertebra...

  15. Neurological Complications Related to Elective Orthopedic Surgery: Part 1: Common Shoulder and Elbow Procedures.

    Science.gov (United States)

    Dwyer, Tim; Henry, Patrick D G; Cholvisudhi, Phantila; Chan, Vincent W S; Theodoropoulos, John S; Brull, Richard

    2015-01-01

    Many anesthesiologists are unfamiliar with the rate of surgical neurological complications of the shoulder and elbow procedures for which they provide local anesthetic-based anesthesia and/or analgesia. Part 1 of this narrative review series on neurological complications of elective orthopedic surgery describes the mechanisms and likelihood of peripheral nerve injury associated with some of the most common shoulder and elbow procedures, including open and arthroscopic shoulder procedures, elbow arthroscopy, and total shoulder and elbow replacement. Despite the many articles available, the overall number of studied patients is relatively low. Large prospective trials are required to establish the true incidence of neurological complications following elective shoulder and elbow surgery. As the popularity of regional anesthesia increases with the development of ultrasound guidance, anesthesiologists should have a thoughtful understanding of the nerves at risk of surgical injury during elective shoulder and elbow procedures.

  16. HLW immobilization in glass

    International Nuclear Information System (INIS)

    Leroy, P.; Jacquet-Francillon, N.; Runge, S.

    1992-01-01

    The immobilization of High Level Waste in glass in France is a long history which started as early as in the 1950's. More than 30 years of Research and Development have been invested in that field. Two industrial facilities are operating (AVM and R7) and a third one (T7), under cold testing, is planned to start active operation in the mid-92. While vitrification has been demonstrated to be an industrially mastered process, the question of the quality of the final waste product, i.e. the HLW glass, must be addressed. The scope of the present paper is to focus on the latter point from both standpoints of the R and D and of the industrial reality

  17. Astym treatment vs. eccentric exercise for lateral elbow tendinopathy: a randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Thomas L. Sevier

    2015-05-01

    Full Text Available Introduction. Patients with chronic lateral elbow (LE tendinopathy, commonly known as tennis elbow, often experience prolonged symptoms and frequent relapses. Astym treatment, evidenced in animal studies to promote the healing and regeneration of soft tissues, is hypothesized to improve outcomes in LE tendinopathy patients. This study had two objectives: (1 to compare the efficacy of Astym treatment to an evidence-based eccentric exercise program (EE for patients with chronic LE tendinopathy, and (2 to quantify outcomes of subjects non-responsive to EE who were subsequently treated with Astym treatment.Study Design. Prospective, two group, parallel, randomized controlled trial completed at a large orthopedic center in Indiana. Inclusion criteria: age range of 18–65 years old, with clinical indications of LE tendinopathy greater than 12 weeks, with no recent corticosteriod injection or disease altering comorbidities.Methods. Subjects with chronic LE tendinopathy (107 subjects with 113 affected elbows were randomly assigned using computer-generated random number tables to 4 weeks of Astym treatment (57 elbows or EE treatment (56 elbows. Data collected at baseline, 4, 8, 12 weeks, 6 and 12 months. Primary outcome measure: DASH; secondary outcome measures: pain with activity, maximum grip strength and function. The treating physicians and the rater were blinded; subjects and treating clinicians could not be blinded due to the nature of the treatments.Results. Resolution response rates were 78.3% for the Astym group and 40.9% for the EE group. Astym subjects showed greater gains in DASH scores (p = 0.047 and in maximum grip strength (p = 0.008 than EE subjects. Astym therapy also resolved 20/21 (95.7% of the EE non-responders, who showed improvements in DASH scores (p < 0.005, pain with activity (p = 0.002, and function (p = 0.004 following Astym treatment. Gains continued at 6 and 12 months. No adverse effects were reported.Conclusion. This study

  18. New Design of a Soft Robotics Wearable Elbow Exoskeleton Based on Shape Memory Alloy Wire Actuators

    OpenAIRE

    Copaci, Dorin; Cano, Enrique; Moreno, Luis; Blanco, Dolores

    2017-01-01

    The elbow joint is a complex articulation composed of the humeroulnar and humeroradial joints (for flexion-extension movement) and the proximal radioulnar articulation (for pronation-supination movement). During the flexion-extension movement of the elbow joint, the rotation center changes and this articulation cannot be truly represented as a simple hinge joint. The main goal of this project is to design and assemble a medical rehabilitation exoskeleton for the elbow with one degree of freed...

  19. Evaluation of thoracic limb loads, elbow movement, and morphology in dogs before and after arthroscopic management of unilateral medial coronoid process disease.

    Science.gov (United States)

    Galindo-Zamora, Vladimir; Dziallas, Peter; Wolf, Davina C; Kramer, Sabine; Abdelhadi, Jalal; Lucas, Karin; Nolte, Ingo; Wefstaedt, Patrick

    2014-10-01

    To (1) evaluate thoracic limb loads and symmetry, and elbow function and morphology, before and after arthroscopic treatment of unilateral medial coronoid process disease (MCPD), and (2) determine if functional variables correlate with morphologic findings. Prospective case series. Dogs (n = 14) with thoracic limb lameness. Dogs were included when unilateral MCPD was confirmed as the cause of lameness. Kinetic analysis of both thoracic limbs, along with kinematic analysis and goniometry of both elbows were carried out before, and 60, 120, and 180 days after partial coronoidectomy by arthroscopy. Radiography and computed tomography of both elbows were performed before and 180 days after arthroscopy. A nonsignificant (P = .11) increase in the peak vertical loads (PFz), and a significant (P = .022) increase in the vertical impulse (iFz) applied by the affected limb were seen. Symmetry indices improved, with significant differences between sessions (PFz: P = .019; iFz: P = .003). Kinematic variables showed no significant differences, between sessions or when comparing both elbows within sessions. Goniometry revealed no significant differences between sessions, but some significant differences were identified when comparing both elbows within sessions. Osteophytosis and degree of lameness showed no correlation, before (rs  = -0.077; P = .79) or after arthroscopy (rs  = 0.27; P = .35). Kinetic variables improved after arthroscopy, without full restoration of function. Kinematic variables did not change significantly. Osteoarthritis and goniometric measurements in the affected joint worsened. Functional variables did not correlate with morphologic findings. © Copyright 2014 by The American College of Veterinary Surgeons.

  20. Does Excision of Heterotopic Ossification of the Elbow Result in Satisfactory Patient-Rated Outcomes?

    Science.gov (United States)

    Sandeep, K N; Suresh, G; Gopisankar, B; Abhishek, N; Sujiv, A

    2017-03-01

    Treatment of heterotopic ossification (HO) of the elbow is challenging and fraught with complications. Patients who sustain direct trauma to the elbow joint, the central nervous system, and thermal burns are at increased risk for development of HO. There is a paucity of studies and reports on patient's self-evaluation after the excision of the heterotopic ossification. This retrospective study assessed outcomes after excision of heterotopic ossification around the elbow in a cohort of ten patients operated from 2012 to 2015. The outcome assessment was done by the Mayo Elbow Performance index (MEPI) and the American Shoulder and Elbow Surgeons-Elbow score (ASES-E scores). The mean follow-up was 18.11 months after the operation. The Mayo Elbow Performance Score was excellent in two elbows, good in six and fair in two. The mean gain in flexion-extension arc after excision of HO was 80 degrees. All of the patients had residual flexion deformity postoperatively. Eight of the nine patients were able to do activities requiring flexion at final follow-up. Excision of HO around the elbow is associated with satisfactory patient-rated outcomes in spite of failure to regain full range of motion.

  1. Muscle contributions to elbow joint rotational stiffness in preparation for sudden external arm perturbations.

    Science.gov (United States)

    Holmes, Michael W R; Keir, Peter J

    2014-04-01

    Understanding joint stiffness and stability is beneficial for assessing injury risk. The purpose of this study was to examine joint rotational stiffness for individual muscles contributing to elbow joint stability. Fifteen male participants maintained combinations of three body orientations (standing, supine, sitting) and three hand preloads (no load, solid tube, fluid filled tube) while a device imposed a sudden elbow extension. Elbow angle and activity from nine muscles were inputs to a biomechanical model to determine relative contributions to elbow joint rotational stiffness, reported as percent of total stiffness. A body orientation by preload interaction was evident for most muscles (Psafety.

  2. Correlation of radiographic, necropsy and histologic findings in 8 dogs with elbow dysplasia

    International Nuclear Information System (INIS)

    Keller, G.G.; Kreeger, J.M.; Mann, F.A.; Lattimer, J.C.

    1997-01-01

    Elbow dysplasia is osteoarthrosis/degenerative joint disease due to abnormal development of the elbow joint. The abnormal development is the result of specific inherited etiologies alone or in combination. This paper attempts to clarify the diagnosis of elbow dysplasia based on the presence of degenerative joint disease by correlating radiographic, necropsy, and histopathologic results using elbows from 8 German Shepherd dogs. All elbows had radiographic changes consistent with osteoarthrosis/degenerative joint disease which were identified best on the flexed medial-lateral projection. Radiographically, a specific diagnosis was made in seven elbows; ununited anconeal process (6) and osteochondrosis (1). At necropsy these lesions were confirmed plus 14 elbows were identified that had fragmented medial coronoid process (6), abnormally shaped medial coronoid processes or fissures in the articular cartilage of the medial coronoid process (8). Additionally, histopathologically there was proliferative synovitis at the radial notch of the ulna and degenerative changes on the proximal, nonarticular surface of the anconeal process at the site of insertion of the olecranon ligament and joint capsule. Therefore, for screening the elbow joint to identify elbow dysplasia, the recognition of osteoarthrosis/degenerative joint disease on an extreme flexed mediolateral radiograph appears to be sufficient

  3. The use of polarized polychromatic non-coherent light as therapy for acute tennis elbow/lateral epicondylalgia: a pilot study.

    Science.gov (United States)

    Stasinopoulos, Dimitrios

    2005-02-01

    The aim of this study was to assess the efficacy of polarized, polychromatic, non-coherent, low energy light (Bioptron 2, Bioptron AG, Switzerland) in the treatment of acute tennis elbow. Tennis elbow, or lateral epicondylitis, is one of the most common lesions affecting the arm. A plethora of treatment regimes have been described for this condition, but no specific therapy has emerged as a gold standard. A pilot study was carried out with 25 patients who had acute tennis elbow. Bioptron 2 device was applied over lateral epicondyle three times per week for 4 weeks. Pain on VAS, function on VAS, and painfree grip strength were measured at the beginning (week 0) and at the end of the study (week 4). The pain on VAS was reduced at the end of treatment (t(24) = 3.84, p = 0.001). Function on VAS was increased at the end of treatment (t(24) = 4.23, p Bioptron 2 could reduce patients' symptoms with acute tennis elbow, future controlled studies are needed to establish the relative and absolute effectiveness of Bioptron 2.

  4. External rotation immobilization for primary shoulder dislocation: a randomized controlled trial.

    Science.gov (United States)

    Whelan, Daniel B; Litchfield, Robert; Wambolt, Elizabeth; Dainty, Katie N

    2014-08-01

    The traditional treatment for primary anterior shoulder dislocations has been immobilization in a sling with the arm in a position of adduction and internal rotation. However, recent basic science and clinical data have suggested recurrent instability may be reduced with immobilization in external rotation after primary shoulder dislocation. We performed a randomized controlled trial to compare the (1) frequency of recurrent instability and (2) disease-specific quality-of-life scores after treatment of first-time shoulder dislocation using either immobilization in external rotation or immobilization in internal rotation in a group of young patients. Sixty patients younger than 35 years of age with primary, traumatic, anterior shoulder dislocations were randomized (concealed, computer-generated) to immobilization with either an internal rotation sling (n = 29) or an external rotation brace (n = 31) at a mean of 4 days after closed reduction (range, 1-7 days). Patients with large bony lesions or polytrauma were excluded. The two groups were similar at baseline. Both groups were immobilized for 4 weeks with identical therapy protocols thereafter. Blinded assessments were completed by independent observers for a minimum of 12 months (mean, 25 months; range, 12-43 months). Recurrent instability was defined as a second documented anterior dislocation or multiple episodes of shoulder subluxation severe enough for the patient to request surgical stabilization. Validated disease-specific quality-of-life data (Western Ontario Shoulder Instability index [WOSI], American Shoulder and Elbow Surgeons evaluation [ASES]) were also collected. Ten patients (17%, five from each group) were lost to followup. Reported compliance with immobilization in both groups was excellent (80%). With the numbers available, there was no difference in the rate of recurrent instability between groups: 10 of 27 patients (37%) with the external rotation brace versus 10 of 25 patients (40%) with the

  5. Glucose Oxidase Immobilization on TMAH-Modified Bentonite

    Directory of Open Access Journals (Sweden)

    Ruth Chrisnasari

    2015-03-01

    Full Text Available The influence of bentonite modification by tetramethyl ammonium hydroxide (TMAH on its capability to immobilize glucose oxidase (GOX was studied. Modification of bentonite was conducted by the adding of 0-5% (v/v TMAH. The observed results show that the different concentrations of TMAH affect the percentage of immobilized enzyme. The results of this study show that the best concentration of TMAH is 5% (v/v which can immobilize up to 84.71% of GOX. X-ray diffraction (XRD and Fourier Transforms Infrared Spectroscopy (FTIR studies have been carried out to observe the structural changes in bentonite due to TMAH modification. The obtained immobilized GOX show the optimum catalytic activity on reaction temperature of 40-50 °C and pH of 7. The immobilized GOX kinetics at the optimum conditions determined the Km and Vmax value to be 4.96x10-2 mM and 4.99x10-3 mM.min-1 respectively. In addition, the immobilized GOX on TMAH-modified bentonite is stable enough so it could be re-used six times before its activity decreased by 39.44%.

  6. Ethanol fermentation by immobilized cells of Zymomonas mobilis

    Energy Technology Data Exchange (ETDEWEB)

    Grote, W.

    1985-01-01

    Previous studies have shown that immobilized yeast cell cultures have commercial potential for fuel ethanol production. In this study the suitability of strains of Z. mobilis for whole cell immobilization was investigated. Experiments revealed that immobilization in Ca-alginate or K-carrageenan gel or use of flocculating strains was effective for ethanol production at relatively high productivities. Two laboratory size reactors were designed and constructed. These were a compartmented multiple discshaft column and a tower fermentor. Results of this work supported other studies that established that growth and fermentation could be uncoupled. The data indicated that specific metabolic rates were dependent on the nature of the fermentation media. The addition of lactobacilli to Z. mobilis continuous fermentations had only a transient effect, and was unlikely to affect an immobilized Z. mobilis process. With 150 gl/sup -1/ glucose media and a Z. mobilis ZM4 immobilized cell reactor, a maximum volumetric ethanol productivity of 55 gl/sup -1/h/sup -1/ was obtained. The fermentation of sucrose media or sucrose-based raw materials (molasses, cane juice, synthetic mill liquor) by immobilized Z. mobilis ZM4 revealed a pattern of rapid sucrose hydrolysis, preferential glucose utilization and the conversion of fructose to the undesirable by-products levan and sorbitol.

  7. Reliability of internal oblique elbow radiographs for measuring displacement of medial epicondyle humerus fractures: a cadaveric study.

    Science.gov (United States)

    Gottschalk, Hilton P; Bastrom, Tracey P; Edmonds, Eric W

    2013-01-01

    Standard elbow radiographs (AP and lateral views) are not accurate enough to measure true displacement of medial epicondyle fractures of the humerus. The amount of perceived displacement has been used to determine treatment options. This study assesses the utility of internal oblique radiographs for measurement of true displacement in these fractures. A medial epicondyle fracture was created in a cadaveric specimen. Displacement of the fragment (mm) was set at 5, 10, and 15 in line with the vector of the flexor pronator mass. The fragment was sutured temporarily in place. Radiographs were obtained at 0 (AP), 15, 30, 45, 60, 75, and 90 degrees (lateral) of internal rotation, with the elbow in set positions of flexion. This was done with and without radio-opaque markers placed on the fragment and fracture bed. The 45 and 60 degrees internal oblique radiographs were then presented to 5 separate reviewers (of different levels of training) to evaluate intraobserver and interobserver agreement. Change in elbow position did not affect the perceived displacement (P=0.82) with excellent intraobserver reliability (intraclass correlation coefficient range, 0.979 to 0.988) and interobserver agreement of 0.953. The intraclass correlation coefficient for intraobserver reliability on 45 degrees internal oblique films for all groups ranged from 0.985 to 0.998, with interobserver agreement of 0.953. For predicting displacement, the observers were 60% accurate in predicting the true displacement on the 45 degrees internal oblique films and only 35% accurate using the 60 degrees internal oblique view. Standardizing to a 45 degrees internal oblique radiograph of the elbow (regardless of elbow flexion) can augment the treating surgeon's ability to determine true displacement. At this degree of rotation, the measured number can be multiplied by 1.4 to better estimate displacement. The addition of a 45 degrees internal oblique radiograph in medial humeral epicondyle fractures has good

  8. Full Range of Motion Induces Greater Muscle Damage Than Partial Range of Motion in Elbow Flexion Exercise With Free Weights.

    Science.gov (United States)

    Baroni, Bruno M; Pompermayer, Marcelo G; Cini, Anelize; Peruzzolo, Amanda S; Radaelli, Régis; Brusco, Clarissa M; Pinto, Ronei S

    2017-08-01

    Baroni, BM, Pompermayer, MG, Cini, A, Peruzzolo, AS, Radaelli, R, Brusco, CM, and Pinto, RS. Full range of motion induces greater muscle damage than partial range of motion in elbow flexion exercise with free weights. J Strength Cond Res 31(8): 2223-2230, 2017-Load and range of motion (ROM) applied in resistance training (RT) affect the muscle damage magnitude and the recovery time-course. Because exercises performed with partial ROM allow a higher load compared with those with full ROM, this study investigated the acute effect of a traditional RT exercise using full ROM or partial ROM on muscle damage markers. Fourteen healthy men performed 4 sets of 10 concentric-eccentric repetitions of unilateral elbow flexion on the Scott bench. Arms were randomly assigned to partial-ROM (50-100°) and full-ROM (0-130°) conditions, and load was determined as 80% of 1 repetition maximum (1RM) in the full- and partial-ROM tests. Muscle damage markers were assessed preexercise, immediately, and 24, 48, and 72 hours after exercise. Primary outcomes were peak torque, muscle soreness during palpation and elbow extension, arm circumference, and joint ROM. The load lifted in the partial-ROM condition (1RM = 19.1 ± 3.0 kg) was 40 ± 18% higher compared with the full-ROM condition (1RM = 13.7 ± 2.2 kg). Seventy-two hours after exercise, the full-ROM condition led to significant higher soreness sensation during elbow extension (1.3-4.1 cm vs. 1.0-1.9 cm) and smaller ROM values (97.5-106.1° vs. 103.6-115.7°). Peak torque, soreness from palpation, and arm circumference were statistically similar between conditions, although mean values in all time points of these outcomes have suggested more expressive muscle damage for the full-ROM condition. In conclusion, elbow flexion exercise with full ROM seems to induce greater muscle damage than partial-ROM exercises, even though higher absolute load was achieved with partial ROM.

  9. Reliability of sonographic assessment of tendinopathy in tennis elbow.

    Science.gov (United States)

    Poltawski, Leon; Ali, Syed; Jayaram, Vijay; Watson, Tim

    2012-01-01

    To assess the reliability and compute the minimum detectable change using sonographic scales to quantify the extent of pathology and hyperaemia in the common extensor tendon in people with tennis elbow. The lateral elbows of 19 people with tennis elbow were assessed sonographically twice, 1-2 weeks apart. Greyscale and power Doppler images were recorded for subsequent rating of abnormalities. Tendon thickening, hypoechogenicity, fibrillar disruption and calcification were each rated on four-point scales, and scores were summed to provide an overall rating of structural abnormality; hyperaemia was scored on a five point scale. Inter-rater reliability was established using the intraclass correlation coefficient (ICC) to compare scores assigned independently to the same set of images by a radiologist and a physiotherapist with training in musculoskeletal imaging. Test-retest reliability was assessed by comparing scores assigned by the physiotherapist to images recorded at the two sessions. The minimum detectable change (MDC) was calculated from the test-retest reliability data. ICC values for inter-rater reliability ranged from 0.35 (95% CI: 0.05, 0.60) for fibrillar disruption to 0.77 (0.55, 0.88) for overall greyscale score, and 0.89 (0.79, 0.95) for hyperaemia. Test-retest reliability ranged from 0.70 (0.48, 0.84) for tendon thickening to 0.82 (0.66, 0.90) for overall greyscale score and 0.86 (0.73, 0.93) for calcification. The MDC for the greyscale total score was 2.0/12 and for the hyperaemia score was 1.1/5. The sonographic scoring system used in this study may be used reliably to quantify tendon abnormalities and change over time. A relatively inexperienced imager can conduct the assessment and use the rating scales reliably.

  10. Management of Tennis Elbow with sodium hyaluronate periarticular injections

    Directory of Open Access Journals (Sweden)

    Petrella Robert J

    2010-02-01

    Full Text Available Abstract Objectives To determine the efficacy and safety of peri-articular hyaluronic acid injections in chronic lateral epicondylosis (tennis elbow. Design Prospective randomized clinical trial in primary care sport medicine. Patients Three hundred and thirty one consecutive competitive racquette sport athletes with chronic (>3 months lateral epicondylosis were administered 2 injections (first injection at baseline into the subcutaneous tissue and muscle 1 cm. from the lateral epicondyle toward the primary point of pain using a two-dimensional fanning technique. A second injection was administered 1 week later. Outcomes measures Assessments were done at baseline, days 7, 14, 30, 90 and 356. Efficacy measures included patient's visual analogue scale (VAS of pain at rest (0-100 mm and following assessment of grip strength (0-100 mm. Grip strength was determined using a jamar hydraulic hand dynamometer. Other assessments included patients' global assessment of elbow injury (5 point categorical scale; 1 = no disability, 5 = maximal disability, patients' assessment of normal function/activity (5 point categorical scale, patients/physician satisfaction assessment (10 point categorical scale, time to return to pain-free and disability-free sport and adverse events as per WHO definition. Differences between groups were determined using an intent-to-treat ANOVA. Results Average age of the study population was 49 years (± 12 years. One hundred and sixty-five patients were randomized to the HA and 166 were randomized to the control groups. The change in VAS pain was -6.7 (± 2.0 for HA vs -1.3 (± 1.5 for control (p Conclusion Peri-articular HA treatment for tennis elbow was significantly better than control in improving pain at rest and after maximal grip testing. Further, HA treatment was highly satisfactory by patients and physicians and resulted in better return to pain free sport compared to control.

  11. High-level-waste immobilization

    International Nuclear Information System (INIS)

    Crandall, J.L.

    1982-01-01

    Analysis of risks, environmental effects, process feasibility, and costs for disposal of immobilized high-level wastes in geologic repositories indicates that the disposal system safety has a low sensitivity to the choice of the waste disposal form

  12. Pediatric elbow fractures: a new angle on an old topic

    Energy Technology Data Exchange (ETDEWEB)

    Emery, Kathleen H.; Anton, Christopher G. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Zingula, Shannon N. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Salisbury, Shelia R. [Cincinnati Children' s Hospital Medical Center, Biostatistics and Epidemiology, Cincinnati, OH (United States); Tamai, Junichi [Cincinnati Children' s Hospital Medical Center, Department of Pediatric Orthopedics, Cincinnati, OH (United States)

    2016-01-15

    The three most common elbow fractures classically reported in pediatric orthopedic literature are supracondylar (50-70%), lateral condylar (17-34%), and medial epicondylar fractures (10%), with fractures of the proximal radius (including but not limited to fractures of the radial neck) being relatively uncommon (5-10%). Our experience at a large children's hospital suggests a different distribution. Our goals were (1) to ascertain the frequency of different elbow fracture types in a large pediatric population, and (2) to determine which fracture types were occult on initial radiographs but detected on follow-up. Review of medical records identified 462 children, median age 6 years and interquartile range for age of 4-8 years (range 0.8-18 years), who were diagnosed with elbow fractures at our institution over a 10-month period. Initial and follow-up radiographs were reviewed in blinded fashion independently by two experienced pediatric musculoskeletal radiologists to identify fracture types on initial and follow-up radiographs. The most common fractures included supracondylar (n = 258, 56%), radial neck (n = 80, 17%), and lateral condylar (n = 69, 15%). Additional fractures were seen on follow-up exams in 32 children. Of these, 25 had a different fracture type than was identified on initial radiographs. The most common follow-up fractures were olecranon (n = 23, 72%), coronoid process (n = 4, 13%) and supracondylar (n = 3, 9%). Olecranon fractures were significantly more common on follow-up radiographs than they were on initial radiographs (n = 33, 7%; P <.0001). Twenty-six children had more than one fracture type on the initial radiograph. The most common fracture combinations were radial neck with olecranon (n = 9) and supracondylar with lateral condylar (n = 9). Supracondylar fractures are the most frequent elbow fracture seen initially, followed by radial neck, lateral condylar, and olecranon fractures in a distribution different from what has been

  13. Kinetic chain contributions to elbow function and dysfunction in sports.

    Science.gov (United States)

    Ben Kibler, W; Sciascia, Aaron

    2004-10-01

    The elbow functions in throwing and other athletic activities as a link in the kinetic chain of force development, regulation, and transfer. Efficient function, with maximal performance and minimal injury risk, requires optimum activation of all the link in the kinetic chain. Injury is often associated with alterations in force production or regulation capabilities in links that may be distant to the site of injury. Evaluation of injured athletes should include screening examinations for these areas, and treatment and conditioning should also include these areas.

  14. Hemophilic osteoarthropathy with special attention to the elbow joint

    International Nuclear Information System (INIS)

    Erlemann, R.; Adolph, J.; Peters, P.E.; Pollmann, H.

    1990-01-01

    Hemophilia is a rare disorder, whereas recurrent bleedings in the joint can result in osteoarthropathy. Radiological changes consist of osteoporosis, enlargement of the epiphyses, irregularity of the subchondral bone surface, narrowing of the joint space, cysts, erosions, joint incongruence and joint deformity. The earlier and the more frequently bleedings have occurred which have not been treated adequately, the more of the changes mentioned above are present. In children, osteoarthropathy of the elbow is present in only about 50% of cases, and in the remaining cases the degree is mostly minimal or moderate. Differential diagnosis consists of juvenile rheumatoid arthritis in children, and rheumatoid arthritis and osteoarthritis in adults. (orig.) [de

  15. Strain measurements at the HDR-pipe-system under LOCA-load: Effects on elbows and displaced weldings

    International Nuclear Information System (INIS)

    Hunger, H.

    1985-01-01

    This paper characterizes some effects which have been detected during strain gauge measurements on a test piping with feed water check valve oscillating under blowdown-load. The ovalization of a pipe elbow subjected to in-plane-bending affects the connected straight pipe; this is shown by means of circumferential stresses. Very high LOCA-load produces plastic strain and changes the pipe dynamics. Artificial displaced welds increase the local strain but no defects have occurred. One example compares stresses from measurement and post-calculation. Moreover there are given some remarks on the optimization of the comparison of measurement and calculation. (orig.)

  16. Design of a Soft Robotic Elbow Sleeve with Passive and Intent-Controlled Actuation

    Directory of Open Access Journals (Sweden)

    Tze Hui Koh

    2017-10-01

    Full Text Available The provision of continuous passive, and intent-based assisted movements for neuromuscular training can be incorporated into a robotic elbow sleeve. The objective of this study is to propose the design and test the functionality of a soft robotic elbow sleeve in assisting flexion and extension of the elbow, both passively and using intent-based motion reinforcement. First, the elbow sleeve was developed, using elastomeric and fabric-based pneumatic actuators, which are soft and lightweight, in order to address issues of non-portability and poor alignment with joints that conventional robotic rehabilitation devices are faced with. Second, the control system was developed to allow for: (i continuous passive actuation, in which the actuators will be activated in cycles, alternating between flexion and extension; and (ii an intent-based actuation, in which user intent is detected by surface electromyography (sEMG sensors attached to the biceps and triceps, and passed through a logic sequence to allow for flexion or extension of the elbow. Using this setup, the elbow sleeve was tested on six healthy subjects to assess the functionality of the device, in terms of the range of motion afforded by the device while in the continuous passive actuation. The results showed that the elbow sleeve is capable of achieving approximately 50% of the full range of motion of the elbow joint among all subjects. Next, further experiments were conducted to test the efficacy of the intent-based actuation on these healthy subjects. The results showed that all subjects were capable of achieving electromyography (EMG control of the elbow sleeve. These preliminary results show that the elbow sleeve is capable of carrying out continuous passive and intent-based assisted movements. Further investigation of the clinical implementation of the elbow sleeve for the neuromuscular training of neurologically-impaired persons, such as stroke survivors, is needed.

  17. Irrecoverable pressure loss coefficients for two out-of-plane piping elbows at high Reynolds number

    Energy Technology Data Exchange (ETDEWEB)

    Coffield, R.D.; Hammond, R.B.; McKeown, P.T.

    1999-02-08

    Pressure drops of multiple piping elbows were experimentally determined for high Reynolds number flows. The testing described has been performed in order to reduce uncertainties in the currently used methods for predicting irrecoverable pressure losses and also to provide a qualification database for computational fluid dynamics (CFD) computer codes. The earlier high Reynolds number correlations had been based on extrapolations over several orders of magnitude in Reynolds number from where the original database existed. Recent single elbow test data shows about a factor of two lower elbow pressure loss coefficient (at 40x 106 Reynolds number) than those from current correlations. This single piping elbow data has been extended in this study to a multiple elbow configuration of two elbows that are 90o out-of-plane relative to each other. The effects of separation distance and Reynolds number have been correlated and presented in a form that can be used for design application. Contrary to earlier extrapolations from low Reynolds numbers (Re c 1.0x 106), a strong Reynolds number dependence was found to exist. The combination of the high Reynolds number single elbow data with the multiple elbow interaction effects measured in this study shows that earlier design correlations are conservative by significant margins at high Reynolds numbers. Qualification of CFD predictions with this new high Reynolds number database will help guide the need for additional high Reynolds number testing of other piping configurations. The study also included velocity measurements at several positions downstream of the first and second test elbows using an ultrasonic flowmeter. Reasonable agreement after the first test elbow was found relative to flow fields that are known to exist from low Reynolds number visual tests and also from CFD predictions. This data should help to qualify CFD predictions of the three-dimensional flow stream downstream of the second test elbow.

  18. Randomised, prospective, non-blinded pilot study comparing the effect of intramuscular steroid injections and intralesional steroid injections in the management of tennis elbow

    Science.gov (United States)

    Tahir, Hasan; Biro, Izolda; Donnelly, Simon; Greenwood, Mandy

    2016-01-01

    Background Tennis elbow is an overuse injury affecting people performing repetitive forearm movements. It is a soft tissue disorder that causes significant disability and pain. The aim of the study was to establish that an intramuscular steroid injection is effective in the short-term pain relief and functional improvement of tennis elbow. The severity of pain at the injection site was monitored to determine whether the intramuscular injection is better tolerated than the intralesional injection. Methods and results 19 patients, who had no treatment for tennis elbow in the preceding 3 months, were recruited from Whipps Cross University Hospital, London, and were randomised to receive either 80 mg of intramuscular Depo-Medrone or 40 mg of intralesional Depo-Medrone injection. Blinding proved difficult as the injection sites differed and placebo arms were not included in the study. A Patient-Rated Tennis Elbow Evaluation (PRTEE) Questionnaire and a 10-point Likert scale were used to assess primary outcome. Six weeks after the treatment, there was a reduction in pain, improvement in function and total PRTEE scores in both intramuscular and intralesional groups (p=0.008) using a 95% CI for mean treatment difference of −26 to +16 points. A statistically significant result (p=0.001) in favour of intramuscular causing less pain at the injection site was noted. Conclusion Non-inferiority of intramuscular to intralesional injections was not confirmed; however, the intramuscular injection proved to be effective in reducing tennis elbow-related symptoms and was found less painful at the site of injection at the time of administration. Trial registration number EUDRACT Number: 2010-022131-11. REC Number: 10/H0718/76 (NRES, Central London REC 1). PMID:28879024

  19. Fracture toughness assessment of in-service aged primary circuit elbows using mini C(T) specimens taken from outer skin

    International Nuclear Information System (INIS)

    Jayet-Gendrot, S.; Meylogan, T.; Ould, P.

    1995-05-01

    Type CF8M cast duplex stainless steels used in the primary circuit elbows of pressurized water reactors are subject to thermal aging embrittlement at their service temperature, around 300 deg. C. This phenomenon affects their fracture toughness properties. In order to assess the residual fracture toughness of these elbows, estimations are made through predictive formulae based on chemical composition and aging conditions, which provide safe values. However, in the case of the most sensitive materials, it is important to obtain more accurate estimations. A new method of determination was thus considered, based on the testing of mini-CT specimens taken from the skin of in-service elbows. The feasibility of using mini-CT specimens to evaluate the tearing resistance of cast duplex stainless steels seems at first sight difficult, in particular because of the very coarse metallurgical structure of these steels: will small specimens be representative of larger volumes (mainly regular T-CT specimens) and will they not induce too much scatter ? In order to answer such questions, an experimental validation program has been undertaken: the completed program shows that the method is relevant and leads to proposed guidelines which aim at optimizing the experimental results analysis. Then the method is applied to an in-service elbow: the results obtained are found to be in good agreement with the toughness estimations given by our predictive formulae. This subsequently contributes to the validation of the general methodology used for the justification of French primary circuit elbows. (authors). 7 refs., 4 figs., 5 tabs

  20. Funding sources and financial disclosures, and their relationship to study outcomes and level of evidence in the Journal of Shoulder and Elbow Surgery.

    Science.gov (United States)

    Foughty, Zachary; Antalis, Matthew S; Ringenberg, Jonathan; Hall, Adam D

    2017-06-01

    Concern exists regarding the reliability of published manuscripts due to influence of industry funding and author financial conflicts of interest (COI). We aim to determine whether COI affect the outcome of a research study or the level of evidence (LOE). We reviewed 244 consecutive original articles in Journal of Shoulder and Elbow Surgery from January 2014 to December 2014. Articles included only those available in the printed journal. For LOE, 178 articles from the Shoulder and Elbow section were used (basic science articles were excluded). COI was determined by comparing financial disclosures and stated funding sources to the study content. COI were present in 44 of 244 articles (18%); of these, 24 (55%) had positive outcomes. Of the 200 without COI, 128 (64%) had positive outcomes. This difference in proportions was determined to be significant (P = .007). COI were present in 27 shoulder and elbow articles; of these, only 1 was LOE I or II (4%). Of the 151 without COI, 34 (23%) were LOE I or II. This difference in proportions was determined to be significant (P = .023). We found that Journal of Shoulder and Elbow Surgery articles with COI are neither more likely to have positive outcomes nor higher LOE than those with no COI. Although the χ 2 analysis found a statistically significant relationship between COI and study outcomes, the study outcomes were more often positive in articles without COI. This is contrary to previously published analyses that found outcomes to be more positive in articles with COI. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  1. Effects of cross-education on the muscle after a period of unilateral limb immobilization using a shoulder sling and swathe.

    Science.gov (United States)

    Magnus, Charlene R A; Barss, Trevor S; Lanovaz, Joel L; Farthing, Jonathan P

    2010-12-01

    The purpose of this study was to apply cross-education during 4 wk of unilateral limb immobilization using a shoulder sling and swathe to investigate the effects on muscle strength, muscle size, and muscle activation. Twenty-five right-handed participants were assigned to one of three groups as follows: the Immob + Train group wore a sling and swathe and strength trained (n = 8), the Immob group wore a sling and swathe and did not strength train (n = 8), and the Control group received no treatment (n = 9). Immobilization was applied to the nondominant (left) arm. Strength training consisted of maximal isometric elbow flexion and extension of the dominant (right) arm 3 days/wk. Torque (dynamometer), muscle thickness (ultrasound), maximal voluntary activation (interpolated twitch), and electromyography (EMG) were measured. The change in right biceps and triceps brachii muscle thickness [7.0 ± 1.9 and 7.1 ± 2.2% (SE), respectively] was greater for Immob + Train than Immob (0.4 ± 1.2 and -1.9 ± 1.7%) and Control (0.8 ± 0.5 and 0.0 ± 1.1%, P effect on maximal voluntary activation or EMG. The cross-education effect on the immobilized limb was greater after elbow extension training. This study suggests that strength training the nonimmobilized limb benefits the immobilized limb for muscle size and strength.

  2. Heterotopic ossification of the elbow after closed reduction and retrograde intramedullary nailing for radial neck fracture treated by anconeus interposition.

    Science.gov (United States)

    Sreenivas, T; Menon, Jagdish; Nataraj, A R

    2013-12-01

    Heterotopic ossification around the elbow can lead to considerable functional disability. We describe a case of a 42-year-old man who developed heterotopic ossification of his elbow after closed reduction of the elbow dislocation and radial neck fracture and retrograde intramedullary nailing for radial neck fracture. During the follow-up after initial surgery, movements of the elbow were gradually deteriorated and diagnosed as heterotopic ossification of the elbow. Implant removal, radial head excision along with heterotopic mass, and also interposition of the anconeus muscle resulted in improvement of his elbow mobility. At 18 months of follow-up, patient had elbow flexion arc of 15°-110°, 70° of supination, and 50° of pronation without recurrence of heterotopic ossification. The uniqueness of this case lies in the treatment of heterotopic ossification of the elbow to prevent its recurrence, which was developed after retrograde intramedullary nailing for radial neck fracture following closed reduction.

  3. Inertial sensors as measurement tools of elbow range of motion in gerontology

    Science.gov (United States)

    Sacco, G; Turpin, JM; Marteu, A; Sakarovitch, C; Teboul, B; Boscher, L; Brocker, P; Robert, P; Guerin, O

    2015-01-01

    Background and purpose Musculoskeletal system deterioration among the aging is a major reason for loss of autonomy and directly affects the quality of life of the elderly. Articular evaluation is part of physiotherapeutic assessment and helps in establishing a precise diagnosis and deciding appropriate therapy. Reference instruments are valid but not easy to use for some joints. The main goal of our study was to determine reliability and intertester reproducibility of the MP-BV, an inertial sensor (the MotionPod® [MP]) combined with specific software (BioVal [BV]), for elbow passive range-of-motion measurements in geriatrics. Methods This open, monocentric, randomized study compared inertial sensor to inclinometer in patients hospitalized in an acute, post-acute, and long-term-care gerontology unit. Results Seventy-seven patients (mean age 83.5±6.4 years, sex ratio 1.08 [male/female]) were analyzed. The MP-BV was reliable for each of the three measurements (flexion, pronation, and supination) for 24.3% (CI 95% 13.9–32.8) of the patients. Separately, the percentages of reliable measures were 59.7% (49.2–70.5) for flexion, 68.8% (58.4–79.5) for pronation, and 62.3% (51.2–73.1) for supination. The intraclass correlation coefficients were 0.15 (0.07–0.73), 0.46 (0.27–0.98), and 0.50 (0.31–40 0.98) for flexion, pronation, and supination, respectively. Conclusion This study shows the convenience of the MP-BV in terms of ease of use and of export of measured data. However, this instrument seems less reliable and valuable compared to the reference instruments used to measure elbow range of motion in gerontology. PMID:25759568

  4. Biomechanics of the elbow joint in tennis players and relation to pathology

    NARCIS (Netherlands)

    Eygendaal, Denise; Rahussen, F. T. G.; Diercks, R. L.

    Elbow injuries constitute a sizeable percentage of tennis injuries. A basic understanding of biomechanics of tennis and analysis of the forces, loads and motions of the elbow during tennis will improve the understanding of the pathophysiology of these injuries. All different strokes in tennis have a

  5. Functional Results in Arthroscopic Treatment in Patients with Chronic Lateral Elbow Pain.

    Science.gov (United States)

    Phorkhar, Termphong; Chanlalit, Cholawish

    2015-11-01

    Modern surgery as elbow arthroscopic surgery is an accepted operation due to benefit in precise intra-articular lesion detection and minimally invasive surgery. To report the functional results when using arthroscopic surgery to treat chronic lateral elbow pain. The data was collected from 25 patients with chronic lateral elbow pain that failed in non-operative treatment and treated with elbow arthroscopic surgery. Five patients were excluded from this study due to diagnosed as instability that needed the ligament reconstruction. The etiology of pain were grouped in to tennis elbow (4 pts), plica (9 pts), tennis elbow combined with plica (4 pts) and cartilage lesion (3 pts). Thai quick DASH questionnaire was used to evaluate the functional results by comparing pre and post operation score and calculated statistic results with paired t-test by level of significance p tennis elbow mean score was 74 and 33, in plica lesion mean score was 65 and 11, combined lesions mean score was 60 and 18 and cartilage lesion mean score was 60 and 20. Approaching chronic lateral elbow pain with arthroscopy can maintain the signficant improvement of functional result in midterm follow-up.

  6. Surgical Procedures of the Elbow: A Nationwide Cross-Sectional Observational Study in the United States

    Directory of Open Access Journals (Sweden)

    Ahmet Kinaci

    2015-01-01

    Full Text Available Background:  Elbow surgery is shared by several subspecialties. We were curious about the most common elbow surgeries and their corresponding diagnoses in the United States.   Methods:  We used the National Hospital Discharge Survey (NHDS and the National Survey of Ambulatory Surgery (NSAS data gathered in 2006-databases that together provide an estimate of all inpatient and ambulatory surgical care in the US.  Results:  An estimated 150,000 elbow surgeries were performed in the US in 2006, 75% in an outpatient setting. The most frequent diagnosis treated operative was enthesopathy (e.g. lateral epicondylitis and it was treated with several different procedures. More than three quarters of all elbow surgeries treated enthesopathy, cubital tunnel syndrome, or fracture (radial head in particular. Arthroscopy and arthroplasty accounted for less than 10% of all elbow surgeries.  Conclusions:  Elbow surgery in the United States primarily addresses enthesopathies such as tennis elbow, cubital tunnel syndrome, and trauma. It is notable that some of the most common elbow surgeries (those that address enthesopathy and radial head fracture are some of the most variably utilized and debated.

  7. Cost effectiveness of brace, physiotherapy, or both for treatment of tennis elbow

    NARCIS (Netherlands)

    Struijs, P. A. A.; Korthals-de Bos, I. B. C.; van Tulder, M. W.; van Dijk, C. N.; Bouter, L. M.; Assendelft, W. J. J.

    2006-01-01

    BACKGROUND: The annual incidence of tennis elbow in the general population is high (1-3%). Tennis elbow often leads to limitation of activities of daily living and work absenteeism. Physiotherapy and braces are the most common treatments. OBJECTIVES: The hypothesis of the trial was that no

  8. The predictive value of the extensor grip test for the effectiveness of bracing for tennis elbow

    NARCIS (Netherlands)

    Struijs, Peter A. A.; Assendelft, Willem J. J.; Kerkhoffs, Gino M. M. J.; Souer, Sebastiaan; van Dijk, C. Niek

    2005-01-01

    Background: Tennis elbow is a common complaint. Several treatment strategies, such as corticosteroid injections and physical therapy and braces, have been described. Hypothesis: The extensor grip test has predictive value in assessing the effectiveness of bracing in tennis elbow. Study Design:

  9. Genetic variances, trends and mode of inheritance for hip and elbow dysplasia in Finnish dog populations

    NARCIS (Netherlands)

    Mäki, K.; Groen, A.F.; Liinamo, A.E.; Ojala, M.

    2002-01-01

    The aims of this study were to assess genetic variances, trends and mode of inheritance for hip and elbow dysplasia in Finnish dog populations. The influence of time-dependent fixed effects in the model when estimating the genetic trends was also studied. Official hip and elbow dysplasia screening

  10. Ratcheting failure of pressurised straight pipes and elbows under reversed bending

    International Nuclear Information System (INIS)

    Vishnuvardhan, S.; Raghava, G.; Gandhi, P.; Saravanan, M.; Goyal, Sumit; Arora, Punit; Gupta, Suneel K.; Bhasin, Vivek

    2013-01-01

    Ratcheting studies were carried out on Type 304LN stainless steel straight pipes and elbows subjected to steady internal pressure and cyclic bending load. The internal pressure for all the straight pipes was 35 MPa and in the case of elbows the internal pressure was varied for different elbows, ranging from 27.6 MPa to 39.2 MPa. Cyclic bending load was applied on the specimens by subjecting them to different levels of load-line displacement. The specimens have undergone significant ratchet swelling (ballooning), ovalization and consequent thinning of the cross-section during ratcheting. The straight pipes failed either by occurrence of through-wall crack accompanied by simultaneous ballooning, or bursting with simultaneous ballooning. All the elbows failed by occurrence of through-wall crack accompanied by simultaneous ballooning. Ratcheting behaviour of straight pipes and elbows were compared and it was generally inferred that ratcheting was more pronounced in straight pipes than in elbows. -- Graphical abstract: Strain history for the specimen QCE-RAT-6-L1. Highlights: • Studies were carried out under combined internal pressure and cyclic bending. • Ratcheting strains were measured at critical locations of the specimens. • Quantified the percentage of ballooning, ovalization and reduction in thickness. • Modes of ratcheting failure of straight pipes and elbows are studied. • Inferred that ratcheting is more pronounced in straight pipes than in elbows

  11. Complex and unstable simple elbow dislocations: a review and quantitative analysis of individual patient data

    NARCIS (Netherlands)

    de Haan, Jeroen; Schep, Niels; Tuinebreijer, Wim; den Hartog, Dennis

    2010-01-01

    The primary objective of this review of the literature with quantitative analysis of individual patient data was to identify the results of available treatments for complex elbow dislocations and unstable simple elbow dislocations. The secondary objective was to compare the results of patients with

  12. Stability of the elbow joint: relevant anatomy and clinical implications of in vitro biomechanical studies

    NARCIS (Netherlands)

    de Haan, J.; Schep, N. W. L.; Eygendaal, D.; Kleinrensink, G.-J.; Tuinebreijer, W. E.; den Hartog, D.

    2011-01-01

    The aim of this literature review is to describe the clinical anatomy of the elbow joint based on information from in vitro biomechanical studies. The clinical consequences of this literature review are described and recommendations are given for the treatment of elbow joint dislocation.The PubMed

  13. Stability of the Elbow Joint: Relevant Anatomy and Clinical Implications of In Vitro Biomechanical Studies

    NARCIS (Netherlands)

    J. de Haan (Jeroen); D. Eygendaal (Denise); N.W.L. Schep (Niels); G.J. Kleinrensink (Gert Jan); W.E. Tuinebreijer (Wim); D. den Hartog (Dennis)

    2011-01-01

    textabstractAbstract: The aim of this literature review is to describe the clinical anatomy of the elbow joint based on information from in vitro biomechanical studies. The clinical consequences of this literature review are described and recommendations are given for the treatment of elbow joint

  14. An evaluation of the carrying angle of the elbow joint in adolescents

    African Journals Online (AJOL)

    McRoy

    Department of Anatomy and Orthopedics, Sri Lakshmi Narayana Institute of Medical Sciences,. Pondicherry - 605 502 ... forearm deviates laterally from the long axis of the humerus, with the arm extended and the palm ... for elbow reconstruction. Key words: Carrying angle, elbow joint, adolescent, forearm, humerus, ulna ...

  15. Isometric elbow extensors strength in supine- and prone-lying positions.

    Science.gov (United States)

    Abdelzaher, Ibrahim E; Ababneh, Anas F; Alzyoud, Jehad M

    2013-01-01

    The purpose of this study was to compare isometric strength of elbow extensors measured in supine- and prone-lying positions at elbow flexion angles of 45 and 90 degrees. Twenty-two male subjects under single-blind procedures participated in the study. Each subject participated in both supine-lying and prone-lying measuring protocols. Calibrated cable tensiometer was used to measure isometric strength of the right elbow extensors and a biofeedback electromyography was used to assure no substitution movements from shoulder girdle muscles. The mean values of isometric strength of elbow extensors measured from supine-lying position at elbow flexion angles of 45 and 90 degrees were 11.1  ±  4.2 kg and 13.1  ±  4.6 kg, while those measured from prone-lying position were 9.9  ±  3.6 kg and 12  ±  4.2 kg, respectively. There is statistical significant difference between the isometric strength of elbow extensors measured from supine-lying position at elbow flexion angles of 45 and 90 degrees compared to that measured from prone-lying position (p  isometric strength of elbow extensors since supine-lying starting position is better than prone-lying starting position.

  16. Angioleiomyoma: A Rare Cause of Fixed Flexion Contracture of the Elbow

    Directory of Open Access Journals (Sweden)

    Asterios Dramis

    2006-01-01

    Full Text Available We describe an unusual case of a patient presented with a painless fixed flexion contracture of the elbow due to an angioleiomyoma. This benign smooth muscle tumour should be considered in the differential diagnosis of flexion contractures of the elbow.

  17. Fracture behavior of circumferentially surface-cracked elbows. Technical report, October 1993--March 1996

    International Nuclear Information System (INIS)

    Kilinski, T.; Mohan, R.; Rudland, D.; Fleming, M.

    1996-12-01

    This report presents the results from Task 2 of the Second International Piping Integrity Research Group (IPIRG-2) program. The focus of the Task 2 work was directed towards furthering the understanding of the fracture behavior of long-radius elbows. This was accomplished through a combined analytical and experimental program. J-estimation schemes were developed for both axial and circumferential surface cracks in elbows. Large-scale, quasi-static and dynamic, pipe-system, elbow fracture experiments under combined pressure and bending loads were performed on elbows containing an internal surface crack at the extrados. In conjunction with the elbow experiments, material property data were developed for the A106-90 carbon steel and WP304L stainless steel elbow materials investigated. A comparison of the experimental data with the maximum stress predictions using existing straight pipe fracture prediction analysis methods, and elbow fracture prediction methods developed in this program was performed. This analysis was directed at addressing the concerns regarding the validity of using analysis predictions developed for straight pipe to predict the fracture stresses of cracked elbows. Finally, a simplified fitting flaw acceptance criteria incorporating ASME B2 stress indices and straight pipe, circumferential-crack analysis was developed

  18. ARTHROSCOPIC TREATMENT OF THE LATERAL ELBOW PAIN –OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Oskar Zupanc

    2008-01-01

    Arthroscopic treatment of the lateral elbow pain has been proved to be very effectiveespecially in younger population and in patients with early elbow osteoarthritis. The lengthof hospital stay is reduced. However, the length of rehabilitation depends on the stage ofelbow osteoarthritis and extensiveness of the arthroscopic intervention

  19. Fracture behavior of circumferentially surface-cracked elbows. Technical report, October 1993--March 1996

    Energy Technology Data Exchange (ETDEWEB)

    Kilinski, T.; Mohan, R.; Rudland, D.; Fleming, M. [and others

    1996-12-01

    This report presents the results from Task 2 of the Second International Piping Integrity Research Group (IPIRG-2) program. The focus of the Task 2 work was directed towards furthering the understanding of the fracture behavior of long-radius elbows. This was accomplished through a combined analytical and experimental program. J-estimation schemes were developed for both axial and circumferential surface cracks in elbows. Large-scale, quasi-static and dynamic, pipe-system, elbow fracture experiments under combined pressure and bending loads were performed on elbows containing an internal surface crack at the extrados. In conjunction with the elbow experiments, material property data were developed for the A106-90 carbon steel and WP304L stainless steel elbow materials investigated. A comparison of the experimental data with the maximum stress predictions using existing straight pipe fracture prediction analysis methods, and elbow fracture prediction methods developed in this program was performed. This analysis was directed at addressing the concerns regarding the validity of using analysis predictions developed for straight pipe to predict the fracture stresses of cracked elbows. Finally, a simplified fitting flaw acceptance criteria incorporating ASME B2 stress indices and straight pipe, circumferential-crack analysis was developed.

  20. Long term results in refractory tennis elbow using autologous blood.

    Science.gov (United States)

    Gani, Naseem Ul; Khan, Hayat Ahmad; Kamal, Younis; Farooq, Munir; Jeelani, Hina; Shah, Adil Bashir

    2014-10-27

    Tennis elbow (TE) is one of the commonest myotendinosis. Different treatment options are available and autologous blood injection has emerged as the one of the acceptable modalities of treatment. Long term studies over a larger group of patients are however lacking. The purpose of this study was to evaluate these patients on longer durations. One-hundred and twenty patients of TE, who failed to respond to conventional treatment including local steroid injections were taken up for this prospective study over the period from year 2005 to 2011 and were followed up for the minimum of 3 years (range 3-9 years). Two mL of autologous blood was taken from the ipsilateral limb and injected into the lateral epicondyle. The effectiveness of the procedure was assessed by Pain Rating Sscale and Nirschl Staging, which was monitored before the procedure, at first week, monthly for first three months, at 6 months and then 3 monthly for first year, six monthly for next 2 years and then yearly. Statistical analysis was done and a P value of tennis elbow should be made as there is lot of controversy regarding the treatment.

  1. Acute effects of maximal isometric muscle action of the elbow extensors on contralateral dynamic task of the elbow flexors: a pilot study

    Directory of Open Access Journals (Sweden)

    Cauê V La Scala Teixeira

    2017-12-01

    Full Text Available ABSTRACT Aim the aim was to investigate the influence of a maximal isometric muscle action of the elbow extensors on the contralateral dynamic task of the elbow flexors. Methods Seventeen recreationally trained men (23.3 ± 4.9 yrs, BMI: 24.8 ± 2.2 Kg/m² underwent two randomized different testing sessions separated by one week. In the control session (CON all subjects performed a maximum number of repetitions test (RMs at 75%1RM using the right elbow flexors. The experimental session (EXP was similar to the CON; however, all subjects were instructed to perform RMs at 75%1RM by using the right elbow flexors and maintaining the maximal voluntary contraction of the left elbow extensors during the test. RMs, rating of perceived exertion (RPE, and training volume (TV were measured and compared between sessions. Results The EXP showed a significant 10.4% increase on the RMs (13.8 vs. 12.5, p < 0.001, d = 0.44 and 12.1% increase in TV (238.0 vs. 212.4 kg, p < 0.001, d = 0.43 than CON. No differences were observed for RPE between sessions. Conclusion The maximum voluntary contraction of the left elbow extensors increased the RMs of the contralateral elbow flexors, reflecting a higher TV, and no differences in the RPE. Our results suggest that the investigated method may be a viable and practical alternative to increase the acute strength performance of elbow flexors when using submaximal loads.

  2. Status of plutonium ceramic immobilization processes and immobilization forms

    Energy Technology Data Exchange (ETDEWEB)

    Ebbinghaus, B.B.; Van Konynenburg, R.A. [Lawrence Livermore National Lab., CA (United States); Vance, E.R.; Jostsons, A. [Australian Nuclear Science and Technology Organization, Menai (Australia)] [and others

    1996-05-01

    Immobilization in a ceramic followed by permanent emplacement in a repository or borehole is one of the alternatives currently being considered by the Fissile Materials Disposition Program for the ultimate disposal of excess weapons-grade plutonium. To make Pu recovery more difficult, radioactive cesium may also be incorporated into the immobilization form. Valuable data are already available for ceramics form R&D efforts to immobilize high-level and mixed wastes. Ceramics have a high capacity for actinides, cesium, and some neutron absorbers. A unique characteristic of ceramics is the existence of mineral analogues found in nature that have demonstrated actinide immobilization over geologic time periods. The ceramic form currently being considered for plutonium disposition is a synthetic rock (SYNROC) material composed primarily of zirconolite (CaZrTi{sub 2}O{sub 7}), the desired actinide host phase, with lesser amounts of hollandite (BaAl{sub 2}Ti{sub 6}O{sub 16}) and rutile (TiO{sub 2}). Alternative actinide host phases are also being considered. These include pyrochlore (Gd{sub 2}Ti{sub 2}O{sub 7}), zircon (ZrSiO{sub 4}), and monazite (CePO{sub 4}), to name a few of the most promising. R&D activities to address important technical issues are discussed. Primarily these include moderate scale hot press fabrications with plutonium, direct loading of PuO{sub 2} powder, cold press and sinter fabrication methods, and immobilization form formulation issues.

  3. Status of plutonium ceramic immobilization processes and immobilization forms

    International Nuclear Information System (INIS)

    Ebbinghaus, B.B.; Van Konynenburg, R.A.; Vance, E.R.; Jostsons, A.

    1996-01-01

    Immobilization in a ceramic followed by permanent emplacement in a repository or borehole is one of the alternatives currently being considered by the Fissile Materials Disposition Program for the ultimate disposal of excess weapons-grade plutonium. To make Pu recovery more difficult, radioactive cesium may also be incorporated into the immobilization form. Valuable data are already available for ceramics form R ampersand D efforts to immobilize high-level and mixed wastes. Ceramics have a high capacity for actinides, cesium, and some neutron absorbers. A unique characteristic of ceramics is the existence of mineral analogues found in nature that have demonstrated actinide immobilization over geologic time periods. The ceramic form currently being considered for plutonium disposition is a synthetic rock (SYNROC) material composed primarily of zirconolite (CaZrTi 2 O 7 ), the desired actinide host phase, with lesser amounts of hollandite (BaAl 2 Ti 6 O 16 ) and rutile (TiO 2 ). Alternative actinide host phases are also being considered. These include pyrochlore (Gd 2 Ti 2 O 7 ), zircon (ZrSiO 4 ), and monazite (CePO 4 ), to name a few of the most promising. R ampersand D activities to address important technical issues are discussed. Primarily these include moderate scale hot press fabrications with plutonium, direct loading of PuO 2 powder, cold press and sinter fabrication methods, and immobilization form formulation issues

  4. Results of Posterior Dislocation of Elbow Associated with Bony and Soft Tissue Injury

    Directory of Open Access Journals (Sweden)

    Neel M Bhavsar

    2013-03-01

    Full Text Available Elbow trauma is challenging to manage by virtue of its complex articular structure and capsuloligamentous and musculotendinous arrangements. We included 17 patients with elbow dislocation and associated injuries in this study. The study protocol included early elbow reduction and planned fixation of the medial or lateral condyle, coronoid and radial head. The sample was 73% male and 27% female with mean duration follow-up of 8 months, and mean age of 37 years. The mean Mayo Elbow Performance Score was 96 points at conclusion of follow-up, indicating an excellent result in 14 patients. Whenever the radial head was excised, we performed a strong transosseous ligamentous repair of the medial and lateral collateral ligaments. Fixation of the coronoid is essential for elbow stability. A small avulsed fragment can be fixed using an ACL jig. We found this technique very useful. Early planned intervention, stable fixation, and repair provide sufficient stability and enhance functional outcomes.

  5. Effect of strength training on regional hypertrophy of the elbow flexor muscles.

    Science.gov (United States)

    Drummond, Marcos D M; Szmuchrowski, Leszek A; Goulart, Karine N O; Couto, Bruno P

    2016-10-01

    Muscle hypertrophy is the main structural adaptation to strength training. We investigated the chronic effects of strength training on muscle hypertrophy in different regions of the elbow flexor muscles. Eleven untrained men (21.8 ± 1.62 years) underwent magnetic resonance imaging to determine the proximal, medial, distal, and mean cross-sectional areas (CSA) of the elbow flexors. The volunteers completed 12 weeks of strength training. The training protocol consisted of 4 sets of 8-10 maximum repetitions of unilateral elbow flexion. The interval between sets was 120 s. The training frequency was 3 sessions per week. The magnetic resonance images verified the presence of significant and similar hypertrophy in the distal, medial, and proximal portions of the elbow flexor muscles. Muscle hypertrophy may be assessed using only the medial CSA. We should not expect different degrees of hypertrophy among the regions of the elbow flexor muscles. Muscle Nerve 54: 750-755, 2016. © 2016 Wiley Periodicals, Inc.

  6. Finite Element Analysis and Experimental Study on Elbow Vibration Transmission Characteristics

    Science.gov (United States)

    Qing-shan, Dai; Zhen-hai, Zhang; Shi-jian, Zhu

    2017-11-01

    Pipeline system vibration is one of the significant factors leading to the vibration and noise of vessel. Elbow is widely used in the pipeline system. However, the researches about vibration of elbow are little, and there is no systematic study. In this research, we firstly analysed the relationship between elbow vibration transmission characteristics and bending radius by ABAQUS finite element simulation. Then, we conducted the further vibration test to observe the vibration transmission characteristics of different elbows which have the same diameter and different bending radius under different flow velocity. The results of simulation calculation and experiment both showed that the vibration acceleration levels of the pipeline system decreased with the increase of bending radius of the elbow, which was beneficial to reduce the transmission of vibration in the pipeline system. The results could be used as reference for further studies and designs for the low noise installation of pipeline system.

  7. Magnetic resonance imaging of the elbow. Part II: Abnormalities of the ligaments, tendons, and nerves

    Energy Technology Data Exchange (ETDEWEB)

    Kijowski, Richard; Tuite, Michael; Sanford, Matthew [University of Wisconsin Hospital, Department of Radiology, Madison, WI (United States)

    2005-01-01

    Part II of this comprehensive review on magnetic resonance imaging of the elbow discusses the role of magnetic resonance imaging in evaluating patients with abnormalities of the ligaments, tendons, and nerves of the elbow. Magnetic resonance imaging can yield high-quality multiplanar images which are useful in evaluating the soft tissue structures of the elbow. Magnetic resonance imaging can detect tears of the ulnar collateral ligament and lateral collateral ligament of the elbow with high sensitivity and specificity. Magnetic resonance imaging can determine the extent of tendon pathology in patients with medial epicondylitis and lateral epicondylitis. Magnetic resonance imaging can detect tears of the biceps tendon and triceps tendon and can distinguishing between partial and complete tendon rupture. Magnetic resonance imaging is also helpful in evaluating patients with nerve disorders at the elbow. (orig.)

  8. Multiple nucleophilic elbows leading to multiple active sites in a single module esterase from Sorangium cellulosum

    DEFF Research Database (Denmark)

    Udatha, D.B.R.K. Gupta; Madsen, Karina Marie; Panagiotou, Gianni

    2015-01-01

    The catalytic residues in carbohydrate esterase enzyme families constitute a highly conserved triad: serine, histidine and aspartic acid. This catalytic triad is generally located in a very sharp turn of the protein backbone structure, called the nucleophilic elbow and identified by the consensus...... sequence GXSXG. An esterase from Sorangium cellulosum Soce56 that contains five nucleophilic elbows was cloned and expressed in Escherichia coli and the function of each nucleophilic elbowed site was characterized. In order to elucidate the function of each nucleophilic elbow, site directed mutagenesis....... To our knowledge, this is the first report presenting the role of multiple nucleophilic elbows in the catalytic promiscuity of an esterase. Further structural analysis at protein unit level indicates the new evolutionary trajectories in emerging promiscuous esterases....

  9. A meniscus causing painful snapping of the elbow joint: MR imaging with arthroscopic and histologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Guo-Shu; Chen, Cheng-Yu [National Defense Medical Center, Department of Radiology, Tri-Service General Hospital, Taipei (Taiwan); Lee, Chian-Her [National Defense Medical Center, Department of Orthopedic Surgery, Tri-Service General Hospital, Taipei (Taiwan); Lee, Herng-Sheng [National Defense Medical Center, Department of Pathology, Tri-Service General Hospital, Taipei (Taiwan)

    2005-12-01

    Snapping of the elbow joint can cause pain. We report a case of painful snapping elbow produced by an interposed meniscus in the radiohumeral joint in a 20-year-old man. The MR arthrogram demonstrated a meniscus-like tissue interposed between the radial head and humeral capitellum. The MR-arthrographic findings were well correlated with surgical findings. The location and appearance of the meniscus-like tissue was similar to that of meniscus in the knee joint. Histologic findings of the excised meniscus-like tissue showed a typical presentation of fibrocartilage. A meniscus may exist in the elbow joint and can be a rare cause of painful snapping elbow. MR arthrography is helpful for identifying the snapping tissue in the elbow joint. (orig.)

  10. Geometric effects of 90-degree vertical elbows on local two-phase flow parameters

    International Nuclear Information System (INIS)

    Yadav, M.; Worosz, T.; Kim, S.

    2011-01-01

    This study presents the geometric effects of 90-degree vertical elbows on the development of the local two-phase flow parameters. A multi-sensor conductivity probe is used to measure local two-phase flow parameters. It is found that immediately downstream of the vertical-upward elbow, the bubbles have a bimodal distribution along the horizontal radius of the pipe cross-section causing a dual-peak in the profiles of local void fraction and local interfacial area concentration. Immediately downstream of the vertical-downward elbow it is observed that the bubbles tend to migrate towards the inside of the elbow's curvature. The axial transport of void fraction and interfacial area concentration indicates that the elbows promote bubble disintegration. Preliminary predictions are obtained from group-one interfacial area transport equation (IATE) model for vertical-upward and vertical-downward two-phase flow. (author)

  11. The effect of repetitive baseball pitching on medial elbow joint space gapping associated with 2 elbow valgus stressors in high school baseball players.

    Science.gov (United States)

    Hattori, Hiroshi; Akasaka, Kiyokazu; Otsudo, Takahiro; Hall, Toby; Amemiya, Katsuya; Mori, Yoshihisa

    2018-04-01

    To prevent elbow injury in baseball players, various methods have been used to measure medial elbow joint stability with valgus stress. However, no studies have investigated higher levels of elbow valgus stress. This study investigated medial elbow joint space gapping measured ultrasonically resulting from a 30 N valgus stress vs. gravitational valgus stress after a repetitive throwing task. The study included 25 high school baseball players. Each subject pitched 100 times. The ulnohumeral joint space was measured ultrasonographically, before pitching and after each successive block of 20 pitches, with gravity stress or 30 N valgus stress. Two-way repeated measures analysis of variance and Pearson correlation coefficient analysis were used. The 30 N valgus stress produced significantly greater ulnohumeral joint space gapping than gravity stress before pitching and at each successive 20-pitch block (P space gapping increased significantly from baseline after 60 pitches (P space gapping (r = 0.727-0.859, P space gapping before pitching; however, 30 N valgus stress appears to induce greater mechanical stress, which may be preferable when assessing joint instability but also has the potential to be more aggressive. The present results may indicate that constraining factors to medial elbow joint valgus stress matched typical viscoelastic properties of cyclic creep. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  12. Immobilization of technetium and nitrate in cement-based materials

    International Nuclear Information System (INIS)

    Tallent, O.K.; McDaniel, E.W.; Del Cul, G.D.; Dodson, K.E.; Trotter, D.R.

    1987-01-01

    The leachabilities of technetium and nitrate wastes immobilized in cement-based grouts have been investigated. Factors found to affect the leachabilities include grout mix ratio, grout fluid density, dry solid blend composition, and waste concentration. 10 refs., 7 figs., 3 tabs

  13. Intrinsic constraint of unlinked total elbow replacements--the ulnotrochlear joint.

    Science.gov (United States)

    Kamineni, S; O'Driscoll, S W; Urban, M; Garg, A; Berglund, L J; Morrey, B F; An, K N

    2005-09-01

    Many unlinked total elbow replacement designs with radically differing articular geometries exist, suggesting that there is no consensus regarding an optimal design. A feature inherent to the articular design is the intrinsic constraint afforded to the joint by the implant. Our aim was to compare the intrinsic constraints of unlinked implants with that of the normal ulnotrochlear joint. We tested twelve cadaveric ulnotrochlear joints with a custom-made multiple-axis materials testing machine. With compressive loads ranging from 10 to 100 N, the joints were moved in either valgus or varus directions at 90 degrees of flexion. The ulnotrochlear components from a single example of five medium-sized unlinked elbow replacements (Ewald, Kudo, Pritchard ERS, Sorbie-Questor, and Souter-Strathclyde) were also tested. The recorded measurements included the torques and forces, angular displacement, and axial displacement of the humerus relative to the ulna. In general, the peak torque and the constraint ratio significantly increased with increasing compressive load for the implants as well as for the normal elbow. In valgus displacement, the Souter-Strathclyde implant had the highest and the Sorbie-Questor had the smallest peak torque and the Souter-Strathclyde had the highest and the Ewald had the smallest constraint ratio. In varus displacement, the Kudo had the highest and the Ewald had the smallest peak torque and constraint ratio. The constraint ratio is a characteristic that is useful for describing elbow joint behavior and for comparing the behavior of implants with that of the human elbow. Of the unlinked implants tested, the Souter-Strathclyde and Kudo prostheses most closely approximated the behavior of the human elbow joint. Implants that resemble the human elbow in appearance do not replicate normal behavior consistently, whereas other implants that do not resemble the human elbow closely do not deviate markedly from human behavior. Thus, much basic information

  14. Can We Achieve Intuitive Prosthetic Elbow Control Based on Healthy Upper Limb Motor Strategies?

    Directory of Open Access Journals (Sweden)

    Manelle Merad

    2018-02-01

    Full Text Available Most transhumeral amputees report that their prosthetic device lacks functionality, citing the control strategy as a major limitation. Indeed, they are required to control several degrees of freedom with muscle groups primarily used for elbow actuation. As a result, most of them choose to have a one-degree-of-freedom myoelectric hand for grasping objects, a myoelectric wrist for pronation/supination, and a body-powered elbow. Unlike healthy upper limb movements, the prosthetic elbow joint angle, adjusted prior to the motion, is not involved in the overall upper limb movements, causing the rest of the body to compensate for the lack of mobility of the prosthesis. A promising solution to improve upper limb prosthesis control exploits the residual limb mobility: like in healthy movements, shoulder and prosthetic elbow motions are coupled using inter-joint coordination models. The present study aims to test this approach. A transhumeral amputated individual used a prosthesis with a residual limb motion-driven elbow to point at targets. The prosthetic elbow motion was derived from IMU-based shoulder measurements and a generic model of inter-joint coordinations built from healthy individuals data. For comparison, the participant also performed the task while the prosthetic elbow was implemented with his own myoelectric control strategy. The results show that although the transhumeral amputated participant achieved the pointing task with a better precision when the elbow was myoelectrically-controlled, he had to develop large compensatory trunk movements. Automatic elbow control reduced trunk displacements, and enabled a more natural body behavior with synchronous shoulder and elbow motions. However, due to socket impairments, the residual limb amplitudes were not as large as those of healthy shoulder movements. Therefore, this work also investigates if a control strategy whereby prosthetic joints are automatized according to healthy individuals

  15. Influence of body mass index on the outcome of brachial plexus surgery: are there any differences between elbow and shoulder results?

    Science.gov (United States)

    Socolovsky, Mariano; Martins, Roberto S; Di Masi, Gilda; Bonilla, Gonzalo; Siqueira, Mario G

    2014-12-01

    Body mass index (BMI) has recently been identified as a predictor of outcomes following reconstructive surgery of shoulder palsies. In this study, we sought to determine if the same holds true for the reconstruction of elbow flexion. Forty patients who had undergone partial ulnar-to-biceps nerve transfer (Oberlin's procedure) for shoulder palsy were assessed and compared against 18 previously reported patients who had undergone reconstruction for elbow palsies. The British Medical Research Council (BMRC) scale and an index dividing shoulder abduction strength in the affected arm by healthy arm were recorded. All patients had undergone surgery within 12 months of injury and had ≥ 12 months of follow-up. M4 or M3 biceps strength was obtained in 90 % of patients. Final strength on the affected side averaged 5.8 kg, versus 20.2 kg on the normal side, for a mean recovery index score of 0.30. In this sample of 40 patients, BMI did not predict percentage strength or BMRC grade recovery. Neither did age, number of roots involved, the affected side, nor time to surgery. Comparing patients with elbow versus shoulder reconstruction, there were no differences, except that patients undergoing Oberlin's procedure had a statistically longer duration of time between injury and surgical repair (7.4 vs 5.1 months, p surgery.

  16. A Newly Designed Tennis Elbow Orthosis With a Traditional Tennis Elbow Strap in Patients With Lateral Epicondylitis

    Science.gov (United States)

    Saremi, Hossein; Chamani, Vahid; Vahab-Kashani, Reza

    2016-01-01

    Background Lateral epicondylitis is a common cause of pain and upper limb dysfunction. The use of counterforce straps for treatment of lateral epicondylitis is widespread. This kind of orthosis can be modified to have a greater effect on relieving pain by reducing tension on the origin of the extensor pronator muscles. Objectives To determine the immediate effects of a newly designed orthosis on pain and grip strength in patients with lateral epicondylitis. Materials and Methods Twelve participants (six men and six women) were recruited (mean age = 41 ± 6.7 years) and evaluated for pain and grip strength in three sessions. A 48-hour break was taken between each session. The first session was without any orthosis, the second session was with the new modified tennis elbow orthosis, and the third session was with a conventional tennis elbow strap. Results Both counterforce straps were effective. However, significantly more improvement was observed in pain and grip strength after using the newly modified orthosis (P < 0.05). Conclusions The newly designed strap reduces pain more effectively and improves grip strength by causing greater localized pressure on two regions with different force applications (two component vectors versus one). PMID:28180116

  17. A Newly Designed Tennis Elbow Orthosis With a Traditional Tennis Elbow Strap in Patients With Lateral Epicondylitis.

    Science.gov (United States)

    Saremi, Hossein; Chamani, Vahid; Vahab-Kashani, Reza

    2016-07-01

    Lateral epicondylitis is a common cause of pain and upper limb dysfunction. The use of counterforce straps for treatment of lateral epicondylitis is widespread. This kind of orthosis can be modified to have a greater effect on relieving pain by reducing tension on the origin of the extensor pronator muscles. To determine the immediate effects of a newly designed orthosis on pain and grip strength in patients with lateral epicondylitis. Twelve participants (six men and six women) were recruited (mean age = 41 ± 6.7 years) and evaluated for pain and grip strength in three sessions. A 48-hour break was taken between each session. The first session was without any orthosis, the second session was with the new modified tennis elbow orthosis, and the third session was with a conventional tennis elbow strap. Both counterforce straps were effective. However, significantly more improvement was observed in pain and grip strength after using the newly modified orthosis (P < 0.05). The newly designed strap reduces pain more effectively and improves grip strength by causing greater localized pressure on two regions with different force applications (two component vectors versus one).

  18. Immobilization needs and technology programs

    International Nuclear Information System (INIS)

    Gray, L.W.; Kan, T.; Shaw, H.; Armantrout, G.

    1995-01-01

    In the aftermath of the Cold War, the US and Russia agreed to large reductions in nuclear weapons. To aid in the selection of long-term management options, DOE has undertaken a multifaceted study to select options for storage and disposition of plutonium in keeping with US policy that plutonium must be subjected to the highest standards of safety, security, and accountability. One alternative being considered is immobilization. To arrive at a suitable immobilization form, we first reviewed published information on high-level waste immobilization technologies and identified 72 possible plutonium immobilization forms to be prescreened. Surviving forms were further screened using multi-attribute utility analysis to determine the most promising technology families. Promising immobilization families were further evaluated to identify chemical, engineering, environmental, safety, and health problems that remain to be solved prior to making technical decisions as to the viability of using the form for long- term disposition of plutonium. From this evaluation, a detailed research and development plan has been developed to provide answers to these remaining questions

  19. Synthesis and immobilization of polystyreneb-polyvinyltriethoxysilane micelles

    KAUST Repository

    Zhu, Saisai

    2018-01-31

    Diblock copolymers polystyrene-block-polyvinyltriethoxysilane (PS-b-PVTES) were synthesized via atom transfer radical polymerization (ATRP), which self-assembled into spherical micelles in solvent of THF-methanol mixtures. The self-assembled micelles were immobilized by cross-linking reaction of VTES in a shell layer of micelles. The chemical structures of block copolymers and morphology of micelles were characterized in detail. It was found that the size of immobilized micelles was strongly affected by the copolymer concentration, composition of mixture solvent, and block ratios.

  20. Immobilization of cellulase by radiation polymerization

    International Nuclear Information System (INIS)

    Kumakura, M.; Kaetsu, I.

    1983-01-01

    Immobilization of cellulase by radiation polymerization at low temperatures was studied. The enzymatic activity of immobilized cellulase pellets varied with the monomer, enzyme concentration, and the thickness of immobilized cellulase pellets. The optimum monomer concentration in the immobilization of cellulase was 30-50% at the pellet thickness of 1.0 mm, in which the enzymatic activity was 50%. The enzymatic activity of immobilized cellulase pellets was examined using various substrates such as cellobiose, carboxymethylcellulose, and paper pretreated by radiation. It was found that irradiated paper can be hydrolyzed by immobilized cellulase pellets. (author)

  1. Revisiting the anatomy and biomechanics of the anconeus muscle and its role in elbow stability.

    Science.gov (United States)

    Pereira, Barry P

    2013-07-01

    Recent studies have designated the anconeus muscle as an option for use as a pedicled flap for covering soft tissue defects about the elbow, with reported minimal risk of morbidity. This has raised the question as to the importance of the anconeus muscle and as to whether this is truly an accessory muscle that can be sacrificed, or whether the anconeus muscle significantly contributes to elbow and forearm stability? This study revisits the anatomy and biomechanics of the anconeus muscle and aims to investigate the neuromuscular compartments of the anconeus muscle and to determine the changes in the muscle length, fibre length and moment arm over a range of elbow flexion angles for each compartment. An anatomical study on 8 human cadavers (51-77 years of age) was done and a 2-dimensional kinematic elbow model developed to determine changes in the muscle length and moment arm of the muscle related to changes in elbow flexion angles. The muscle was modelled with two possible lines of action, one along the posterior and another on the anterior edge of the muscle as they had different muscle fibre lengths (posterior: average of 32 mm, anterior: average of 20 mm). The anterior edge also had an aponeurosis which was 70% of its length. From 0 to 120° elbow flexion, the length of the posterior and anterior edges increased with a maximum change recorded at 90° elbow flexion (31.7±1.0 mm and 65.3±1.4 mm, respectively). The moment arm is 14-mm at 0° flexion, but between the posterior and anterior edges it decreases at different rates with increasing elbow flexion angle. Beyond 80°, the anterior edge behaves as an elbow flexor, while the posterior edge remains an elbow extensor. The study demonstrates that the anconeus muscle has two neuromuscular compartments each with distinct intramuscular innervations and muscle fibre lengths. The posterior and deep aspect of the muscle functions as an elbow extensor decreasing in influence with increasing elbow flexion angle. The

  2. Use of a radiographic scoring technique for the assessment of dogs with elbow osteochondrosis

    International Nuclear Information System (INIS)

    Guthrie, S.

    1989-01-01

    A retrospective study was made of 335 dogs with elbow osteochondrosis that had been seen at the Royal Veterinary College in 1977 to 1987. The most commonly affected breeds were the labrador, retriever and rottweiler. Males were affected more often than females. The condition was bilateral in 50 per cent of cases and the peak age for the onset of lameness was four to six months. In rottweilers, the lesions found at exploratory arthrotomy were predominantly abnormalities of the coronoid process, while in retrievers and labradors lesions most commonly affected the medial humeral condyle or the coronoid process. A scoring system for grading the standard projection (lateral and postero-anterior) radiographs was devised and the score was correlated with the lesion found at surgery. Some cases were reviewed radiographically and any alteration in the degree of periarticular arthrosis, seen as an increase in radiographic score, was noted. The exact extent of the lesion found at surgery was recorded diagrammatically in 65 cases. It did not prove possible to predict from the radiographic score the nature and extent of the lesion and no correlation could be found between the radiographic score [and clinical degree of lameness. The scoring system did have some merit for reviewing cases because an increase in score indicated the extent to which joint changes had advanced

  3. Immobile Complex Verbs in Germanic

    DEFF Research Database (Denmark)

    Vikner, Sten

    2005-01-01

    the V° requirements or the V* requirements. Haider (1993, p. 62) and Koopman (1995), who also discuss such immobile verbs, only account for verbs with two prefix-like parts (e.g., German uraufführen ‘to perform (a play) for the first time' or Dutch herinvoeren ‘to reintroduce'), not for the more...... frequent type with only one prefix-like part (e.g., German bauchreden/Dutch buikspreken ‘to ventriloquize'). This analysis will try to account not only for the data discussed in Haider (1993) and Koopman (1995) but also for the following: - why immobile verbs include verbs with only one prefix-like part...... are immobile, - why such verbs are not found in Germanic VO-languages such as English and Scandinavian....

  4. Light transfer in agar immobilized microalgae cell cultures

    Science.gov (United States)

    Kandilian, Razmig; Jesus, Bruno; Legrand, Jack; Pilon, Laurent; Pruvost, Jérémy

    2017-09-01

    This paper experimentally and theoretically investigates light transfer in agar-immobilized cell cultures. Certain biotechnological applications such as production of metabolites secreted by photosynthetic microorganisms require cells to be immobilized in biopolymers to minimize contamination and to facilitate metabolite recovery. In such applications, light absorption by cells is one of the most important parameters affecting cell growth or metabolite productivity. Modeling light transfer therein can aid design and optimize immobilized-cell reactors. In this study, Parachlorella kessleri cells with areal biomass concentrations ranging from 0.36 to 16.9 g/m2 were immobilized in 2.6 mm thick agar gels. The average absorption and scattering cross-sections as well as the scattering phase function of P. kessleri cells were measured. Then, the absorption and transport scattering coefficients of the agar gel were determined using an inverse method based on the modified two-flux approximation. The forward model was used to predict the normal-hemispherical transmittance and reflectance of the immobilized-cell films accounting for absorption and scattering by both microalgae and the agar gel. Good agreement was found between the measured and predicted normal-hemispherical transmittance and reflectance provided absorption and scattering by agar were taken into account. Moreover, good agreement was found between experimentally measured and predicted mean rate of photon absorption. Finally, optimal areal biomass concentration was determined to achieve complete absorption of the incident radiation.

  5. Immobilization of acid digestion residue

    International Nuclear Information System (INIS)

    Greenhalgh, W.O.; Allen, C.R.

    1983-01-01

    Acid digestion treatment of nuclear waste is similar to incineration processes and results in the bulk of the waste being reduced in volume and weight to some residual solids termed residue. The residue is composed of various dispersible solid materials and typically contains the resultant radioactivity from the waste. This report describes the immobilization of the residue in portland cement, borosilicate glass, and some other waste forms. Diagrams showing the cement and glass virtification parameters are included in the report as well as process steps and candidate waste product forms. Cement immobilization is simplest and probably least expensive; glass vitrification exhibits the best overall volume reduction ratio

  6. Probabilistic assessment of critically flawed LMFBR PHTS piping elbows

    International Nuclear Information System (INIS)

    Balkey, K.R.; Wallace, I.T.; Vaurio, J.K.

    1982-01-01

    One of the important functions of the Primary Heat Transport System (PHTS) of a large Liquid Metal Fast Breeder Reactor (LMFBR) plant is to contain the circulating radioactive sodium in components and piping routed through inerted areas within the containment building. A significant possible failure mode of this vital system is the development of cracks in the piping components. This paper presents results from the probabilistic assessment of postulated flaws in the most-critical piping elbow of each piping leg. The criticality of calculated maximum sized flaws is assessed against an estimated material fracture toughness to determine safety factors and failure probability estimates using stress-strength interference theory. Subsequently, a different approach is also employed in which the randomness of the initial flaw size and loading are more-rigorously taken into account. This latter approach yields much smaller probability of failure values when compared to the stress-strength interference analysis results

  7. Lesions of the elbow and forearm in childhood

    International Nuclear Information System (INIS)

    Zanella, F.E.

    1984-01-01

    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 statistical frequency of the individual types of lesions, and of the numerous combined sequels to traumas. The valuable aid given by the roentgenological 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. (orig.) [de

  8. Lesions of the elbow and forearm in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Zanella, F.E.

    1984-03-01

    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 statistical frequency of the individual types of lesions, and of the numerous combined sequels to traumas. The valuable aid given by the roentgenological 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.

  9. Unstable elbow dislocations: the description and cadaveric feasibility study of a new surgical technique

    Directory of Open Access Journals (Sweden)

    Harris Mark

    2015-01-01

    Full Text Available Introduction: A small proportion of simple elbow dislocations are grossly unstable and joint congruence is not maintained after reduction. In this rare situation operative treatment is indicated. We describe a new intra articular reconstruction that utilises a slip of triceps tendon to provide immediate stability to the elbow. Methods: We assessed 20 cadaveric elbows, measuring the length of triceps tendon available and required to complete the reconstruction. We then sequentially sectioned the ligamentous stabilisers of an elbow before performing the new technique. We measured the displacement and angulation possible at the elbow before and after the reconstruction. Results: All 20 elbows had sufficient triceps tendon length to complete the new technique. Prior to the reconstruction greater than 30 mm of joint distraction and 90 degrees varus or valgus angulation was possible. Following the reconstruction it was not possible to re-dislocate the elbow. Only 2 mm of joint distraction and 10 degrees of varus or valgus angulation were possible with the triceps graft fixed in position. Discussion: This novel technique elegantly avoids many of the problems associated with current methods. We have demonstrated that it is technically feasible and easy to perform with minimal equipment requirements or costs.

  10. Ulnar neuropathy and medial elbow pain in women's fastpitch softball pitchers: a report of 6 cases.

    Science.gov (United States)

    Smith, Adam M; Butler, Thomas H; Dolan, Michael S

    2017-12-01

    Elite-level women's fastpitch softball players place substantial biomechanical strains on the elbow that can result in medial elbow pain and ulnar neuropathic symptoms. There is scant literature reporting the expected outcomes of the treatment of these injuries. This study examined the results of treatment in a series of these patients. We identified 6 female softball pitchers (4 high school and 2 collegiate) with medial elbow pain and ulnar neuropathic symptoms. Trials of conservative care failed in all 6, and they underwent surgical treatment with subcutaneous ulnar nerve transposition. These patients were subsequently monitored postoperatively to determine outcome. All 6 female pitchers had early resolution of elbow pain and neuropathic symptoms after surgical treatment. Long-term follow-up demonstrated that 1 patient quit playing softball because of other injuries but no longer reported elbow pain or paresthesias. One player was able to return to pitching at the high school level but had recurrent forearm pain and neuritis 1 year later while playing a different sport and subsequently stopped playing competitive sports. Four patients continued to play at the collegiate level without further symptoms. Medial elbow pain in women's softball pitchers caused by ulnar neuropathy can be treated effectively with subcutaneous ulnar nerve transposition if nonsurgical options fail. Further study is necessary to examine the role of overuse, proper training techniques, and whether pitching limits may be necessary to avoid these injuries. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  11. Treatment of neglected elbow dislocations with the help of hinged external fixator: Report of two cases

    Directory of Open Access Journals (Sweden)

    Özgür Karakoyun

    2014-06-01

    Full Text Available Elbow dislocations are cases that have to be treated in emergency conditions. Neglected elbow dislocations are seen very rarely and the treatment of such cases are more complicated than acute cases. We present two cases of neglected elbow dislocations treated with open reduction and hinged external fixators. Case 1: 23 year old female patient had a neglected posterior dislocation of left elbow with ipsilateral humeral shaft fracture caused by car accident. The patient was treated after 3 months of initial trauma. We have performed open reduction for the joint. After that we fixed the joint whit a hinged external fixator. The humeral shaft fracture was also fixed with the components of the external fixator. Case 2: 33 year male patient had a large bone and soft tissue defect around the left elbow accompanying with neglected medial elbow dislocation. He presented to our clinic with a delay of 2 months. The patient was treated with open reduction and hinged external fixator after reconstruction of bone defect of distal humerus. Conclusion: The treatment of neglected cases is quite challenging. Open reduction and external fixation has satisfactory results in treatment of late cases of elbow dislocation with the possibility of early rehabilitation. This method can be considered as an option for such cases. J Clin Exp Invest 2014; 5 (2: 443-446

  12. Phase-dependence of elbow muscle coactivation in front crawl swimming.

    Science.gov (United States)

    Lauer, Jessy; Figueiredo, Pedro; Vilas-Boas, João Paulo; Fernandes, Ricardo J; Rouard, Annie Hélène

    2013-08-01

    Propulsion in swimming is achieved by complex sculling movements with elbow quasi-fixed on the antero-posterior axis to transmit forces from the hand and the forearm to the body. The purpose of this study was to investigate how elbow muscle coactivation was influenced by the front crawl stroke phases. Ten international level male swimmers performed a 200-m front crawl race-pace bout. Sagittal views were digitized frame by frame to determine the stroke phases (aquatic elbow flexion and extension, aerial elbow flexion and extension). Surface electromyograms (EMG) of the right biceps brachii and triceps brachii were recorded and processed using the integrated EMG to calculate a coactivation index (CI) for each phase. A significant effect of the phases on the CI was revealed with highest levels of coactivation during the aquatic elbow flexion and the aerial elbow extension. Swimmers stabilize the elbow joint to overcome drag during the aquatic phase, and act as a brake at the end of the recovery to replace the arm for the next stroke. The CI can provide insight into the magnitude of mechanical constraints supported by a given joint, in particular during a complex movement. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Elbow, forearm, wrist, and hand injuries among sport rock climbers.

    Science.gov (United States)

    Holtzhausen, L M; Noakes, T D

    1996-07-01

    Sport rock climbing with its repetitive high-torque movements in gaining the ascent of a rock face or wall, often in steep overhanging positions, is associated with a unique distribution and form of upper limb injuries. In this article, we review the biomechanical aspects of sport rock climbing and the types of injuries commonly encountered in the forearm, wrist, and hand regions of elite sport rock climbers. Because elbow, forearm, wrist, and hand injuries predominate, representing 62% of the total injuries encountered, these anatomical areas have been selected for review. The predominant source of data are the published work of Bollen et al. The remaining sources were obtained through electronic search of the Medline and Current Contents Databases (last searched May 1995). German and French articles were included in the search criteria. Only studies dealing with acute soft tissue and overuse injuries amongst sport rock climbers were selected. Data were extracted directly from the sourced articles. The following injuries have been described in detail with regard to their presentation, diagnosis, treatment, and prevention amongst sport rock climbers: medial epicondylitis, brachialis tendonitis, biceps brachii tendonitis, ulnar collateral ligament sprain of the elbow, carpal tunnel syndrome, digital flexor tendon pulley sheath tears, interphalangeal joint effusions, fixed flexion deformities of the interphalangeal joints, and collateral ligament tears of the interphalangeal joints. Many of the injuries are specific to the handhold types used by the rock climber. Accurate diagnosis and effective treatment of these unique injuries will be facilitated by a wider understanding of the biomechanical aspects of rock climbing and an awareness of the patterns and incidence of injuries in this sport.

  14. Comparative study of phrenic and intercostal nerve transfers for elbow flexion after global brachial plexus injury.

    Science.gov (United States)

    Liu, Yuzhou; Lao, Jie; Zhao, Xin

    2015-04-01

    Global brachial plexus injuries (BPIs) are devastating events frequently resulting in severe functional impairment. The widely used nerve transfer sources for elbow flexion in patients with global BPIs include intercostal and phrenic nerves. The aim of this study was to compare phrenic and intercostal nerve transfers for elbow flexion after global BPI. A retrospective review of 33 patients treated with phrenic and intercostal nerve transfer for elbow flexion in posttraumatic global root avulsion BPI was carried out. In the phrenic nerve transfer group, the phrenic nerve was transferred to the anterolateral bundle of the anterior division of the upper trunk (23 patients); in the intercostal nerve transfer group, three intercostal nerves were coapted to the anterolateral bundles of the musculocutaneous nerve. The British Medical Research Council (MRC) grading system, angle of elbow flexion, and electromyography (EMG) were used to evaluate the recovery of elbow flexion at least 3 years postoperatively. The efficiency of motor function in the phrenic nerve transfer group was 83%, while it was 70% in the intercostal nerve transfer group. The two groups were not statistically different in terms of the MRC grade (p=0.646) and EMG results (p=0.646). The outstanding rates of angle of elbow flexion were 48% and 40% in the phrenic and intercostal nerve transfer groups, respectively. There was no significant difference of outstanding rates in the angle of elbow flexion between the two groups. Phrenic nerve transfer had a higher proportion of good prognosis for elbow flexion than intercostal nerve transfer, but the effective and outstanding rate had no significant difference for biceps reinnervation between the two groups according to MRC grading, angle of elbow flexion, and EMG. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. (Im)mobile Geographies

    NARCIS (Netherlands)

    Minca, C.

    2013-01-01

    The growing tendency to evaluate – sometimes even ''measure'' – the ''productivity'' of academics is seriously affecting what we consider to be relevant geographical output. This tendency is also significantly reshaping the actual geographies of the disciplinary debate, by introducing important

  16. Radiation immobilization of catalase and its application

    International Nuclear Information System (INIS)

    Wang Guanghui; Ha Hongfei; Wang Xia; Wu Jilan

    1988-01-01

    Catalase was immobilized by a chemical method on porous polyacrylamide particles produced by radiation polymerization of acrylamide monomer at low temperature (-78 0 C). Activity of immobilized catalase was enhanced distinctly by joining a chemical arm to the support. The method of recovery of catalase activity on immobilized polymer was found by soaking it in certain buffer. The treatment of H 2 O 2 both in aqueous solution and alcoholic solution by using the immobilized catalase was performed. (author)

  17. Biomechanics of the elbow joint in tennis players and relation to pathology.

    Science.gov (United States)

    Eygendaal, Denise; Rahussen, F Th G; Diercks, R L

    2007-11-01

    Elbow injuries constitute a sizeable percentage of tennis injuries. A basic understanding of biomechanics of tennis and analysis of the forces, loads and motions of the elbow during tennis will improve the understanding of the pathophysiology of these injuries. All different strokes in tennis have a different repetitive biomechanical nature that can result in tennis-related injuries. In this article, a biomechanically-based evaluation of tennis strokes is presented. This overview includes all tennis-related pathologies of the elbow joint, whereby the possible relation of biomechanics to pathology is analysed, followed by treatment recommendations.

  18. Fracture resistance of cracked duplex stainless steel elbows under bending with or without internal pressure

    International Nuclear Information System (INIS)

    Semete, P.; Le Delliou, P.; Ignaccolo, S.

    1997-12-01

    EDF, in co-operation with Framatome, has conducted a research program on the fracture behaviour of aged cast duplex stainless steel elbows. One important task of this program consisted of testing three large diameter (580 mm O.D.) aged cast elbows, which are 2/3-scale models of PWR primary loop elbows. Furthermore, detailed finite element analyses of those three tests were conducted in order to be compared with experimental results. The results of this research program are presented. (K.A.)

  19. Evaluation of hyper-tempering and machining residual stresses in a pipe and a cast elbow

    International Nuclear Information System (INIS)

    Dupas, P.; Le Delliou, P.; Sussen, L.

    1995-01-01

    Cast elbows in austeno-ferritic stainless steel from the primary circuit of nuclear power plants suffer from important residual stresses initiated during their manufacturing (hyper-tempering followed by machining). Measurements and calculations were performed to determine these stresses. Measurements show a difference between circumferential stresses in the depth of a pipe and of an elbow. On the contrary, calculations indicate similar profiles. Thus, the experimental differences cannot be explained by a geometrical effect of the elbow. (J.S.). 4 refs., 5 figs

  20. Liquid metal flow in a large-radius elbow with a uniform magnetic fluid

    International Nuclear Information System (INIS)

    Moon, T.J.; Walker, J.S.

    1988-07-01

    This paper treats the liquid-metal flow in an elbow between two straight, rectangular ducts. There is a uniform magnetic field in the plane of the elbow. The duct has thin, electrically conducting walls. The Hartmann number and the interaction parameter are assumed to be large, while the magnetic Reynolds number is assumed to be small. Solutions for the velocity at each cross section of the elbow and for the pressure drop due to three-dimensional effects are presented. 10 refs., 5 figs

  1. Qualifying Elbow Meters for High Pressure Flow Measurements in an Operating Nuclear Power Plant

    International Nuclear Information System (INIS)

    Chan, A.M.; Maynard, K.J.; Ramundi, J.; Wiklung, E.

    2006-01-01

    To support the installation and use of elbow meters to measure the high pressure emergency coolant injection flow in an operating nuclear station, a test program was performed to qualify: (i) the 'hot' tapping procedure for field application and (ii) the use of elbow meters for accurate flow measurements over the full range of station ECI flow conditions. This paper describes the design conditions and major components of a flow loop used for the elbow meter calibrations. Typical test results are presented and discussed. (authors)

  2. The improvement of the methods of radial diagnosis and surgical treatment of patients with rheumatoid arthritis of knee and elbow joints

    International Nuclear Information System (INIS)

    Karimov, M.Yu.

    2005-05-01

    Aim of the inquiry: To improve the radial diagnosis of rheumatoid arthritis of knee and elbow joints and to work out new approaches of orthopedic-surgical treatment. Method of research: roentgenography, roentgen densitometry, magnetic resonance imaging, digital subtraction angiography, neutron activation analysis, electromyography, topographic anatomical study, arthroscopy. The results achieved and their novelty: For the first time the data about the peculiarities of blood circulation after long period corticosteroid therapy and without applying corticosteroid therapy, in patients with RA are presented according to the data of angiography. The MRI was supplemented - semiotics of knee and elbow joints affection in RA, which allowed to estimate the stage and the activity of the process more objective way. Also the RD, EMG were carried out and the estimation of condition of the patients with RA was worked out by points, that allowed to see the effectiveness of surgical treatment of RA. The results of NAA of the structure of knee joint of patients with RA allow to determine the distribution of macro- and microelements in tissues of knee. The quantitative estimation of osteoporosis by RD method gives an opportunity to evaluate objectively its degree. According to the results of topographic anatomical study of knee and elbow joints the following have been worked out: the lateral parapatellar approach to structure of knee joints and expanded intermuscular one to structures of elbow joint, which is less traumatic and promotes early rehabilitation of the patients with RA, and also promotes to radical ablation of synovial membrane of elbow joint, which is the reason of joint deformity. By the method of arthroscopy the peculiarities of steroid arthropathy of knee joint of patients with RA have been identified for the first time. Practical value:of the work contains the elaboration of the complex of radial method (roentgenographia, RD, MRI, DSA, NAA) of the diagnosis of the RA

  3. Immobilization and characterization of inulinase from Ulocladium

    Indian Academy of Sciences (India)

    Ulocladium atrum inulinase was immobilized on different composite membranes composed of chitosan/nonwoven fabrics. Km values of free and immobilized U. atrum inulinase on different composite membranes were calculated. The enzyme had optimum pH at 5.6 for free and immobilized U. atrum inulinase on polyester ...

  4. Immobilization of Mitochondria on Graphene

    Science.gov (United States)

    2013-08-29

    poly-L-lysine has also been reported for immobilization of yeast mitochondria. Coating was performed by repetitive washing of cover slips with 0.02...of Poly-L-lysine Applications of PLL PLL is a production of bacterial fermentation and is used as a food preservative. In biology, PLL is used in

  5. Immobilization of antibodies and enzyme-labeled antibodies by radiation polymerization

    International Nuclear Information System (INIS)

    Kumakura, M.; Kaetsu, I.; Suzuki, M.; Adachi, S.

    1983-01-01

    Immobilization of antibodies and enzyme-labeled antibodies by radiation polymerization at low temperatures was studied. The antibody activity of antibody was not affected by irradiation at an irradiation dose of below 8 MR and low temperatures. Immobilization of peroxidase-labeled anti-rabbit IgG goat IgG, anti-peroxidase, peroxidase, and anti-alpha-fetoprotein was carried out with hydrophilic and hydrophobic monomers. The activity of the immobilized enzyme-labeled antibody membranes varied with the thickness of the membranes and increased with decreasing membrane thickness. The activity of the immobilized antibody particles was varied by particle size. Immobilized anti-alpha-fetoprotein particles and membranes can be used for the assay of alpha-fetoprotein by the antigen-antibody reaction, such as a solid-phase sandwich method with high sensitivity

  6. Immobilization of Gibberella fujikuroi cells with carriers modified by radiation polymerization

    International Nuclear Information System (INIS)

    Lu Zhaoxin; Xie Zhongchuan; Wei Qijiang

    1994-01-01

    Gibberella fujikuroi cells were immobilized on modified carriers (gauze) by using the radiation polymerization technique. The mycelium was firmly adhered to the surface of fibril covered with hydrophobic polymer, poly (diethylene glycol dimethyl acrylate) and hydrophobic-hydrophilic copolymer poly (diethylene glycol dimethyl acrylate-sodium acrylate), but it was not immobilized onto the polyethylene net, which has a similar network structure to that of the modified carrier. The weight of immobilized cells was affected by covered polymer. Gibberellic acid productivity in immobilized cells was similar to that of free cells, and the immobilized cells was of good stability. A optimum culture condition for gibberellic acid production was at pH 5.5 and under 20 ∼ 30 degree C

  7. Immobilization of radioactive strontium in contaminated soils by phosphate treatment

    International Nuclear Information System (INIS)

    Kim, K.H.; Ammons, J.T.

    1990-01-01

    The feasibility of in situ phosphate- and metal- (calcium, aluminum, and iron) solution treatment for 90 Sr immobilization was investigated. Batch and column experiments were performed to find optimum conditions for coprecipitation of 90 Sr with Ca-, Al-, and Fe-phosphate compounds in contaminated soils. Separate columns were packed with artificially 85 Sr-contaminated acid soil as well as 90 Sr-contaminated soil from the Oak Ridge Reservation. After metal-phosphate treatment, the columns were then leached successively with either tapwater or 0.001 M CaCl 2 solution. Most of the 85 Sr coprecipitated with the metal phosphate compounds. Immobilization of 85 Sr and 90 Sr was affected by such factors as solution pH, metal and phosphate concentration, metal-to-phosphate ratio, and soil characteristics. Equilibration time after treatments also affected 85 Sr immobilization. Many technology aspects still need to be investigated before field applications are feasible, but these experiments indicate that phosphate-based in situ immobilization should prevent groundwater contamination and will be useful as a treatment technology for 90 Sr-contaminated sites. 15 refs., 3 figs., 1 tab

  8. PET-scan shows peripherally increased neurokinin 1 receptor availability in chronic tennis elbow: visualizing neurogenic inflammation?

    Directory of Open Access Journals (Sweden)

    Magnus Peterson

    Full Text Available In response to pain, neurokinin 1 (NK1 receptor availability is altered in the central nervous system. The NK1 receptor and its primary agonist, substance P, also play a crucial role in peripheral tissue in response to pain, as part of neurogenic inflammation. However, little is known about alterations in NK1 receptor availability in peripheral tissue in chronic pain conditions and very few studies have been performed on human beings. Ten subjects with chronic tennis elbow were therefore examined by positron emission tomography (PET with the NK1 specific radioligand [(11C]GR205171 before and after treatment with graded exercise. The radioligand signal intensity was higher in the affected arm as compared with the unaffected arm, measured as differences between the arms in volume of voxels and signal intensity of this volume above a reference threshold set as 2.5 SD above mean signal intensity of the unaffected arm before treatment. In the eight subjects examined after treatment, pain ratings decreased in all subjects but signal intensity decreased in five and increased in three. In conclusion, NK1 receptors may be activated, or up-regulated in the peripheral, painful tissue of a chronic pain condition. This up-regulation does, however, have moderate correlation to pain ratings. The increased NK1 receptor availability is interpreted as part of ongoing neurogenic inflammation and may have correlation to the pathogenesis of chronic tennis elbow.ClinicalTrials.gov NCT00888225 http://clinicaltrials.gov/

  9. Radiographic evaluation of the canine elbow joint with special reference to the medial humeral condyle and the medial coronoid process

    International Nuclear Information System (INIS)

    Voorhout, G.; Hazewinkel, H.A.W.

    1987-01-01

    The results of radiographic examination of clinically affected elbow joints in 14 young, large-breed dogs, including standard and oblique projections and linear tomography, were compared with the findings of medial arthrotomy. Radiographs revealed arthrosis (13 dogs), osteochondrosis of the medial humeral condyle (2 dogs), fragmentation of the medial coronoid process (5 dogs), and a combination of osteochondrosis of the medial humeral condyle and fragmentation of the medial coronoid process (2 dogs). In one dog fissures in the medial coronoid process and in another dog a linear radiopacity along the articular surface of the medial coronoid process were found. In three dogs both medial humeral condyle and medial coronoid process appeared normal. The radiographic findings were confirmed during surgery in 11 dogs. Cartilage erosion of the medial humeral condyle in two dogs and of the medial coronoid process in one dog had not resulted in radiographically visible abnormalities. Radiographic examination of the elbow joints in young, large-breed dogs should include standard mediolateral and craniocaudal projections, a mediolateral projection with the joint maximally extended and the leg supinated 15°, and a craniolateral-to-caudomedial projection

  10. MR imaging of edematous anconeus epitrochlearis: another cause of medial elbow pain?

    International Nuclear Information System (INIS)

    Jeon, In-Ho; Neumann, Lars; Wallace, W. Angus; Fairbairn, K. Julia

    2005-01-01

    Two patients with unusual medial elbow pain had MRI scans performed that revealed edema of the aberrant muscle of the anconeus epitrochlearis. MRI of this anconeus epitrochlearis muscle are presented. (orig.)

  11. Series elastic actuation of an elbow rehabilitation exoskeleton with axis misalignment adaptation.

    Science.gov (United States)

    Wu, Kuan-Yi; Su, Yin-Yu; Yu, Ying-Lung; Lin, Kuei-You; Lan, Chao-Chieh

    2017-07-01

    Powered exoskeletons can facilitate rehabilitation of patients with upper limb disabilities. Designs using rotary motors usually result in bulky exoskeletons to reduce the problem of moving inertia. This paper presents a new linearly actuated elbow exoskeleton that consists of a slider crank mechanism and a linear motor. The linear motor is placed beside the upper arm and closer to shoulder joint. Thus better inertia properties can be achieved while lightweight and compactness are maintained. A passive joint is introduced to compensate for the exoskeleton-elbow misalignment and intersubject size variation. A linear series elastic actuator (SEA) is proposed to obtain accurate force and impedance control at the exoskeleton-elbow interface. Bidirectional actuation between exoskeleton and forearm is verified, which is required for various rehabilitation processes. We expect this exoskeleton can provide a means of robot-aided elbow rehabilitation.

  12. The utility of the elbow sign in the diagnosis of OSA

    Directory of Open Access Journals (Sweden)

    Haytham Samy Diab

    2015-04-01

    Conclusion: The elbow sign questionnaire is a simple and quick screening tool for OSA with good sensitivity and specificity in comparison to other questionnaires, further studies are needed in other populations to determine its reliability and predictive utility.

  13. Influences of overload on low cycle fatigue behaviors of elbow pipe with local wall thinning

    International Nuclear Information System (INIS)

    Sato, Kyohei; Ogino, Kanako; Takahashi, Koji; Ando, Kotoji; Urabe, Yoshio

    2011-01-01

    Low cycle fatigue tests were conducted using 100A elbow pipe specimens with or without local wall thinning. Local wall thinning was machined on the inside of the extrados of test elbows to simulate metal loss due to flow-accelerated corrosion or liquid droplet impingement erosion. Low cycle fatigue tests were carried out under displacement control with an inner pressure of 9 MPa. To simulate seismic events, low cycle fatigue tests were carried out on elbow pipe subjected to cyclic overloads. Regardless of local wall thinning, fatigue life of overload pipe was not so different from that of the non-overload pipe in appearance. Miner's rule can be applied to evaluate fatigue life of the elbow pipes with and without wall thinning, even if overload is applied. (author)

  14. Clinical reliability and validity of elbow functional assessment in rheumatoid arthritis.

    NARCIS (Netherlands)

    Boer, Y.A. de; Ende, C.H.M. van den; Eygendaal, D.; Jolie, I.M.M.; Hazes, J.M.W.; Rozing, P.M.

    1999-01-01

    OBJECTIVES: (1) To investigate the measurement characteristics of the Hospital for Special Surgery (HSS) and Mayo Clinic elbow assessment instruments, utilizing methodological criteria including feasibility, reliability, validity, and discriminative ability; and (2) to develop an efficient and

  15. Good Functional Recovery of Complex Elbow Dislocations Treated With Hinged External Fixation: A Multicenter Prospective Study

    NARCIS (Netherlands)

    Iordens, Gijs I. T.; den Hartog, Dennis; van Lieshout, Esther M. M.; Tuinebreijer, Wim E.; de Haan, Jeroen; Patka, Peter; Verhofstad, Michael H. J.; Schep, Niels W. L.; Bronkhorst, M. W. G. A.; de Vries, M. R.; Goslings, J. C.; Rhemrev, S. J.; Roukema, G. R.; van der Meulen, H. G. W. M.; Verleisdonk, E. J. M. M.; Vroemen, J. P. A. M.; Wittich, Ph

    2015-01-01

    After a complex dislocation, some elbows remain unstable after closed reduction or fracture treatment. Function after treatment with a hinged external fixator theoretically allows collateral ligaments to heal without surgical reconstruction. However, there is a lack of prospective studies that

  16. Good Functional Recovery of Complex Elbow Dislocations Treated With Hinged External Fixation: A Multicenter Prospective Study

    NARCIS (Netherlands)

    G.I.T. Iordens (Gijs); D. den Hartog (Dennis); E.M.M. van Lieshout (Esther); W.E. Tuinebreijer (Wim); J. de Haan (Jeroen); P. Patka (Peter); M.H.J. Verhofstad (Michiel); N.W.L. Schep (Niels)

    2015-01-01

    textabstractBackground: After a complex dislocation, some elbows remain unstable after closed reduction or fracture treatment. Function after treatment with a hinged external fixator theoretically allows collateral ligaments to heal without surgical reconstruction. However, there is a lack of

  17. Flow characteristics of helium gas going through a 90°elbow for flow measurement

    International Nuclear Information System (INIS)

    Feng Beibei; Wang Shiming; Yang Xingtuan; Jiang Shengyao

    2014-01-01

    Numerical simulation is performed to investigate the pressure distribution of He-gas under high pressure and high temperature for 10MW High Temperature Gas-cooled Reactor (HTGR-10). Experimental measurements of wall pressure through a self-built test system are carried out to validate the credibility of the computational approach. We present a study for complex flow structure of He-gas using the case of an structurally 90°elbow that is reconstructed from the steam generator of HTGR-10. Pressure measurement of inner wall and outer wall is used to compare with the numerical results. Distribution of wall pressure of He-gas flowing through 90° elbow based on the numerical and experimental approaches show good agreement. Wall pressure distribution of eight cross sections of the elbow is given in detail to represent the entire region of elbow. (author)

  18. Effect of Reynolds number on flow and mass transfer characteristics of a 90 degree elbow

    Science.gov (United States)

    Fujisawa, Nobuyuki; Ikarashi, Yuya; Yamagata, Takayuki; Taguchi, Syoichi

    2016-11-01

    The flow and mass transfer characteristics of a 90 degree elbow was studied experimentally by using the mass transfer measurement by plaster dissolution method, the surface flow visualization by oil film method and stereo PIV measurement. The experiments are carried out in a water tunnel of a circular pipe of 56mm in diameter with a working fluid of water. The Reynolds number was varied from 30000 to 200000. The experimental result indicated the change of the mass transfer coefficient distribution in the elbow with increasing the Reynolds number. This phenomenon is further examined by the surface flow visualization and measurement of secondary flow pattern in the elbow, and the results showed the suggested change of the secondary flow pattern in the elbow with increasing the Reynolds numbers.

  19. Biodiesel production with immobilized lipase: A review.

    Science.gov (United States)

    Tan, Tianwei; Lu, Jike; Nie, Kaili; Deng, Li; Wang, Fang

    2010-01-01

    Fatty acid alkyl esters, also called biodiesel, are environmentally friendly and show great potential as an alternative liquid fuel. Biodiesel is produced by transesterification of oils or fats with chemical catalysts or lipase. Immobilized lipase as the biocatalyst draws high attention because that process is "greener". This article reviews the current status of biodiesel production with immobilized lipase, including various lipases, immobilization methods, various feedstocks, lipase inactivation caused by short chain alcohols and large scale industrialization. Adsorption is still the most widely employed method for lipase immobilization. There are two kinds of lipase used most frequently especially for large scale industrialization. One is Candida antartica lipase immobilized on acrylic resin, and the other is Candida sp. 99-125 lipase immobilized on inexpensive textile membranes. However, to further reduce the cost of biodiesel production, new immobilization techniques with higher activity and stability still need to be explored. Copyright 2010 Elsevier Inc. All rights reserved.

  20. Posterolateral rotatory instability from multiple steroids injections for tennis elbow: a case report.

    Science.gov (United States)

    Chanlalit, Cholawish; Limsricharoen, Warodom

    2013-01-01

    This article reports the complication (lateral collateral ligament rupture) arising from improper numbers of steroids injections for the chronic lateral elbow pain (tennis elbow). Clinical sign and investigation with MRI confirmed a diagnosis of LCL rupture. In the present report, we describe the successful outcome of one year results in surgical debridement and lateral collateral ligament (LCL) reconstruction. A discussion of the proper conservative role for the chronic lateral epicondyalgia and the surgical decision to resolve this complication is also included.

  1. The "moving valgus stress test" for medial collateral ligament tears of the elbow.

    Science.gov (United States)

    O'Driscoll, Shawn W M; Lawton, Richard L; Smith, Adam M

    2005-02-01

    The diagnosis of a painful partial tear of the medial collateral ligament in overhead-throwing athletes is challenging, even for experienced elbow surgeons and despite the use of sophisticated imaging techniques. The "moving valgus stress test" is an accurate physical examination technique for diagnosis of medial collateral ligament attenuation in the elbow. Cohort study (diagnosis); Level of evidence, 2. Twenty-one patients underwent surgical intervention for medial elbow pain due to medial collateral ligament insufficiency or other abnormality of chronic valgus overload, and they were assessed preoperatively with an examination called the moving valgus stress test. To perform the moving valgus stress test, the examiner applies and maintains a constant moderate valgus torque to the fully flexed elbow and then quickly extends the elbow. The test is positive if the medial elbow pain is reproduced at the medial collateral ligament and is at maximum between 120 degrees and 70 degrees. The moving valgus stress test was highly sensitive (100%, 17 of 17 patients) and specific (75%, 3 of 4 patients) when compared to assessment of the medial collateral ligament by surgical exploration or arthroscopic valgus stress testing. The mean shear range (ie, the arc within which pain was produced with the moving valgus stress test) was 120 degrees to 70 degrees. The mean angle at which pain was at a maximum was 90 degrees of elbow flexion. The moving valgus stress test is an accurate physical examination technique that, when performed and interpreted correctly, is highly sensitive for medial elbow pain arising from the medial collateral ligament.

  2. No stabilizing effect of the elbow joint capsule. A kinematic study

    DEFF Research Database (Denmark)

    Nielsen, K K; Olsen, Bo Sanderhoff

    1999-01-01

    We dissected 7 cadaveric elbow specimens, leaving the collateral ligaments and the joint capsule intact. The anterior and the posterior capsule were sequentially transected, followed by kinematic testings. We found no change in joint laxity after total transection of the capsule.......We dissected 7 cadaveric elbow specimens, leaving the collateral ligaments and the joint capsule intact. The anterior and the posterior capsule were sequentially transected, followed by kinematic testings. We found no change in joint laxity after total transection of the capsule....

  3. Design rules for piping: experimental validation of flexibility and elastic stress indices for elbows under bending

    International Nuclear Information System (INIS)

    Touboul, F.; Ben Jdidia, M.; Acker, D.

    1989-01-01

    Design rules for class 1 piping components are based on stress indices (B, C, K) and flexibility factors (k). For elbows, adjacent straight parts and internal pressure inhibit ovalization of the cross-section, so reducing the sub-mentioned indices. Published theoretical works and experimental results allow for improvement of coded values. End effect may be represented by a suitable function of the elbow angle. The favourable effect of pressure on C 2 , for fatigue damage evaluation, can be taken into account

  4. Luxation of the elbow complicated by proximal radio-ulnar translocation

    International Nuclear Information System (INIS)

    Ekloef, O.; Nybonde, T.; Karlsson, G.; St. Goeran's Children's Hospital, Stockholm

    1990-01-01

    Luxation of the elbow complicated by proximal radio-ulnar translocation is a rare entity. The clue to diagosis is the reversed position of the bones of the proxomal forearm. In the a.p. projection the radial head articulates with the trochlea and the ulna with the capitellum. This unexpected anatomic relationship is easily overlooked. Delayed reduction may result in permanent impairment of elbow motility. Our experience with three recent cases is presented. (orig.)

  5. Luxation of the elbow complicated by proximal radio-ulnar translocation

    Energy Technology Data Exchange (ETDEWEB)

    Ekloef, O.; Nybonde, T.; Karlsson, G. (St. Goeran' s Children' s Hospital, Stockholm (Sweden). Dept. of Radiology St. Goeran' s Children' s Hospital, Stockholm (Sweden). Dept. of Surgery)

    1990-03-01

    Luxation of the elbow complicated by proximal radio-ulnar translocation is a rare entity. The clue to diagosis is the reversed position of the bones of the proxomal forearm. In the a.p. projection the radial head articulates with the trochlea and the ulna with the capitellum. This unexpected anatomic relationship is easily overlooked. Delayed reduction may result in permanent impairment of elbow motility. Our experience with three recent cases is presented. (orig.).

  6. Management of post-traumatic elbow instability after failed radial head excision: A case report

    OpenAIRE

    Touloupakis, Georgios; Theodorakis, Emmanouil; Favetti, Fabio; Nannerini, Massimiliano

    2017-01-01

    Radial head excision has always been a safe commonly used surgical procedure with a satisfactory clinical outcome for isolated comminuted radial head fractures. However, diagnosis of elbow instability is still very challenging and often underestimated in routine orthopaedic evaluation. We present the case of a 21-years old female treated with excision after radial head fracture, resulting in elbow instability. The patient underwent revision surgery after four weeks. We believe that ligament r...

  7. Arthroscopic Treatment of Septic Arthritis of the Elbow in a 4-Year-Old Girl

    Directory of Open Access Journals (Sweden)

    Masashi Koide

    2015-01-01

    Full Text Available Pediatric septic arthritis is uncommon and has been traditionally treated by joint aspiration or open arthrotomy. There are some reports about arthroscopic surgery in pediatric septic arthritis of the knee, hip, and shoulder. However, there is no report for the case of elbow. We report a case of pediatric septic arthritis of elbow treated with arthroscopically with good clinical condition at 3-year follow-up. This paper is based on a report first published in Japanese (Tojo (2012.

  8. Experimental study on fluid mixing phenomena in T-pipe junction with upstream elbow

    International Nuclear Information System (INIS)

    Hiroshi Ogawa; Minoru Igarashi; Nobuyuki Kimura; Hideki Kamide

    2005-01-01

    Full text of publication follows: Temperature fluctuation in fluid causes high cycle thermal fatigue in shroud structure according to its amplitude and frequency. There are still some incidents of thermal fatigue and leakage in light water reactors (Japanese PWR Tomari-2 in 2003, French PWR CIVAUX in 1998), and also in sodium cooled reactors (French FBR Phenix in 1992). Mixing tee is a typical component where temperature fluctuation occurs. Water experiment has been carried out to investigate temperature fluctuation characteristics and flow velocity field in a simple T-pipe junction with straight inlet pipings for main and branch lines; test facility is named as WATLON (Water Experiment on Fluid Mixing in T-pipe with Long Cycle Fluctuation). Here, influence of upstream elbow in the main pipe was studied in the WATLON facility. Elbow can be set near the mixing tee in a real plant. Outlet of the elbow has biased velocity distribution and also the secondary flow, which decays unsteadily. Temperature distribution in the mixing tee was measured by a movable tree with 17 thermocouples and velocity field was measured by Dynamic PIV (high speed particle image velocimetry) with sampling frequency of 200 Hz. Measured temperature showed that fluctuation intensity near the wall was larger in the elbow geometry than in the straight inlet pipes in a case of wall jet (branch flow velocity is smaller than main pipe flow velocity); high intensity region in the elbow case was enlarged around the jet exiting from the branch pipe. The result of flow velocity measurement showed that secondary flow and biased flow velocity distributions due to the elbow influenced bending of the jet exiting from the branch pipe and the temperature fluctuation intensity around the jet. The detailed flow velocity distributions and the secondary flow of upstream elbow can be measured by Dynamic PIV. Influence of such elbow was discussed based on detailed temperature data together with fluctuated velocity

  9. MR imaging findings and MR criteria for instability in osteochondritis dissecans of the elbow in children

    International Nuclear Information System (INIS)

    Jans, Lennart B.O.; Ditchfield, Michael; Anna, Gomez; Jaremko, Jacob L.; Verstraete, Koenraad L.

    2012-01-01

    Purpose: Osteochondritis dissecans (OCD) of the elbow is an uncommon cause of elbow pain in adolescents and occurs at different locations in the elbow joint. Early diagnosis and treatment may prevent surgery. The aim of the study is to describe the MR imaging features of OCD at initial imaging, and to correlate these findings with surgical findings of stability and instability with arthroscopic findings as the reference standard. Methods: Patients were identified through a keyword search of the radiology information system from 2000 to 2009. Twenty-five patients (26 elbows) with OCD of the elbow were identified (age 10.4–18 years, mean age 14 years). MR studies were retrospectively reviewed by two radiologists in consensus to define MR imaging findings and to determine the presence of previously described MR imaging criteria for OCD instability (i.e., high T2 signal rim, surrounding cysts, high T2 signal fracture line, fluid-filled osteochondral defect). Sensitivity of the individual and combined criteria was calculated. Results: OCD occurred in the capitellum in 24 patients (92%), in the trochlea in 2 patients (8%) and radial head in 1 patient (4%). Loose bodies were identified in 11 (42%) patients. Eighteen patients demonstrated MRI findings in keeping with unstable lesions. In all 11 patients who had surgery the surgical findings of instability correlated with the MRI findings. When combined, the MR criteria were 100% sensitive for instability of OCD lesions of the elbow. Conclusion: The vast majority of OCD of the elbow occurs in the capitellum. When used together, the MR criteria for instability were 100% sensitive for evaluation OCD lesions of the elbow.

  10. Long term results in refractory tennis elbow using autologous blood

    Directory of Open Access Journals (Sweden)

    Naseem ul Gani

    2014-11-01

    Full Text Available Tennis elbow (TE is one of the commonest myotendinosis. Different treatment options are available and autologous blood injection has emerged as the one of the acceptable modalities of treatment. Long term studies over a larger group of patients are however lacking. The purpose of this study was to evaluate these patients on longer durations. One-hundred and twenty patients of TE, who failed to respond to conventional treatment including local steroid injections were taken up for this prospective study over the period from year 2005 to 2011 and were followed up for the minimum of 3 years (range 3-9 years. Two mL of autologous blood was taken from the ipsilateral limb and injected into the lateral epicondyle. The effectiveness of the procedure was assessed by Pain Rating Sscale and Nirschl Staging, which was monitored before the procedure, at first week, monthly for first three months, at 6 months and then 3 monthly for first year, six monthly for next 2 years and then yearly. Statistical analysis was done and a P value of <0.05 was taken as significant. The patients (76 females and 44 males were evaluated after procedure. The mean age group was 40.67±8.21. The mean follow up was 5.7±1.72 (range 3 to 9 years. The mean pain score and Nirschl stage before the procedure was 3.3±0.9 and 6.2±0.82 respectively. At final follow up the pain score and Nirschl were 1.1±0.9 and 1.5±0.91 respectively. Autologous blood injection was found to be one of the modalities for treatment of TE. Being cheap, available and easy method of treatment, it should be considered as a treatment modality before opting for the surgery. Universal guidelines for the management of tennis elbow should be made as there is lot of controversy regarding the treatment.

  11. ARTHROSCOPIC TREATMENT OF PATIENTS WITH LATERAL HUMERAL EPICONDYLITIS (TENNIS ELBOW

    Directory of Open Access Journals (Sweden)

    M. R. Salikhov

    2017-01-01

    Full Text Available In the past decade the clinical and anatomical studies proved that lateral humeral epicondylitis can be successfully treated arthroscopically.Purpose of the study is to identify the optimal method of surgical treatment for patients with lateral humeral epicondylitis.Material and methods. The authors conducted an integral study consisting of two sections: clinical and anatomical. Anatomical section included precision preparation of extensor muscles of the forearm. Clinical section was dedicated to comparative analysis of statistically valid and matched by lesion severity groups of patients who underwent open and arthroscopic procedures. All patients were divided into three groups. Patients of Group I underwent arthroscopic release of extensor carpi radialis brevis tendon (ECRB without decorticating of the lateral humeral epicondyle. Patients of Group II underwent arthroscopic release of ECRB in combination with decortication of the lateral humeral epicondyle. Patients in Group III underwent an open release of ECRB.Results. Patients who underwent arthroscopic release of ECRB demonstrated less pronounced pain syndrome as compared to patients after ECRB release along with decortication of epicondyle or after open release (р<0,05. VAS pain score in Group I decreased from 7 to 1 point, in Group II — from 7 to 3 points, in Group III — from 7 to 4 points. Mean time until full recovery after the surgery was 24,2±7,8 days in Group I, 39,4±5,6 days in Group II and 60,2±15,6 days in Group III (р<0,05. Functional outcomes were assessed by Mayo Elbow Performance Score (MEPS in 9 weeks postoperatively: Group I — improvement from 60 to 79 points, Group II — from 62 to 75 points, Group III — from 60 to 75 points.Conclusion. Drilling or removal of periosteum of the damaged epicondyle does not provide a positive effect. Decortication also has certain disadvantages like postoperative pain intensification leading to lesser range of motion in elbow and

  12. New Design of a Soft Robotics Wearable Elbow Exoskeleton Based on Shape Memory Alloy Wire Actuators

    Science.gov (United States)

    Cano, Enrique; Moreno, Luis; Blanco, Dolores

    2017-01-01

    The elbow joint is a complex articulation composed of the humeroulnar and humeroradial joints (for flexion-extension movement) and the proximal radioulnar articulation (for pronation-supination movement). During the flexion-extension movement of the elbow joint, the rotation center changes and this articulation cannot be truly represented as a simple hinge joint. The main goal of this project is to design and assemble a medical rehabilitation exoskeleton for the elbow with one degree of freedom for flexion-extension, using the rotation center for proper patient elbow joint articulation. Compared with the current solutions, which align the exoskeleton axis with the elbow axis, this offers an ergonomic physical human-robot interface with a comfortable interaction. The exoskeleton is actuated with shape memory alloy wire-based actuators having minimum rigid parts, for guiding the actuators. Thanks to this unusual actuation system, the proposed exoskeleton is lightweight and has low noise in operation with a simple design 3D-printed structure. Using this exoskeleton, these advantages will improve the medical rehabilitation process of patients that suffered stroke and will influence how their lifestyle will change to recover from these diseases and improve their ability with activities of daily living, thanks to brain plasticity. The exoskeleton can also be used to evaluate the real status of a patient, with stroke and even spinal cord injury, thanks to an elbow movement analysis. PMID:29104424

  13. Complete dislocation of the ulnar nerve at the elbow: a protective effect against neuropathy?

    Science.gov (United States)

    Leis, A Arturo; Smith, Benn E; Kosiorek, Heidi E; Omejec, Gregor; Podnar, Simon

    2017-08-01

    Recurrent complete ulnar nerve dislocation has been perceived as a risk factor for development of ulnar neuropathy at the elbow (UNE). However, the role of dislocation in the pathogenesis of UNE remains uncertain. We studied 133 patients with complete ulnar nerve dislocation to determine whether this condition is a risk factor for UNE. In all, the nerve was palpated as it rolled over the medial epicondyle during elbow flexion. Of 56 elbows with unilateral dislocation, UNE localized contralaterally in 17 elbows (30.4%) and ipsilaterally in 10 elbows (17.9%). Of 154 elbows with bilateral dislocation, 26 had UNE (16.9%). Complete dislocation decreased the odds of having UNE by 44% (odds ratio = 0.475; P =  0.028), and was associated with less severe UNE (P = 0.045). UNE occurs less frequently and is less severe on the side of complete dislocation. Complete dislocation may have a protective effect on the ulnar nerve. Muscle Nerve 56: 242-246, 2017. © 2016 Wiley Periodicals, Inc.

  14. Three-dimensional analysis of elbow soft tissue footprints and anatomy.

    Science.gov (United States)

    Capo, John T; Collins, Christopher; Beutel, Bryan G; Danna, Natalie R; Manigrasso, Michaele; Uko, Linda A; Chen, Linda Y

    2014-11-01

    Tendinous and ligamentous injuries commonly occur in the elbow. This study characterized the location, surface areas, and origin and insertional footprints of major elbow capsuloligamentous and tendinous structures in relation to bony landmarks with the use of a precision 3-dimensional modeling system. Nine unpaired cadaveric elbow specimens were dissected and mounted on a custom jig. Mapping of the medial collateral ligament (MCL), lateral ulnar collateral ligament (LUCL), triceps, biceps, brachialis, and capsular reflections was then performed with 3-dimensional digitizing technology. The location, surface areas, and footprints of the soft tissues were calculated. The MCL had a mean origin (humeral) footprint of 216 mm(2), insertional footprint of 154 mm(2), and surface area of 421 mm(2). The LUCL had a mean origin footprint of 136 mm(2), an insertional footprint of 142 mm(2), and a surface area of 532 mm(2). Of the tendons, the triceps maintained the largest insertional footprint, followed by the brachialis and the biceps (P anatomy of key elbow capsuloligamentous and tendinous structures is crucial for effective reconstruction after bony or soft tissue trauma. This study provides the upper extremity surgeon with information that may aid in restoring elbow biomechanics and preserving range of motion in these patients. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  15. New Design of a Soft Robotics Wearable Elbow Exoskeleton Based on Shape Memory Alloy Wire Actuators.

    Science.gov (United States)

    Copaci, Dorin; Cano, Enrique; Moreno, Luis; Blanco, Dolores

    2017-01-01

    The elbow joint is a complex articulation composed of the humeroulnar and humeroradial joints (for flexion-extension movement) and the proximal radioulnar articulation (for pronation-supination movement). During the flexion-extension movement of the elbow joint, the rotation center changes and this articulation cannot be truly represented as a simple hinge joint. The main goal of this project is to design and assemble a medical rehabilitation exoskeleton for the elbow with one degree of freedom for flexion-extension, using the rotation center for proper patient elbow joint articulation. Compared with the current solutions, which align the exoskeleton axis with the elbow axis, this offers an ergonomic physical human-robot interface with a comfortable interaction. The exoskeleton is actuated with shape memory alloy wire-based actuators having minimum rigid parts, for guiding the actuators. Thanks to this unusual actuation system, the proposed exoskeleton is lightweight and has low noise in operation with a simple design 3D-printed structure. Using this exoskeleton, these advantages will improve the medical rehabilitation process of patients that suffered stroke and will influence how their lifestyle will change to recover from these diseases and improve their ability with activities of daily living, thanks to brain plasticity. The exoskeleton can also be used to evaluate the real status of a patient, with stroke and even spinal cord injury, thanks to an elbow movement analysis.

  16. Pediatric elbow trauma: an orthopaedic perspective on the importance of radiographic interpretation.

    Science.gov (United States)

    Jacoby, Sidney M; Herman, Martin J; Morrison, William B; Osterman, A Lee

    2007-03-01

    Radiographic interpretation of pediatric elbow trauma presents a daunting task for both the radiologist and treating orthopaedic surgeon. Proper radiographic diagnosis and appropriate intervention requires a thorough understanding and appreciation of developmental anatomy. As the pediatric elbow matures, it transitions from multiple cartilaginous anlagen through a predictable pattern of ossification and fusion. When children sustain trauma to the elbow, they may have a limited capacity to communicate specific complaints and are sometimes difficult to examine reliably. Furthermore, the presence of multiple growth centers, and their variability, makes radiographic evaluation of pediatric elbow injuries particularly challenging. These variables, coupled with the known adverse long-term sequelae of pediatric elbow trauma (painful nonunion, malunion, elbow stiffness, growth disturbance, etc.) highlight the importance of accurate radiographic interpretation, which facilitates appropriate treatment. By using an orderly, systematic approach based on well-defined anatomical relationships and accepted radiographic markers, the radiologist may effectively interpret and communicate pertinent findings to the treating orthopaedic surgeon. Furthermore, using common classification systems may facilitate interdisciplinary communication. Finally, it is crucial that caregivers of children consider the possibility of child abuse in suspect cases.

  17. New Design of a Soft Robotics Wearable Elbow Exoskeleton Based on Shape Memory Alloy Wire Actuators

    Directory of Open Access Journals (Sweden)

    Dorin Copaci

    2017-01-01

    Full Text Available The elbow joint is a complex articulation composed of the humeroulnar and humeroradial joints (for flexion-extension movement and the proximal radioulnar articulation (for pronation-supination movement. During the flexion-extension movement of the elbow joint, the rotation center changes and this articulation cannot be truly represented as a simple hinge joint. The main goal of this project is to design and assemble a medical rehabilitation exoskeleton for the elbow with one degree of freedom for flexion-extension, using the rotation center for proper patient elbow joint articulation. Compared with the current solutions, which align the exoskeleton axis with the elbow axis, this offers an ergonomic physical human-robot interface with a comfortable interaction. The exoskeleton is actuated with shape memory alloy wire-based actuators having minimum rigid parts, for guiding the actuators. Thanks to this unusual actuation system, the proposed exoskeleton is lightweight and has low noise in operation with a simple design 3D-printed structure. Using this exoskeleton, these advantages will improve the medical rehabilitation process of patients that suffered stroke and will influence how their lifestyle will change to recover from these diseases and improve their ability with activities of daily living, thanks to brain plasticity. The exoskeleton can also be used to evaluate the real status of a patient, with stroke and even spinal cord injury, thanks to an elbow movement analysis.

  18. Immobilization of iodine in concrete

    Science.gov (United States)

    Clark, Walter E.; Thompson, Clarence T.

    1977-04-12

    A method for immobilizing fission product radioactive iodine recovered from irradiated nuclear fuel comprises combining material comprising water, Portland cement and about 3-20 wt. % iodine as Ba(IO.sub.3).sub.2 to provide a fluid mixture and allowing the fluid mixture to harden, said Ba(IO.sub.3).sub.2 comprising said radioactive iodine. An article for solid waste disposal comprises concrete prepared by this method. BACKGROUND OF THE INVENTION This invention was made in the course of, or under a contract with the Energy Research and Development Administration. It relates in general to reactor waste solidification and more specifically to the immobilization of fission product radioactive iodine recovered from irradiated nuclear fuel for underground storage.

  19. Contaminant immobilization via microbial activity

    International Nuclear Information System (INIS)

    1991-11-01

    The aim of this study was to search the literature to identify biological techniques that could be applied to the restoration of contaminated groundwaters near uranium milling sites. Through bioremediation it was hypothesized that the hazardous heavy metals could be immobilized in a stable, low-solubility form, thereby halting their progress in the migrating groundwater. Three basic mechanisms were examined: reduction of heavy metals by microbially produced hydrogen sulfide; direct microbial mediated reduction; and biosorption

  20. Immobilization of iodine in concrete

    International Nuclear Information System (INIS)

    Clark, W.E.; Thompson, C.T.

    1977-01-01

    A method for immobilizing fission product radioactive iodine recovered from irradiated nuclear fuel comprises combining material comprising water, Portland cement and about 3 to 20 wt percent iodine as Ba(IO 3 ) 2 to provide a fluid mixture and allowing the fluid mixture to harden, said Ba(IO 3 ) 2 comprising said radioactive iodine. An article for solid waste disposal comprises concrete prepared by this method. 10 claims, 2 figures

  1. A novel method for assessing elbow pain resulting from epicondylitis

    Science.gov (United States)

    Polkinghorn, Bradley S.

    2002-01-01

    Abstract Objective To describe a novel orthopedic test (Polk's test) which can assist the clinician in differentiating between me- dial and lateral epicondylitis, 2 of the most common causes of elbow pain. This test has not been previously described in the literature. Clinical Features The testing procedure described in this paper is easy to learn, simple to perform and may provide the clinician with a quick and effective method of differentiating between lateral and medial epicondylitis. The test also helps to elucidate normal activities of daily living that the patient may unknowingly be performing on a repetitive basis that are hindering recovery. The results of this simple test allow the clinician to make immediate lifestyle recommendations to the patient that should improve and hasten the response to subsequent treatment. It may be used in conjunction with other orthopedic testing procedures, as it correlates well with other clinical tests for assessing epicondylitis. Conclusion The use of Polk's Test may help the clinician to diagnostically differentiate between lateral and medial epicondylitis, as well as supply information relative to choosing proper instructions for the patient to follow as part of their treatment program. Further research, performed in an academic setting, should prove helpful in more thoroughly evaluating the merits of this test. In the meantime, clinical experience over the years suggests that the practicing physician should find a great deal of clinical utility in utilizing this simple, yet effective, diagnostic procedure. PMID:19674572

  2. "Popeye muscle" morphology in OBPI elbow flexion contracture.

    Science.gov (United States)

    Coroneos, Christopher J; Maizlin, Zeev V; DeMatteo, Carol; Gjertsen, Deborah; Bain, James R

    2015-01-01

    The pathophysiology of elbow flexion contracture (EFC) in obstetrical brachial plexus injury (OBPI) is not established. In basic science models, neonatal denervation leads to impaired muscle growth. In clinical studies, diminished growth is correlated with extent of denervation, and improved with surgical repair. In EFC, the biceps are clinically short and round vs the contralateral size, termed the "Popeye muscle". The objective of this study was to determine if the biceps morphology (muscle belly and tendon length) in arms with EFC secondary to OBPI is different vs the contralateral. This is a retrospective matched-cohort study. Patients with unilateral EFC (>20°) secondary to OBPI were identified (median = 6.6 years, range = 4.7-16.8). A blinded radiologist used computed tomography to measure length of the biceps short head muscle belly, and tendon bilaterally using standardised anatomical landmarks. Twelve patients were analyzed. The biceps muscle belly in the injured arm was shorter in all patients vs contralateral, mean difference = 3.6 cm (80%), p muscle belly and overall length, but longer tendon vs normal. This is termed the "Popeye muscle" for its irregular morphology. Findings are consistent with impaired limb growth in denervation.

  3. Propagation of ovalization along straight pipes and elbows

    International Nuclear Information System (INIS)

    Millard, A.; Roche, R.L.

    1981-01-01

    The aim of this paper is to present analytical solutions for the propagation of evalization and the variation of the flexibility factor along pipe bends terminated by straight pipes or flanges, under in-plane bending, assuming an elastic material behaviour. The influence of the various strains in analysed in the simple case of a straight pipe, subjected to an elliptical cross-section shape deformation at one end. The results enlighten the very important part played by the distorsion in the propagation. They have been compared with finite elements solutions and with simple experiments. The solution is developed for an elbow terminated by a straight pipe or a flange, following the Von Karman's approach: local displacements are expanded in Fourier series, the coefficients of which vary along the curvilinear abscissa, like the rotation of the cross-section as a whole; the differential equations as well as the boundary conditions are found by minimization of the total potential energy of the assembly. The solutions are compared to existing and experimental results. (orig./HP)

  4. Immobilization of microbial cells on cellulose-polymer surfaces by radiation polymerization

    International Nuclear Information System (INIS)

    Kumakura, M.; Kaetsu, I.

    1983-01-01

    Streptomyces phaeochromogens cells were immobilized on cellulose-polymer surfaces by radiation polymerization using hydrophilic monomers and paper. The enzyme activity of immobilized cell sheets was higher than that of immobilized cell composites obtained by the usual radiation polymerization technique. The enzyme activity of the sheets was affected by monomer concentration, the thickness of paper, and the degree of polymerization of paper. The copolymerization of hydroxyethyl methacrylate and methoxytetraethyleneglycol methacrylate in the sheets led to a further increase of the enzyme activity due to the increase of the hydrophilicity of the polymer matrix. The Michaelis constant of the sheets from low monomer concentration was close to that of intact cells

  5. Compensating for intersegmental dynamics across the shoulder, elbow, and wrist joints during feedforward and feedback control.

    Science.gov (United States)

    Maeda, Rodrigo S; Cluff, Tyler; Gribble, Paul L; Pruszynski, J Andrew

    2017-10-01

    Moving the arm is complicated by mechanical interactions that arise between limb segments. Such intersegmental dynamics cause torques applied at one joint to produce movement at multiple joints, and in turn, the only way to create single joint movement is by applying torques at multiple joints. We investigated whether the nervous system accounts for intersegmental limb dynamics across the shoulder, elbow, and wrist joints during self-initiated planar reaching and when countering external mechanical perturbations. Our first experiment tested whether the timing and amplitude of shoulder muscle activity account for interaction torques produced during single-joint elbow movements from different elbow initial orientations and over a range of movement speeds. We found that shoulder muscle activity reliably preceded movement onset and elbow agonist activity, and was scaled to compensate for the magnitude of interaction torques arising because of forearm rotation. Our second experiment tested whether elbow muscles compensate for interaction torques introduced by single-joint wrist movements. We found that elbow muscle activity preceded movement onset and wrist agonist muscle activity, and thus the nervous system predicted interaction torques arising because of hand rotation. Our third and fourth experiments tested whether shoulder muscles compensate for interaction torques introduced by different hand orientations during self-initiated elbow movements and to counter mechanical perturbations that caused pure elbow motion. We found that the nervous system predicted the amplitude and direction of interaction torques, appropriately scaling the amplitude of shoulder muscle activity during self-initiated elbow movements and rapid feedback control. Taken together, our results demonstrate that the nervous system robustly accounts for intersegmental dynamics and that the process is similar across the proximal to distal musculature of the arm as well as between feedforward (i

  6. The reliability, validity and responsiveness of the Dutch version of the Oxford elbow score

    Directory of Open Access Journals (Sweden)

    Patka Peter

    2011-07-01

    Full Text Available Abstract Background The Oxford elbow score (OES is an English questionnaire that measures the patients' subjective experience of elbow surgery. The OES comprises three domains: elbow function, pain, and social-psychological effects. This questionnaire can be completed by the patient and used as an outcome measure after elbow surgery. The aim of this study was to develop and evaluate the Dutch version of the translated OES for reliability, validity and responsiveness with respect to patients after elbow trauma and surgery. Methods The 12 items of the English-language OES were translated into Dutch and then back-translated; the back-translated questionnaire was then compared to the original English version. The OES Dutch version was completed by 69 patients (group A, 60 of whom had an elbow luxation, four an elbow fracture and five an epicondylitis. QuickDASH, the visual analogue pain scale (VAS and the Mayo Elbow Performance Index (MEPI were also completed to examine the convergent validity of the OES in group A. To calculate the test-retest reliability and responsiveness of the OES, this questionnaire was completed three times by 43 different patients (group B. An average of 52 days elapsed between therapy and the administration of the third OES (SD = 24.1. Results The Cronbach's α coefficients for the function, pain and social-psychological domains were 0.90, 0.87 and 0.90, respectively. The intra-class correlation coefficients for the domains were 0.87 for function, 0.89 for pain and 0.87 for social-psychological. The standardised response means for the domains were 0.69, 0.46 and 0.60, respectively, and the minimal detectable changes were 27.6, 21.7 and 24.0, respectively. The convergent validity for the function, pain and social-psychological domains, which were measured as the Spearman's correlation of the OES domains with the MEPI, were 0.68, 0.77 and 0.77, respectively. The Spearman's correlations of the OES domains with QuickDASH were

  7. Preparation of immobilized enzyme membrane by radiation-cast-polymerization

    International Nuclear Information System (INIS)

    Kumakura, M.; Kaetsu, I.

    1989-01-01

    The preparation of immobilized enzyme membranes was studied by radiation cast-polymerization at low temperatures using cellulase enzyme, hydrophilic and hydrophobic monomers. The enzyme activity of the membranes was affected by monomer concentration, membrane thickness, and hydrophilicity of monomer, in which the membranes with 100 μm thickness from high monomer concentration (80%) had high enzyme activity, which was similar to that of the membranes with 1.0 mm thickness from low monomer concentration (20%). (author)

  8. Plutonium Immobilization Project Binder Burnout and Sintering Studies (Milestone 6.6a)

    International Nuclear Information System (INIS)

    Chandler, G.

    1999-01-01

    The Plutonium Immobilization Team has developed an integrated test program to understand and optimize the controlling variables for the sintering step of the plutonium immobilization process. Sintering is the key process step that controls the product mineralogy. It is expected that the sintering will be the limiting process step that controls the throughput of the production line. The goal of the current sintering test program is to better understand factors that affect the sintering process

  9. Plutonium Immobilization Project Binder Burnout and Sintering Studies (Milestone 6.6a)

    Energy Technology Data Exchange (ETDEWEB)

    Chandler, G.

    1999-10-28

    The Plutonium Immobilization Team has developed an integrated test program to understand and optimize the controlling variables for the sintering step of the plutonium immobilization process. Sintering is the key process step that controls the product minerology. It is expected that the sintering will be the limiting process step that controls the throughput of the production line. The goal of the current sintering test program is to better understand factors that affect the sintering process.

  10. The Snapping Elbow Syndrome as a Reason for Chronic Elbow Neuralgia in a Tennis Player – MR, US and Sonoelastography Evaluation

    International Nuclear Information System (INIS)

    Łasecki, Mateusz; Olchowy, Cyprian; Pawluś, Aleksander; Zaleska-Dorobisz, Urszula

    2014-01-01

    Ulnar neuropathy is the second most common peripheral nerve neuropathy after median neuropathy, with an incidence of 25 cases per 100 000 men and 19 cases per 100 000 women each year. Skipping (snapping) elbow syndrome is an uncommon cause of pain in the posterior-medial elbow area, sometimes complicated by injury of the ulnar nerve. One of the reason is the dislocation of the abnormal insertion of the medial triceps head over the medial epicondyle during flexion and extension movements. Others are: lack of the Osboune fascia leading to ulnar nerve instability and focal soft tissue tumors (fibromas, lipomas, etc). Recurrent subluxation of the nerve at the elbow results in a tractional and frictional neuritis with classical symptoms of peripheral neuralgia. As far as we know snapping triceps syndrome had never been evaluated in sonoelastography. A 28yo semi-professional left handed tennis player was complaining about pain in posterior-medial elbow area. Initial US examination suggest golfers elbow syndrome which occurs quite commonly and has a prevalence of 0.3–0.6% in males and 0–3–1.1% in women and may be associated (approx. 50% of cases) with ulnar neuropathy. However subsequently made MRI revealed unusual distal triceps anatomy, moderate ulnar nerve swelling and lack of medial epicondylitis symptoms. Followed (second) US examination and sonoelastography have detected slipping of the both ulnar nerve and the additional band of the medial triceps head. Snapping elbow syndrome is a poorly known medical condition, sometimes misdiagnosed as the medial epicondylitis. It describes a broad range of pathologies and anatomical abnormalities. One of the most often reasons is the slipping of the ulnar nerve as the result of the Osborne fascia/anconeus epitrochlearis muscle absence. Simultaneously presence of two or more “snapping reasons” is rare but should be always taken under consideration. There are no sonoelastography studies describing golfers elbow syndrome

  11. Applicability of ANSYS ELBOW290 element for flexibility calculation of tight radius bends on feeder pipes in CANDU reactors

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, X., E-mail: Xuan.Zhang@candu.com [Candu Energy Inc, Mississauga, ON (Canada)

    2015-07-01

    A curved pipe element, ELBOW290, became available in ANSYS 12. This element was developed based on a simplified shell theory, and maintains the ability to capture cross-sectional deformations of elbows. Numerical testing on the applicability of this element for the flexibility calculation of the tight radius bends in CANDU reactors is carried out to determine the usability of this element in completing stress analyses for feeder pipes. Comparisons are made between the ELBOW290 and the shell element for various feeder bend types found in domestic and overseas CANDU reactors. The comparisons show that the ELBOW290 element is suitable for calculating the flexibility of the tight radius bends. (author)

  12. Properties of immobilized papain by radiation polymerization

    International Nuclear Information System (INIS)

    Kumakura, Minoru; Kaetsu, Isao

    1984-01-01

    Papain was immobilized by the radiation polymerization of various monomers at low temperatures and the effects of the polymer matrix on the enzyme activity and thermal stability of the immobilized enzymes were studied. The activity of the immobilized enzymes prepared from monofunctional (acrylate and methacrylate) monomers was higher than that from bifunctional (bismethacrylate) monomers and that from polyoxyethylene dimethacrylate monomers increased with an increase in the number of oxyethylene units. The thermal stability of the immobilized enzymes prepared from hydrophilic monomers was higher than that from hydrophobic monomers and increased markedly with increasing monomer concentration. (author)

  13. Immobilization and controlled release of drug using plasma polymerized thin film

    Energy Technology Data Exchange (ETDEWEB)

    Myung, Sung-Woon [Department of Dental Materials, School of Dentistry, MRC Center, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju (Korea, Republic of); Jung, Sang-Chul [Department of Environmental Engineering, Sunchon National University, Sunchon 540-742 (Korea, Republic of); Kim, Byung-Hoon, E-mail: kim5055@chosun.ac.kr [Department of Dental Materials, School of Dentistry, MRC Center, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju (Korea, Republic of)

    2015-06-01

    In this study, plasma polymerization of acrylic acid was employed to immobilize drug and control its release. Doxorubicin (DOX) was immobilized covalently on the glass surface deposited with plasma polymerized acrylic acid (PPAAc) thin film containing the carboxylic group. At first, the PPAAc thin film was coated on a glass surface at a pressure of 1.33 Pa and radio frequency (RF) discharge power of 20 W for 10 min. DOX was immobilized on the PPAAc deposition in a two environment of phosphate buffer saline (PBS) and dimethyl sulfoxide (DMSO) solutions. The DOX immobilized surface was characterized by scanning electron microscope, atomic force microscope and attenuated total reflection Fourier transform infrared spectroscopy. The DOX molecules were more immobilized in PBS than DMSO solution. The different immobilization and release profiles of DOX result from the solubility of hydrophobic DOX in aqueous and organic solutions. Second, in order to control the release of the drug, PPAAc thin film was covered over DOX dispersed layer. Different thicknesses and cross-linked PPAAc thin films by adjusting deposition time and RF discharge power were covered on the DOX layer dispersed. PPAAc thin film coated DOX layer reduced the release rate of DOX. The thickness control of plasma deposition allows controlling the release rate of drug. - Highlights: • Doxorubicin was immobilized on the surface of plasma polymerized acrylic acid thin film. • Release profile of doxorubicin was affected by aqueous and organic solutions. • Plasma polymerized acrylic acid thin film can be used to achieve controlled release.

  14. Preliminary assessment of modified borosilicate glasses for chromium and ruthenium immobilization

    Energy Technology Data Exchange (ETDEWEB)

    Farid, Osama M. [Reactors Department, Nuclear Research Center, Atomic Energy Authority of Egypt, P.O. 13759, Inshas, Cairo (Egypt); Centre of Nuclear Engineering (CNE), Department of Materials, Imperial College London, London, SW7 2BP (United Kingdom); Abdel Rahman, R.O., E-mail: alaarehab@yahoo.com [Hot Laboratory Center, Atomic Energy Authority of Egypt, P.O. 13759, Inshas, Cairo (Egypt)

    2017-01-15

    The feasibility of using modified alkali borosilicate glasses for ruthenium and chromium immobilization is preliminary assessed by investigating the immobilization system structure under normal conditions. Within this context, reference alkali borosilicate, and simulated Magnox-modified glasses were prepared and studied. The results indicate that ruthenium is immobilized in the vitreous structure as encapsulated RuO{sub 2} crystallites that act as seeds for heterogeneous nucleation of other crystalline phases. The presence of Zn, as modifier, has contributed to chromium immobilization in zincochromite spinel structure, whereas Ca is accommodated in the vitreous structure. Immobilization performance was evaluated by conducting conservative static leach test and studying the leached glass. Leached glass morphology was altered, where near surface reference glass is leached over 400 nm and simulated Magnox-modified sample is altered over 300 nm. Normalized release rates are within normal range for borosilicate material. For simulated Magnox-modified sample, Ca and alkali structural element, i.e. Na and Li, are leached via ion-exchange reaction. The ion-exchanged fraction equals 1.06 × 10{sup −8} mol/m{sup 2} s and chromium has slightly lower normalized release rate value than ruthenium. - Highlights: • The presence of modifiers and waste oxides led to localized de-vitrification. • Ruthenium is encapsulated within the vitreous glass network as RuO{sub 2} crystals. • Chromium is immobilized within the zincochromite spinel structure. • Pitting and cracks induced by leaching did not affect the immobilization performance.

  15. Enhanced starch hydrolysis using α-amylase immobilized on cellulose ultrafiltration affinity membrane.

    Science.gov (United States)

    Konovalova, Viktoriia; Guzikevich, Kateryna; Burban, Anatoliy; Kujawski, Wojciech; Jarzynka, Karolina; Kujawa, Joanna

    2016-11-05

    In order to prepare ultrafiltration membranes possessing biocatalytic properties, α-amylase has been immobilized on cellulose membranes. Enzyme immobilization was based on a covalent bonding between chitosan and a surface of cellulose membrane, followed by an attachment of Cibacron Blue F3G-A dye as affinity ligand. Various factors affecting the immobilization process, such as enzyme concentration, pH of modifying solution, zeta-potential of membrane surface, and stability of immobilized enzyme were studied. The applicability of immobilized α-amylase has been investigated in ultrafiltration processes. The immobilization of α-amylase on membrane surface allows to increase the value of mass transfer coefficient and to decrease the concentration polarization effect during ultrafiltration of starch solutions. The enzyme layer on the membrane surface prevents a rapid increase of starch concentration due to the amylase hydrolysis of starch in the boundary layer. The presented affinity immobilization technique allows also for the regeneration of membranes from inactivated enzyme. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Pertechnetate immobilization in aqueous media with hydrogen sulfide under anaerobic and aerobic environments

    International Nuclear Information System (INIS)

    Liu, Y.; Jurisson, S.; Terry, J.

    2007-01-01

    The basic chemistry for the immobilization of pertechnetate (TcO 4 - ) by hydrogen sulfide was investigated in aqueous solution under both aerobic and anaerobic environments. Pertechnetate immobilization was acid dependent, with accelerated rates and increased immobilization yields as the acid concentration increased. Oxygen had no effect under acidic conditions. Under anaerobic alkaline conditions, the pH, and therefore the speciation of sulfide, was the determining factor on the immobilization of pertechnetate. Only 53% of the TcO 4 - was immobilized at pH 8, while the yield increased to 83% at pH 9 as HS - became the dominant sulfide species. The immobilization yield then decreased to 73% at pH 13. No reaction was observed between TcO 4 - and sulfide under aerobic alkaline conditions, indicating that oxygen suppressed this reaction. Pertechnetate immobilization was found to be first order with respect to both sulfide and pertechnetate in acidic solutions, and in alkaline solution under anaerobic conditions. The results of stoichiometry studies and product analysis under alkaline anaerobic environments indicated that Tc 2 S 7 was obtained at pH 9. EXAFS (extended X-ray absorption fine structure) and XANES (X-ray absorption near edge structure) studies suggested that the samples obtained from acidic, aerobic solution and alkaline anaerobic solution were both Tc 2 S 7 . The stability of Tc 2 S 7 is affected by O 2 with accelerated dissolution at high pH. (orig.)

  17. Immobilization and controlled release of drug using plasma polymerized thin film

    International Nuclear Information System (INIS)

    Myung, Sung-Woon; Jung, Sang-Chul; Kim, Byung-Hoon

    2015-01-01

    In this study, plasma polymerization of acrylic acid was employed to immobilize drug and control its release. Doxorubicin (DOX) was immobilized covalently on the glass surface deposited with plasma polymerized acrylic acid (PPAAc) thin film containing the carboxylic group. At first, the PPAAc thin film was coated on a glass surface at a pressure of 1.33 Pa and radio frequency (RF) discharge power of 20 W for 10 min. DOX was immobilized on the PPAAc deposition in a two environment of phosphate buffer saline (PBS) and dimethyl sulfoxide (DMSO) solutions. The DOX immobilized surface was characterized by scanning electron microscope, atomic force microscope and attenuated total reflection Fourier transform infrared spectroscopy. The DOX molecules were more immobilized in PBS than DMSO solution. The different immobilization and release profiles of DOX result from the solubility of hydrophobic DOX in aqueous and organic solutions. Second, in order to control the release of the drug, PPAAc thin film was covered over DOX dispersed layer. Different thicknesses and cross-linked PPAAc thin films by adjusting deposition time and RF discharge power were covered on the DOX layer dispersed. PPAAc thin film coated DOX layer reduced the release rate of DOX. The thickness control of plasma deposition allows controlling the release rate of drug. - Highlights: • Doxorubicin was immobilized on the surface of plasma polymerized acrylic acid thin film. • Release profile of doxorubicin was affected by aqueous and organic solutions. • Plasma polymerized acrylic acid thin film can be used to achieve controlled release

  18. Ulnohumeral chondral and ligamentous overload: biomechanical correlation for posteromedial chondromalacia of the elbow in throwing athletes.

    Science.gov (United States)

    Osbahr, Daryl C; Dines, Joshua S; Breazeale, Nathan M; Deng, Xiang-Hua; Altchek, David W

    2010-12-01

    Previous studies have documented increased posteromedial contact forces with the elbow at lower flexion angles associated with valgus extension overload; however, the authors believe that posteromedial elbow impingement in association with valgus laxity is a complex pathological process that may occur throughout the entire throwing motion in the form of ulnohumeral chondral and ligamentous overload. Valgus laxity with the elbow at 90° of flexion may lead to chondromalacia secondary to a subtle shift in the contact point between the tip of the olecranon and the distal humeral trochlea. Controlled laboratory study. Six fresh human cadaveric elbows were dissected and subjected to a static valgus load. Pressure-sensitive Fuji film measured the contact pressure, contact area, and shift in contact area across the posteromedial elbow before and after sectioning the anterior bundle of the ulnar collateral ligament. The contact pressure between the tip of the olecranon process and the medial crista of the posterior humeral trochlea significantly increased, from an average of 0.27 ± 0.06 kg/cm² to 0.40 ± 0.08 kg/cm². The contact area also significantly decreased, from an average of 30.34 ± 9.17 mm² to 24.59 ± 6.44 mm², and shifted medially on the medial humeral crista, which corresponds to the position of the posteromedial chondral lesions that was observed in throwing athletes in the authors' clinical practice. While simulating the early acceleration phase of the throwing motion with the elbow in 90° of flexion, the results illustrate that abnormal contact may occur as a result of valgus laxity through increased contact pressures across the posteromedial elbow between the medial tip of the olecranon and medial crista of the humeral trochlea. In addition, congruency of the ulnohumeral joint changed, as there was a statistically significant medial shift of the olecranon on the posterior humeral trochlea with the elbow at 90° of flexion after sectioning the anterior

  19. Arthroscopic resection of humeroradial synovial plica for persistent lateral elbow pain.

    Science.gov (United States)

    Rajeev, Aysha; Pooley, Joesph

    2015-04-01

    To review the outcome of 121 patients who underwent arthroscopic resection of a humeroradial synovial plica for persistent lateral elbow pain. 92 men and 29 women aged 24 to 56 (mean, 38) years with chronic lateral elbow pain underwent arthroscopic resection of a humeroradial synovial plica using a motorised soft tissue shaver, followed by intensive physiotherapy. The modified elbow score and range of motion were assessed, as were wound healing, infection, soft tissue swelling or effusion, tenderness, ligamentous instability, and motor strength. No patient had any ligamentous instability. 80 patients were pain-free at 3 months; only 3 patients were taking pain medication at 6 months. All patients had full pronation and supination; the mean range of motion was 3º to 135º of flexion. The mean modified elbow score at 12 months was 93.2 (range, 72-100). The percentages of patients with excellent, good, fair, and poor score were 70%, 17%, 8%, and 5% at 3 months, 74%, 20%, 3%, and 3% at 6 months, and 76%, 18%, 3%, and 3% at 12 months, respectively. A humeroradial synovial plica is one of the causes of chronic lateral elbow pain. Arthroscopic resection of the synovial plica followed by intensive physiotherapy achieved good outcome.

  20. Isokinetic profile of elbow flexion and extension strength in elite junior tennis players.

    Science.gov (United States)

    Ellenbecker, Todd S; Roetert, E Paul

    2003-02-01

    Descriptive study. To determine whether bilateral differences exist in concentric elbow flexion and extension strength in elite junior tennis players. The repetitive nature of tennis frequently produces upper extremity overuse injuries. Prior research has identified tennis-specific strength adaptation in the dominant shoulder and distal upper extremity musculature of elite players. No previous study has addressed elbow flexion and extension strength. Thirty-eight elite junior tennis players were bilaterally tested for concentric elbow flexion and extension muscle performance on a Cybex 6000 isokinetic dynamometer at 90 degrees/s, 210 degrees/s, and 300 degrees/s. Repeated-measures ANOVAs were used to test for differences between extremities, muscle groups, and speed. Significantly greater (Pelbow extension peak torque values were measured at 90 degrees/s, 210 degrees/s, and 300 degrees/s for males. Significantly greater (Pelbow flexion muscular performance in males and for elbow flexion or extension peak torque and single-repetition work values in females. No significant difference between extremities was measured in elbow flexion/extension strength ratios in females and significant differences between extremities in this ratio were only present at 210 degrees/s in males (Pelbow in male elite junior tennis players but not females. These data have ramifications for clinicians rehabilitating upper extremity injuries in patients from this population.

  1. A Failure Estimation Method of Steel Pipe Elbows under In-plane Cyclic Loading

    Directory of Open Access Journals (Sweden)

    Bub-Gyu Jeon

    2017-02-01

    Full Text Available The relative displacement of a piping system installed between isolated and nonisolated structures in a severe earthquake might be larger when without a seismic isolation system. As a result of the relative displacement, the seismic risks of some components in the building could increase. The possibility of an increase in seismic risks is especially high in the crossover piping system in the buildings. Previous studies found that an elbow which could be ruptured by low-cycle ratcheting fatigue is one of the weakest elements. Fatigue curves for elbows were suggested based on component tests. However, it is hard to find a quantitative evaluation of the ultimate state of piping elbows. Generally, the energy dissipation of a solid structure can be calculated from the relation between displacement and force. Therefore, in this study, the ultimate state of the pipe elbow, normally considered as failure of the pipe elbow, is defined as leakage under in-plane cyclic loading tests, and a failure estimation method is proposed using a damage index based on energy dissipation.

  2. Seismic Capacity Estimation of Steel Piping Elbow under Low-cycle Fatigue Loading

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Bub Gyu; Kim, Sung Wan; Choi, Hyoung Suk; Kim, Nam Sik [Pusan National University, Busan (Korea, Republic of); Hahm, Dae Gi [KAERI, Daejeon (Korea, Republic of)

    2016-05-15

    In some cases, this large relative displacement can increase seismic risk of the isolated facility. Especially, a inelastic behavior of crossover piping system to connect base isolated building and fixed base building can caused by a large relative displacement. Therefore, seismic capacity estimation for isolated piping system is needed to increase safety of nuclear power plant under seismic condition. Dynamic behavior analysis of piping system under seismic condition using shake table tests was performed by Touboul et al in 1995. In accordance with their study, plastic behavior could be occurred at pipe elbow under seismic condition. Experimental researches for dynamic behavior of typical piping system in nuclear power plant have been performed for several years by JNES(Japan Nuclear Energy Safety Organization) and NUPEC(Nuclear Power Engineering Corporation). A low cycle ratcheting fatigue test was performed with scaled model of elbow which is a weakest component in piping system by Mizuno et al. In-plane cyclic loading tests under internal pressure condition were performed to evaluate the seismic capacity of the steel piping elbow. Leakage phenomenon occurred on and near the crown in piping elbow. Those cracks grew up in axial direction. The fatigue curve was estimated from test results. In the fatigue curve, loading amplitude exponentially decreased as the number of cycles increased. A FEM model of piping elbow was modified with test results. The relationships between displacement and force from tests and numerical analysis was well matched.

  3. Serial casting for elbow flexion contractures in neonatal brachial plexus palsy.

    Science.gov (United States)

    Duijnisveld, B J; Steenbeek, D; Nelissen, R G H H

    2016-09-02

    The objective of this study was to evaluate the effectiveness of serial casting of elbow flexion contractures in neonatal brachial plexus palsy. A prospective consecutive cohort study was performed with a median follow-up of 5 years. Forty-one patients with elbow flexion contractures ≥ 30° were treated with serial casting until the contracture was ≤ 10°, for a maximum of 8 weeks. Range of motion, number of recurrences and patient satisfaction were recorded and analyzed using Wilcoxon signed-rank and Cox regression tests. Passive extension increased from a median of -40° (IQR -50 to -30) to -15° (IQR -10 to -20, p casting had to be prematurely replaced by night splinting due to complaints. Serial casting improved elbow flexion contractures, although recurrences were frequent. The severity of elbow flexion contracture is a predictor of recurrence. We recommend more research on muscle degeneration and determinants involved in elbow flexion contractures to improve treatment strategies and prevent side-effects.

  4. A failure estimation method of steel pipe elbows under in-plane cyclic loading

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Bub Gyu; Kim, Sung Wan; Choi, Hyoung Suk; Park, Dong Uk [Seismic Simulation Tester Center, Pusan National University, Yangsan (Korea, Republic of); Kim, Nam Sik [Dept. of Civil and Environmental Engineering, Pusan National University, Busan (Korea, Republic of)

    2017-02-15

    The relative displacement of a piping system installed between isolated and nonisolated structures in a severe earthquake might be larger when without a seismic isolation system. As a result of the relative displacement, the seismic risks of some components in the building could increase. The possibility of an increase in seismic risks is especially high in the crossover piping system in the buildings. Previous studies found that an elbow which could be ruptured by low-cycle ratcheting fatigue is one of the weakest elements. Fatigue curves for elbows were suggested based on component tests. However, it is hard to find a quantitative evaluation of the ultimate state of piping elbows. Generally, the energy dissipation of a solid structure can be calculated from the relation between displacement and force. Therefore, in this study, the ultimate state of the pipe elbow, normally considered as failure of the pipe elbow, is defined as leakage under in-plane cyclic loading tests, and a failure estimation method is proposed using a damage index based on energy dissipation.

  5. Effect of Obesity on Complication Rate After Elbow Arthroscopy in a Medicare Population.

    Science.gov (United States)

    Werner, Brian C; Fashandi, Ahmad H; Chhabra, A Bobby; Deal, D Nicole

    2016-03-01

    To use a national insurance database to explore the association of obesity with the incidence of complications after elbow arthroscopy in a Medicare population. Using Current Procedural Terminology (CPT) and International Classification of Diseases, 9th Revision (ICD-9) procedure codes, we queried the PearlDiver database for patients undergoing elbow arthroscopy. Patients were divided into obese (body mass index [BMI] >30) and nonobese (BMI arthroscopy were identified from 2005 to 2012; 628 patients (22.5%) were coded as obese or morbidly obese, and 628 matched nonobese patients formed the control group. There were no differences between the obese patients and matched control nonobese patients regarding type of elbow arthroscopy, previous elbow fracture or previous elbow arthroscopy. Obese patients had greater rates of all assessed complications, including infection (odds ratio [OR] 2.8, P = .037), nerve injury (OR 5.4, P = .001), stiffness (OR 1.9, P = .016) and medical complications (OR 6.9, P arthroscopy in a Medicare population, including infection, nerve injury, stiffness, and medical complications. Therapeutic Level III, case-control study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  6. Prolonged phone-call posture causes changes of ulnar motor nerve conduction across elbow.

    Science.gov (United States)

    Padua, Luca; Coraci, Daniele; Erra, Carmen; Doneddu, Pietro Emiliano; Granata, Giuseppe; Rossini, Paolo Maria

    2016-08-01

    Postures and work-hobby activities may play a role in the origin and progression of ulnar neuropathy at the elbow (UNE), whose occurrence appears to be increasing. The time spent on mobile-phone has increased in the last decades leading to an increased time spent with flexed elbow (prolonged-phone-posture, PPP). We aimed to assess the effect of PPP both in patients with symptoms of UNE and in symptom-free subjects. Patients with pure sensory symptoms of UNE and negative neurophysiological tests (MIN-UNE) and symptom-free subjects were enrolled. We evaluated ulnar motor nerve conduction velocity across elbow at baseline and after 6, 9, 12, 15, and 18min of PPP in both groups. Fifty-six symptom-free subjects and fifty-eight patients were enrolled. Globally 186 ulnar nerves from 114 subjects were studied. Conduction velocity of ulnar nerve across the elbow significantly changed over PPP time in patients with MIN-UNE, showing a different evolution between the two groups. PPP causes a modification of ulnar nerve functionality in patients with MIN-UNE. PPP may cause transient stress of ulnar nerve at elbow. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Radial nerve injury following elbow external fixator: report of three cases and literature review.

    Science.gov (United States)

    Trigo, Luis; Sarasquete, Juan; Noguera, Laura; Proubasta, Ignacio; Lamas, Claudia

    2017-07-01

    Radial nerve palsy is a rare but serious complication following elbow external fixation. Only 11 cases have been reported in the literature to date, but the incidence may be underreported. We present three new cases of this complication. We analyzed the three cases of radial palsy seen in our center following the application of an external fixator as treatment for complex elbow injuries. Mean patient age at surgery was 50 years. Two patients were female and one was male. In the three cases, the initial lesion was a posterior elbow dislocation, associated with a fracture of the radial shaft in one and a radial head fracture and coronoid fracture, respectively, in the other two. Due to persistent elbow instability, an external fixator was applied in all three cases. The fixator pins were introduced percutaneously in two cases and under direct vision in an open manner in the third case. Radial palsy was noted immediately postoperatively in all cases. It was permanent in two cases and temporary in the third. Radial nerve palsy after placement of an external elbow fixator was resolved in only 1 of our 3 cases and in 6 of the 11 cases in the literature to date. Although the event is rare, these alarming results highlight the need for recommendations to avoid this complication.

  8. Phrenic Nerve Transfer for Reconstruction of Elbow Extension in Severe Brachial Plexus Injuries.

    Science.gov (United States)

    Flores, Leandro P; Socolovsky, Mariano

    2016-09-01

    Background Restoring elbow extension is an important objective to pursue when repairing the brachial plexus in patients with a flail arm. Based upon the good results obtained using the phrenic nerve to restore elbow flexion and shoulder stability, we hypothesized that this nerve could also be employed to reconstruct elbow extension in patients with severe brachial plexus injuries. Methods A retrospective study of 10 patients in which the phrenic nerve targeted the radial nerve (7 patients) or the branch to the long head of the triceps (3 patients) as a surgical strategy for reconstruction of the brachial plexus. Results The mean postoperative follow-up time was 34 months. At final follow-up, elbow extension graded as M4 was measured in three patients, Medical Research Council MRC M3 in five patients, and M2 in one patient, while one patient experienced no measurable recovery (M0). No patient complained or demonstrated any signs of respiratory insufficiency postoperatively. Conclusions The phrenic nerve is a reliable donor for reanimation of elbow extension in such cases, and the branch to the long head of the triceps should be considered as a better target for the nerve transfer. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. sEMG feature evaluation for identification of elbow angle resolution in graded arm movement.

    Science.gov (United States)

    Castro, Maria Claudia F; Colombini, Esther L; Aquino, Plinio T; Arjunan, Sridhar P; Kumar, Dinesh K

    2014-11-25

    Automatic and accurate identification of elbow angle from surface electromyogram (sEMG) is essential for myoelectric controlled upper limb exoskeleton systems. This requires appropriate selection of sEMG features, and identifying the limitations of such a system.This study has demonstrated that it is possible to identify three discrete positions of the elbow; full extension, right angle, and mid-way point, with window size of only 200 milliseconds. It was seen that while most features were suitable for this purpose, Power Spectral Density Averages (PSD-Av) performed best. The system correctly classified the sEMG against the elbow angle for 100% cases when only two discrete positions (full extension and elbow at right angle) were considered, while correct classification was 89% when there were three discrete positions. However, sEMG was unable to accurately determine the elbow position when five discrete angles were considered. It was also observed that there was no difference for extension or flexion phases.

  10. A failure estimation method of steel pipe elbows under in-plane cyclic loading

    International Nuclear Information System (INIS)

    Jeon, Bub Gyu; Kim, Sung Wan; Choi, Hyoung Suk; Park, Dong Uk; Kim, Nam Sik

    2017-01-01

    The relative displacement of a piping system installed between isolated and nonisolated structures in a severe earthquake might be larger when without a seismic isolation system. As a result of the relative displacement, the seismic risks of some components in the building could increase. The possibility of an increase in seismic risks is especially high in the crossover piping system in the buildings. Previous studies found that an elbow which could be ruptured by low-cycle ratcheting fatigue is one of the weakest elements. Fatigue curves for elbows were suggested based on component tests. However, it is hard to find a quantitative evaluation of the ultimate state of piping elbows. Generally, the energy dissipation of a solid structure can be calculated from the relation between displacement and force. Therefore, in this study, the ultimate state of the pipe elbow, normally considered as failure of the pipe elbow, is defined as leakage under in-plane cyclic loading tests, and a failure estimation method is proposed using a damage index based on energy dissipation

  11. Production of Biodiesel Using Immobilized Lipase and the Characterization of Different Co-Immobilizing Agents and Immobilization Methods

    Directory of Open Access Journals (Sweden)

    Kang Zhao

    2016-08-01

    Full Text Available Lipase from Candida sp. 99–125 is widely employed to catalyzed transesterification and can be used for biodiesel production. In this study, the lipase was immobilized by combined adsorption and entrapment to catalyze biodiesel production from waste cooking oil (WCO via transesterification, and investigating co-immobilizing agents as additives according to the enzyme activity. The addition of the mixed co-immobilizing agents has positive effects on the activities of the immobilized lipase. Three different immobilizing methods were compared by the conversion ratio of biodiesel and structured by Atom Force Microscopy (AFM and Scanning Electron Microscopy (SEM, respectively. It was found that entrapment followed by adsorption was the best method. The effect of the co-immobilizing agent amount, lipase dosage, water content, and reuse ability of the immobilized lipase was investigated. By comparison with previous research, this immobilized lipase showed good reuse ability: the conversion ratio excesses 70% after 10 subsequent reactions, in particular, was better than Novozym435 and TLIM on waste cooking oil for one unit of lipase.

  12. Immobilization of lipases on alkyl silane modified magnetic nanoparticles: effect of alkyl chain length on enzyme activity.

    Directory of Open Access Journals (Sweden)

    Jiqian Wang

    Full Text Available BACKGROUND: Biocatalytic processes often require a full recycling of biocatalysts to optimize economic benefits and minimize waste disposal. Immobilization of biocatalysts onto particulate carriers has been widely explored as an option to meet these requirements. However, surface properties often affect the amount of biocatalysts immobilized, their bioactivity and stability, hampering their wide applications. The aim of this work is to explore how immobilization of lipases onto magnetite nanoparticles affects their biocatalytic performance under carefully controlled surface modification. METHODOLOGY/PRINCIPAL FINDINGS: Magnetite nanoparticles, prepared through a co-precipitation method, were coated with alkyl silanes of different alkyl chain lengths to modulate their surface hydrophobicity. Candida rugosa lipase was then directly immobilized onto the modified nanoparticles through hydrophobic interaction. Enzyme activity was assessed by catalytic hydrolysis of p-nitrophenyl acetate. The activity of immobilized lipases was found to increase with increasing chain length of the alkyl silane. Furthermore, the catalytic activities of lipases immobilized on trimethoxyl octadecyl silane (C18 modified Fe(3O(4 were a factor of 2 or more than the values reported from other surface immobilized systems. After 7 recycles, the activities of the lipases immobilized on C18 modified nanoparticles retained 65%, indicating significant enhancement of stability as well through hydrophobic interaction. Lipase immobilized magnetic nanoparticles facilitated easy separation and recycling with high activity retaining. CONCLUSIONS/SIGNIFICANCE: The activity of immobilized lipases increased with increasing alkyl chain length of the alkyl trimethoxy silanes used in the surface modification of magnetite nanoparticles. Lipase stability was also improved through hydrophobic interaction. Alkyl silane modified magnetite nanoparticles are thus highly attractive carriers for

  13. Immobilization of lipases on alkyl silane modified magnetic nanoparticles: effect of alkyl chain length on enzyme activity.

    Science.gov (United States)

    Wang, Jiqian; Meng, Gang; Tao, Kai; Feng, Min; Zhao, Xiubo; Li, Zhen; Xu, Hai; Xia, Daohong; Lu, Jian R

    2012-01-01

    Biocatalytic processes often require a full recycling of biocatalysts to optimize economic benefits and minimize waste disposal. Immobilization of biocatalysts onto particulate carriers has been widely explored as an option to meet these requirements. However, surface properties often affect the amount of biocatalysts immobilized, their bioactivity and stability, hampering their wide applications. The aim of this work is to explore how immobilization of lipases onto magnetite nanoparticles affects their biocatalytic performance under carefully controlled surface modification. Magnetite nanoparticles, prepared through a co-precipitation method, were coated with alkyl silanes of different alkyl chain lengths to modulate their surface hydrophobicity. Candida rugosa lipase was then directly immobilized onto the modified nanoparticles through hydrophobic interaction. Enzyme activity was assessed by catalytic hydrolysis of p-nitrophenyl acetate. The activity of immobilized lipases was found to increase with increasing chain length of the alkyl silane. Furthermore, the catalytic activities of lipases immobilized on trimethoxyl octadecyl silane (C18) modified Fe(3)O(4) were a factor of 2 or more than the values reported from other surface immobilized systems. After 7 recycles, the activities of the lipases immobilized on C18 modified nanoparticles retained 65%, indicating significant enhancement of stability as well through hydrophobic interaction. Lipase immobilized magnetic nanoparticles facilitated easy separation and recycling with high activity retaining. The activity of immobilized lipases increased with increasing alkyl chain length of the alkyl trimethoxy silanes used in the surface modification of magnetite nanoparticles. Lipase stability was also improved through hydrophobic interaction. Alkyl silane modified magnetite nanoparticles are thus highly attractive carriers for enzyme immobilization enabling efficient enzyme recovery and recycling.

  14. [Efficacies of arthroscopic debridement and olecranon fossa plasty in the treatment of osteoarthritis and posterior elbow impingement].

    Science.gov (United States)

    Liu, Yu-jie; Wang, Jun-liang; Li, Hai-feng; Qi, Wei; Wang, Ning

    2012-07-17

    To evaluate the efficacies of arthroscopic debridement and removal of osteophyma for olecroanon and olecranon fossa plasty for posterior impingement of elbow joint. Between 1999 and 2008, a total of 21 cases were diagnosed with osteoarthritis and posterior elbow impingement. There were 15 males and 6 females. And there were 16 right and 15 left cases. They included volleyball players (n = 7), tennis players (n = 7), golf enthusiasts (n = 4) and fencers (n = 3). The average duration of onset-operation was 3.5 years (range: 2.5 - 8). Arthroscopic exploration revealed synovial hyperplasia hypertrophy, cartilage degeneration and olecranon fossa hyperplasia with deformed olecranon fossa. Debridement and plasty were performed. Loose bodies were removed from elbow joint in 6 patients. Partial resection of posterior olecranon tip was performed and osteophytes or fibrous tissue removed in this area. Dynamic observation showed no posterior elbow impingement. Postoperative follow-up was conducted in 19 cases and 2 cases became lost to follow-up. The average follow-up period was 25.3 months (range: 18 - 42). All patients were evaluated preoperatively and postoperatively with the Hospital for Special Surgery Elbow Assessment Scale. The outcomes were excellent (n = 12), good (n = 7) and fair (n = 2). Postoperative patients elbow swelling and pain relieve, sports and life function returns to normal, elbow flexion and rotating mobility obviously improved. With the elbow radiological films to measure the range of motion, the average range of motion was 90.5° preoperatively and improved to 130° postoperatively. There was significant improvement in all cases. Posterior elbow impingement is caused by hyperextension trauma and elbow overuse during specific sporting activities. Arthroscopic debridement and olecroanon or olecranon fossa plasty demonstrates excellent results for posterior impingement of elbow joint.

  15. The effect of load-controlled bending load on the failure pressure of wall-thinned pipe elbows

    International Nuclear Information System (INIS)

    Kim, Jin Weon; Yoon, Min Soo; Park, Chi Yong

    2013-01-01

    Highlights: • We evaluated bending load effect on the failure pressure of wall-thinned pipe elbows. • Burst tests were conducted on real-scale elbow specimens with local wall thinning. • The tests were performed under combined pressure and load-controlled bending. • Load-controlled bending reduced the failure pressure of wall-thinned elbows. • Bending load effect was significant for opening-mode and intrados wall-thinning case. - Abstract: In this research, burst tests were conducted on real-scale elbow specimens, each with an artificial local wall-thinning defect, under combined internal pressure and constant in-plane bending load, as well as under simple internal pressure, to evaluate the effect of load-controlled bending load on the failure pressure of locally wall-thinned pipe elbows. Ninety-degree, 65A Schedule 80 elbows, with wall-thinning defects in the intrados and extrados, were used as specimens. The bending loads were in-plane opening- and closing-mode bending, applied in load-control mode. The results clearly indicated that a load-controlled in-plane bending load reduced the failure pressure of wall-thinned pipe elbows, in contrast to observations previously made under displacement-controlled bending conditions. The effect of the bending load was more significant for opening-mode than for closing-mode bending, regardless of the wall-thinning location in the elbow. Also, the effect was greater when the wall-thinning defect was located in the intrados region of the elbow, rather than the extrados region. Existing models that have been proposed to evaluate the failure of wall-thinned elbows under simple internal pressure conservatively predicted the failure pressure of elbows subjected to a combined internal pressure and load-controlled bending load

  16. Technetium Immobilization Forms Literature Survey

    Energy Technology Data Exchange (ETDEWEB)

    Westsik, Joseph H.; Cantrell, Kirk J.; Serne, R. Jeffrey; Qafoku, Nikolla

    2014-05-01

    Of the many radionuclides and contaminants in the tank wastes stored at the Hanford site, technetium-99 (99Tc) is one of the most challenging to effectively immobilize in a waste form for ultimate disposal. Within the Hanford Tank Waste Treatment and Immobilization Plant (WTP), the Tc will partition between both the high-level waste (HLW) and low-activity waste (LAW) fractions of the tank waste. The HLW fraction will be converted to a glass waste form in the HLW vitrification facility and the LAW fraction will be converted to another glass waste form in the LAW vitrification facility. In both vitrification facilities, the Tc is incorporated into the glass waste form but a significant fraction of the Tc volatilizes at the high glass-melting temperatures and is captured in the off-gas treatment systems at both facilities. The aqueous off-gas condensate solution containing the volatilized Tc is recycled and is added to the LAW glass melter feed. This recycle process is effective in increasing the loading of Tc in the LAW glass but it also disproportionally increases the sulfur and halides in the LAW melter feed which increases both the amount of LAW glass and either the duration of the LAW vitrification mission or the required supplemental LAW treatment capacity.

  17. Degradation of phenol and TCE using suspended and chitosan-bead immobilized Pseudomonas putida.

    Science.gov (United States)

    Chen, Yan-Min; Lin, Tsair-Fuh; Huang, Chih; Lin, Jui-Che; Hsieh, Feng-Ming

    2007-09-30

    The degradability of phenol and trichloroethene (TCE) by Pseudomonas putida BCRC 14349 in both suspended culture and immobilized culture systems are investigated. Chitosan beads at a size of about 1-2mm were employed to encapsulate the P. putida cells, becoming an immobilized culture system. The phenol concentration was controlled at 100 mg/L, and that of TCE was studied from 0.2 to 20 mg/L. The pH, between 6.7 and 10, did not affect the degradation of either phenol or TCE in the suspended culture system. However, it was found to be an important factor in the immobilized culture system in which the only significant degradation was observed at pH >8. This may be linked to the surface properties of the chitosan beads and its influence on the activity of the bacteria. The transfer yield of TCE on a phenol basis was almost the same for the suspended and immobilized cultures (0.032 mg TCE/mg phenol), except that these yields occurred at different TCE concentrations. The transfer yield at a higher TCE concentration for the immobilized system suggested that the cells immobilized in carriers can be protected from harsh environmental conditions. For kinetic rate interpretation, the Monod equation was employed to describe the degradation rates of phenol, while the Haldane's equation was used for TCE degradation. Based on the kinetic parameters obtained from the two equations, the rate for the immobilized culture systems was only about 1/6 to that of the suspended culture system for phenol degradation, and was about 1/2 for TCE degradation. The slower kinetics observed for the immobilized culture systems was probably due to the slow diffusion of substrate molecules into the beads. However, compared with the suspended cultures, the immobilized cultures may tolerate a higher TCE concentration as much less inhibition was observed and the transfer yield occurred at a higher TCE concentration.

  18. Immobilization of olfactory receptors onto gold electrodes for electrical biosensor

    Energy Technology Data Exchange (ETDEWEB)

    Casuso, Ignacio [Departament d' Electronica, Universitat de Barcelona, Laboratori de Nanobioenginyeria-IBEC, Parc Cientific de Barcelona, C/Josep Samitier 1-5, Barcelona (Spain)], E-mail: icasuso@pcb.ub.es; Pla-Roca, Mateu [Departament d' Electronica, Universitat de Barcelona, Laboratori de Nanobioenginyeria-IBEC, Parc Cientific de Barcelona, C/Josep Samitier 1-5, Barcelona (Spain); Gomila, Gabriel [Departament d' Electronica, Universitat de Barcelona, Laboratori de Nanobioenginyeria-IBEC, Parc Cientific de Barcelona, C/Josep Samitier 1-5, Barcelona (Spain)], E-mail: ggomila@pcb.ub.es; Samitier, Josep [Departament d' Electronica, Universitat de Barcelona, Laboratori de Nanobioenginyeria-IBEC, Parc Cientific de Barcelona, C/Josep Samitier 1-5, Barcelona (Spain); Minic, Jasmina; Persuy, Marie A.; Salesse, Roland; Pajot-Augy, Edith [INRA, Neurobiologie de l' Olfaction et de la Prise Alimentaire, Equipe Recepteurs et Communication Chimique, Domaine de Vilvert, Jouy en Josas Cedex (France)

    2008-07-01

    We investigate the immobilization of native nanovesicles containing functional olfactory receptors onto gold electrodes by means of atomic force microscopy in liquid. We show that nanovesicles can be adsorbed without disrupting them presenting sizes once immobilized ranging from 50 nm to 200 nm in diameter. The size of the nanovesicles shows no dependence on the electrode hydrophobicity being constant in a height/width ratio close to 1:3. Nevertheless, electrode hydrophobicity does affect the surface coverage, the surface coverage is five times higher in hydrophilic electrodes than on hydrophobic ones. Surface coverage is also affected by nanovesicles dimensions in suspension, the size homogenization to around 50 nm yields a further five fold increment in surface coverage achieving a coverage of about 50% close to the hard spheres jamming limit (54.7%). A single layer of nanovesicles is always formed with no particle overlap. Present results provide insights into the immobilization on electrodes of olfactory receptors for further olfactory electrical biosensor development.

  19. Locking the Elbow: Improved Antibody Fab Fragments as Chaperones for Structure Determination.

    Science.gov (United States)

    Bailey, Lucas J; Sheehy, Kimberly M; Dominik, Pawel K; Liang, Wenguang G; Rui, Huan; Clark, Michael; Jaskolowski, Mateusz; Kim, Yejoon; Deneka, Dawid; Tang, Wei-Jen; Kossiakoff, Anthony A

    2018-02-02

    Antibody Fab fragments have been exploited with significant success to facilitate the structure determination of challenging macromolecules as crystallization chaperones and as molecular fiducial marks for single particle cryo-electron microscopy approaches. However, the inherent flexibility of the "elbow" regions, which link the constant and variable domains of the Fab, can introduce disorder and thus diminish their effectiveness. We have developed a phage display engineering strategy to generate synthetic Fab variants that significantly reduces elbow flexibility, while maintaining their high affinity and stability. This strategy was validated using previously recalcitrant Fab-antigen complexes where introduction of an engineered elbow region enhanced crystallization and diffraction resolution. Furthermore, incorporation of the mutations appears to be generally portable to other synthetic antibodies and may serve as a universal strategy to enhance the success rates of Fabs as structure determination chaperones. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Determination of optimal tool parameters for hot mandrel bending of pipe elbows

    Science.gov (United States)

    Tabakajew, Dmitri; Homberg, Werner

    2018-05-01

    Seamless pipe elbows are important components in mechanical, plant and apparatus engineering. Typically, they are produced by the so-called `Hamburg process'. In this hot forming process, the initial pipes are subsequently pushed over an ox-horn-shaped bending mandrel. The geometric shape of the mandrel influences the diameter, bending radius and wall thickness distribution of the pipe elbow. This paper presents the numerical simulation model of the hot mandrel bending process created to ensure that the optimum mandrel geometry can be determined at an early stage. A fundamental analysis was conducted to determine the influence of significant parameters on the pipe elbow quality. The chosen methods and approach as well as the corresponding results are described in this paper.

  1. The role of physical examinations in studies of musculoskeletal disorders of the elbow

    DEFF Research Database (Denmark)

    Kryger, Ann Isabel; Lassen, C. F.; Andersen, JH

    2007-01-01

    OBJECTIVES: To present data on pain and physical findings from the elbow region, and to discuss the role of diagnostic criteria in epidemiological studies of epicondylitis. METHODS: From a cohort of computer workers a subgroup of 1369 participants, who reported at least moderate pain in the neck...... completed on the day of examination. RESULTS: 349 participants met the authors' criteria for being an arm case and 249 were elbow cases. Among the 1369 participants the prevalence of at least mild palpation tenderness and indirect tenderness at the lateral epicondyle was 5.8%. The occurrence of physical...... findings increased markedly by level of pain score. Only about one half with physical findings fulfilled the authors' pain criteria for having lateral epicondylitis. A large part with physical findings reported no pain at all in the elbow in any of the two questionnaires, 28% and 22%, respectively. Inter...

  2. Elbow joint laxity after experimental radial head excision and lateral collateral ligament rupture

    DEFF Research Database (Denmark)

    Jensen, Steen Lund; Olsen, Bo Sanderhoff; Tyrdal, Stein

    2005-01-01

    The objectives of this experimental study were to investigate the effect of radial head excision and lateral collateral ligament (LCL) division on elbow joint laxity and to determine the efficacy of radial head prosthetic replacement and LCL repair. Valgus, varus, internal rotation, and external...... rotation of the ulna were measured during passive flexion-extension and application of a 0.75-Nm torque in 6 intact cadaveric elbows and after (1) either excision of the radial head or division of the LCL, (2) removal of both constraints, (3) isolated radial head prosthetic replacement, (4) isolated LCL...... normalized varus laxity but resulted in a 2.9 degrees increase in external rotatory laxity. The combined procedures restored laxity completely. The radial head is a constraint to varus and external rotation in the elbow joint, functioning by maintaining tension in the LCL. Still, removal of both constraints...

  3. Kinematics of partial and total ruptures of the medial collateral ligament of the elbow

    DEFF Research Database (Denmark)

    Eygendaal, D; Olsen, Bo Sanderhoff; Jensen, Steen Lund

    2000-01-01

    In this study the kinematics of partial and total ruptures of the medial collateral ligament of the elbow are investigated. After selective transection of the medial collateral ligament of 8 osteoligamentous intact elbow preparations was performed, 3-dimensional measurements of angular displacement......, increase in medial joint opening, and translation of the radial head were examined during application of relevant stress. Increase in joint opening was significant only after complete transection of the anterior part of the medial collateral ligament was performed. The joint opening was detected during...... valgus and internal rotatory stress only. After partial transection of the anterior bundle of the medial collateral ligament was performed, there was an elbow laxity to valgus and internal rotatory force, which became significant after transection of 100% of the anterior bundle of the medial collateral...

  4. Development and evaluation of a musculoskeletal model of the elbow joint complex

    Science.gov (United States)

    Gonzalez, Roger V.; Hutchins, E. L.; Barr, Ronald E.; Abraham, Lawrence D.

    1993-01-01

    This paper describes the development and evaluation of a musculoskeletal model that represents human elbow flexion-extension and forearm pronation-supination. The length, velocity, and moment arm for each of the eight musculotendon actuators were based on skeletal anatomy and position. Musculotendon parameters were determined for each actuator and verified by comparing analytical torque-angle curves with experimental joint torque data. The parameters and skeletal geometry were also utilized in the musculoskeletal model for the analysis of ballistic elbow joint complex movements. The key objective was to develop a computational model, guided by parameterized optimal control, to investigate the relationship among patterns of muscle excitation, individual muscle forces, and movement kinematics. The model was verified using experimental kinematic, torque, and electromyographic data from volunteer subjects performing ballistic elbow joint complex movements.

  5. MR imaging of the most commonly injured and diseased structures of the elbow and ankle

    International Nuclear Information System (INIS)

    Mesgarzadeh, M.; Schneck, C.; Ross, G.; Bonakdarpour, A.

    1987-01-01

    Seventeen elbows and 23 ankles of cadavers, normal volunteers, and patients with various disorders were examined by MR imaging. The cadaver specimens were sectioned for direct image correlation. The exhibit illustrates (1) the ability of MR imaging to identify all of the commonly injured or diseased structures about the elbow and ankle, (2) the optimum imaging plane and positioning for each structure, (3) the value of T1- and T2-weighted images in identifying and specifically localizing the disruption, edema, hemorrhage, or effusion that occurs in pathologic processes such as ankle ligament injury and tendinitis at the elbow, and (4) the ability of serial axial sections to follow the ulnar, median, radial, and tibial nerves and their associated vessels through their common entrapment sites

  6. INVESTIGATING THE EFFECT OF SLURRY SEAWATER FLOW IN CARBON-STEEL ELBOWS

    Directory of Open Access Journals (Sweden)

    Mohamed Shehadeh

    2013-12-01

    Full Text Available Understanding the failure mechanism due to erosion helps in introducing predictive means for parts that are vulnerable to erosion–corrosion effects, such as elbows. This paper is concerned with studying the behavior of steel elbows working in erosive environments. Rates of iron losses due to both flow rate variations and sand concentration variations were investigated. In order to avoid interference from other parts of the system, a PVC test rig, fitted with only one steel elbow at a time, was constructed. The flow rate was controlled to cover both the laminar and turbulent flow regimes. The sand concentration varied from nil up to 9 grams per liter. A spectrophotometer was utilized to measure the quantity of iron losses. Results showed that the critical sand concentration for the erosion mechanism is 3 g/l. Also an empirical formula was developed for estimating the erosion-corrosion rate in laminar and turbulent flow regimes with different sand contamination levels.

  7. Studies on the preparation of immobilized enzymes by radio-polymerization, 10

    International Nuclear Information System (INIS)

    Amarakone, S.P.; Hayashi, Toru; Kawashima, Koji.

    1983-01-01

    β-Galactosidase of E. coli origin was immobilized in the form of beads by the radiopolymerization of different combinations of monomers using a gamma irradiation technique. With the dialysed enzyme, recoveries of over 300 % could be obtained on suitable monomer combinations containing magnesium and sodium acrylates. The recovery of the enzyme also depended on the irradiation time. The immobilized enzyme had better pH and temperature stability and was less affected by the presence of metal ions in the medium, compared to the native enzyme. The optimum pH and temperatures of the immobilized enzyme were different from those of the native enzyme and were 7.0 to 7.5 and 50 deg C respectively. The immobilized enzyme was used in a column for the continuous determination of lactose with a standard type autoanalyser. Good linearity could be observed even up to 3 % lactose in the sample. (author)

  8. High Efficiency Acetylcholinesterase Immobilization on DNA Aptamer Modified Surfaces

    Directory of Open Access Journals (Sweden)

    Orada Chumphukam

    2014-04-01

    Full Text Available We report here the in vitro selection of DNA aptamers for electric eel acetylcholinesterase (AChE. One selected aptamer sequence (R15/19 has a high affinity towards the enzyme (Kd = 157 ± 42 pM. Characterization of the aptamer showed its binding is not affected by low ionic strength (~20 mM, however significant reduction in affinity occurred at high ionic strength (~1.2 M. In addition, this aptamer does not inhibit the catalytic activity of AChE that we exploit through immobilization of the DNA on a streptavidin-coated surface. Subsequent immobilization of AChE by the aptamer results in a 4-fold higher catalytic activity when compared to adsorption directly on to plastic.

  9. Optimization of Adsorptive Immobilization of Alcohol Dehydrogenases

    NARCIS (Netherlands)

    Trivedi, Archana; Heinemann, Matthias; Spiess, Antje C.; Daussmann, Thomas; Büchs, Jochen

    2005-01-01

    In this work, a systematic examination of various parameters of adsorptive immobilization of alcohol dehydrogenases (ADHs) on solid support is performed and the impact of these parameters on immobilization efficiency is studied. Depending on the source of the enzymes, these parameters differently

  10. Plutonium Immobilization Can Loading Equipment Review

    International Nuclear Information System (INIS)

    Kriikku, E.; Ward, C.; Stokes, M.; Randall, B.; Steed, J.; Jones, R.; Hamilton, L.

    1998-05-01

    This report lists the operations required to complete the Can Loading steps on the Pu Immobilization Plant Flow Sheets and evaluates the equipment options to complete each operation. This report recommends the most appropriate equipment to support Plutonium Immobilization Can Loading operations

  11. Strong and Reversible Monovalent Supramolecular Protein Immobilization

    NARCIS (Netherlands)

    Young, Jacqui F.; Nguyen, Hoang D.; Yang, Lanti; Huskens, Jurriaan; Jonkheijm, Pascal; Brunsveld, Luc

    2010-01-01

    Proteins with an iron clasp: Site-selective incorporation of a ferrocene molecule into a protein allows for easy, strong, and reversible supramolecular protein immobilization through a selective monovalent interaction of the ferrocene with a cucurbit[7]uril immobilized on a gold surface. The

  12. Drug immobilization of walrus (Odobenus rosmarus)

    Science.gov (United States)

    DeMaster, D.P.; Faro, J.B.; Estes, J.A.; Taggart, James; Zabel, C.

    1981-01-01

    Five out of nine walrus (Odobenus rosmarus) were successfully immobilized at Round Island, Alaska, in May of 1978 by combinations of phencyclidine hydrochloride and acepromazine hydrochloride. A crossbow was an effective delivery technique. Walruses that had recently hauled out were more suitable for immobilization than well-rested animals. Care was taken to prevent walruses from overheating or suffocating.

  13. The first 100 elbow arthroscopies of one surgeon: analysis of complications.

    Science.gov (United States)

    Marti, Darius; Spross, Christian; Jost, Bernhard

    2013-04-01

    Elbow arthroscopy is technically challenging and prone to complications especially due to the close relation of nerves and vessels. Complication rates up to 20% are reported, depending on indication and how complications are defined. This study analyzes the complications of the first 100 elbow arthroscopies done by 1 fellowship- and cadaver-trained surgeon. From September 2004 to April 2009, 100 consecutive elbow arthroscopies were performed, and thus consequently standardized, by 1 surgeon in 1 institution. The clinical data of all patients were retrospectively analyzed for indication-specific complications. Complications were divided into minor (transient) and major (persistent or infection). Included were 65 male and 35 female patients (mean age, 41 years; range, 12-70 years) with a minimum follow-up of 12 months (clinical or telephone). The following indications were documented (several per patient were possible): osteoarthritis in 29, stiffness in 27, loose bodies in 27, tennis elbow in 24, traumatic sequelae in 19, and others in 24. No major complications occurred, but 6 minor complications occurred in 5 patients (5%), comprising 2 hematoma, 2 transient nerve lesions, 1 wound-healing problem, and 1 complex regional pain syndrome. No revision surgery was necessary. Complications were not significantly associated with the indication for operation or the surgeon's learning curve. This study shows an acceptable complication rate of the first 100 elbow arthroscopies from a single surgeon. A profound clinical education, including cadaver training as well as standardization of patient position, portals, and surgery, help to achieve this. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  14. The Boyd–McLeod procedure for tennis elbow: mid- to long-term results

    Science.gov (United States)

    Jeavons, Richard; Richards, Ian; Bayliss, Neil

    2014-01-01

    Background Tennis elbow is a common condition that usually responds to conservative measures. In refractory cases, surgical intervention is indicated. A plethora of surgical techniques have been described. We report the mid- to long-term outcomes of the Boyd–McLeod procedure for refractory tennis elbow. Methods A retrospective analysis and current review of patients that had undergone the Boyd–McLeod procedure over a 12-year period was undertaken. Demographics, time to discharge, length of follow-up and outcome scores were collected. Results Seventy patients underwent surgery. Mean time to discharge was 15.35 weeks, with 88% successful outcomes. Fifty-four patients were available for current follow-up at mean of 5.52 years (range 1.17 years to 11.49 years). Range of motion in all patients was unchanged. There were no revision procedures. Mean (SD) Mayo Elbow Performance Score was 90.85 (13.11), with 75.5% returning a good or excellent score and 24.5% a fair outcome. The mean (SD) Oxford Elbow Score was 44.04 (6.92); mean (SD) pain score was 89.5 (17.58); mean (SD) function score was 95.34 (9.59) and mean (SD) socio-psychological score was 91.50 (17.01). Overall, 83% of patients had an Oxford Elbow Score of 43 or greater, suggesting excellent outcome. Conclusions We show that the Boyd–McLeod procedure is an excellent option over both the short- and long-term for refractory tennis elbow. PMID:27582946

  15. Postoperative Single-Fraction Radiation for Prevention of Heterotopic Ossification of the Elbow

    International Nuclear Information System (INIS)

    Robinson, Clifford G.; Polster, Joshua M.; Reddy, Chandana A.; Lyons, Janice A.; Evans, Peter J.; Lawton, Jeffrey N.; Graham, Thomas J.; Suh, John H.

    2010-01-01

    Purpose: Heterotopic ossification (HO) about the elbow has been described after surgery, trauma, and burns. Even limited deposits can lead to significant functional deficits. Little data exist regarding outcomes of patients treated with radiation therapy (RT) after elbow surgery. We report here the Cleveland Clinic experience with single-fraction radiation following surgery to the elbow. The primary endpoint was the rate of new HO after RT. Secondary endpoints were range of motion, functional compromise, and toxicity. Methods and Materials: From May 1993 to July 2006, 36 patients underwent elbow surgery followed by single-fraction RT. Range of motion data were collected before and during surgery and at last follow-up. Radiographs were reviewed for persistent or new HO. Patient and treatment factors were analyzed for correlation with development of HO or functional compromise. Results: Median follow-up was 8.7 months, median age was 42 years, and 75% of patients were male. Twenty-six (72%) patients had HO prior to surgery. All patients had significant limitations in flexion/extension or pronation/supination at baseline. Thirty-one (86%) patients had prior elbow trauma, and 26 (72%) patients had prior surgery. RT was administered a median of 1 day postoperatively (range, 1-4 days). Thirty-four patients received 700 cGy, and 2 patients received 600 cGy. Three (8%) patients developed new HO after RT. All patients had improvement in range of motion from baseline. No patient or treatment factors were significantly associated with the development of HO or functional compromise. Conclusions: Single-fraction RT after surgery to the elbow is associated with favorable functional and radiographic outcomes.

  16. Clinical rating systems in elbow research-a systematic review exploring trends and distributions of use.

    Science.gov (United States)

    Evans, Jonathan P; Smith, Chris D; Fine, Nicola F; Porter, Ian; Gangannagaripalli, Jaheeda; Goodwin, Victoria A; Valderas, Jose M

    2018-04-01

    Clinical rating systems are used as outcome measures in clinical trials and attempt to gauge the patient's view of his or her own health. The choice of clinical rating system should be supported by its performance against established quality standards. A search strategy was developed to identify all studies that reported the use of clinical rating systems in the elbow literature. The strategy was run from inception in Medline Embase and CINHAL. Data extraction identified the date of publication, country of data collection, pathology assessed, and the outcome measure used. We identified 980 studies that reported clinical rating system use. Seventy-two separate rating systems were identified. Forty-one percent of studies used ≥2 separate measures. Overall, 54% of studies used the Mayo Elbow Performance Score (MEPS). For arthroplasty, 82% used MEPS, 17% used Disabilities of Arm, Shoulder and Hand (DASH), and 7% used QuickDASH. For trauma, 66.7% used MEPS, 32% used DASH, and 23% used the Morrey Score. For tendinopathy, 31% used DASH, 23% used Patient-Rated Tennis Elbow Evaluation (PRTEE), and 13% used MEPS. Over time, there was an increased proportional use of the MEPS, DASH, QuickDASH, PRTEE, and the Oxford Elbow Score. This study identified a wide choice and usage of clinical rating systems in the elbow literature. Numerous studies reported measures without a history of either a specific pathology or cross-cultural validation. Interpretability and comparison of outcomes is dependent on the unification of outcome measure choice. This was not demonstrated currently. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  17. Sensitivity Analysis on Elbow Piping Components in Seismically Isolated NPP under Seismic Loading

    Energy Technology Data Exchange (ETDEWEB)

    Ju, Hee Kun; Hahm, Dae Gi; Kim, Min Kyu [KAERI, Daejeon (Korea, Republic of); Jeon, Bub Gyu; Kim, Nam Sik [Pusan National University, Busan (Korea, Republic of)

    2016-05-15

    In this study, the FE model is verified using specimen test results and simulation with parameter variations are conducted. Effective parameters will randomly sampled and used as input values for simulations to be applied to the fragility analysis. pipelines are representative of them because they could undergo larger displacements when they are supported on both isolated and non-isolated structures simultaneously. Especially elbows are critical components of pipes under severed loading conditions such as earthquake action because strain is accumulated on them during the repeated bending of the pipe. Therefore, seismic performance of pipe elbow components should be examined thoroughly based on the fragility analysis. Fragility assessment of interface pipe should take different sources of uncertainty into account. However, selection of important sources and repeated tests with many random input values are very time consuming and expensive, so numerical analysis is commonly used. In the present study, finite element (FE) model of elbow component will be validated using the dynamic test results of elbow components. Using the verified model, sensitivity analysis will be implemented as a preliminary process of seismic fragility of piping system. Several important input parameters are selected and how the uncertainty of them are apportioned to the uncertainty of the elbow response is to be studied. Piping elbows are critical components under cyclic loading conditions as they are subjected large displacement. In a seismically isolated NPP, seismic capacity of piping system should be evaluated with caution. Seismic fragility assessment preliminarily needs parameter sensitivity analysis about the output of interest with different input parameter values.

  18. Risk factors for decreased range of motion and poor outcomes in open periarticular elbow fractures.

    Science.gov (United States)

    Dickens, Jonathan F; Wilson, Kevin W; Tintle, Scott M; Heckert, Reed; Gordon, Wade T; D'Alleyrand, Jean-Claude G; Potter, Benjamin K

    2015-04-01

    The purpose of this study was to identify risk factors present at the time of injury that predict poor functional outcomes and heterotopic ossification (HO) in open periarticular elbow fractures. We performed a retrospective review of 136 combat-related open elbow fractures from 2003 to 2010. Patient demographics, injury characteristics, treatment variables, and complications were recorded. Functional outcomes were analyzed to determine range of motion (ROM) and Mayo Elbow Performance Score (MEPS). Secondary outcome measures included the development of HO, return to duty, and revision operation. At a median 2.7 years from injury the median MEPS was 67.8 (range 30-100) with an average ulnohumeral arc motion of 89°. Bipolar fractures, with periarticular fractures on both sides of the elbow and at least one side containing intra-articular extension, were independently associated with decreased ulnohumeral motion (p=0.02) and decreased MEPS (pROM included more severe osseous comminution (p=0.001), and increased time to definitive fixation (p=0.03) and HO (p=0.02). More severe soft tissue injury (Gustilo and Anderson fracture type, p=0.02), peripheral nerve injury (p=0.04), and HO (p=0.03) were independently associated with decreased MEPS. HO developed in 65% (89/136) of extremities and was associated with more severe Orthopaedic Trauma Association (OTA) fracture type (p=0.01) and escalating Gustilo and Anderson fracture classification (p=0.049). In the largest series of open elbow fractures, we identified risk factors that portend a poor clinical outcome and decreased ROM. Bipolar elbow fractures, which have not previously been associated with worse results, are particularly prone to decreased ROM and worse outcomes. Prognostic level IV. Published by Elsevier Ltd.

  19. Long-term results after Ilizarov treatment for severe high-energy injuries of the elbow.

    Science.gov (United States)

    Fodor, Lucian; Ullmann, Yehuda; Soudry, Michael; Lerner, Alexander

    2009-06-01

    Clinical aspects, such as the long-term results after circular external fixation and functional rehabilitation after high-energy injuries of the elbow joint, have not received sufficient attention in the literature. Fourteen patients with high-energy elbow injuries were treated in our hospital over the last 15 years with a circular external fixation frame. The mechanism of injury was blast in eight patients, gunshot wounds in two, motor vehicle crash in two, and fall from height in two. Twelve patients had high-energy open periarticular fractures, nine had Gustillo-Anderson 3B fractures, and three had Gustillo-Anderson 3C fractures. Two patients suffered from closed high-energy periarticular elbow injuries. Seven patients had associated peripheral neurologic injuries and three had vascular injuries. Average Ilizarov fixation time was 20 weeks (range, 6-47 weeks). The follow-up period varied from 1.5 years to 11 years. The average arc of elbow flexion was 110.4 degrees and extension was 19.6 degrees. The average arc of forearm rotation was of 63.5 degrees for pronation (range, 5-90 degrees) and 63.2 degrees for supination (range, 5-90 degrees). The average Mayo Elbow Performance Index score was 84 points (range, 60-100) and the average Khalfayan functional score was 83.4 (range, 68.7-100). Long-term follow-up proved that the hinged Ilizarov/hybrid frame represents a useful instrument to provide stabilization of the elbow joint while facilitating early movements and physiotherapy. The main indication is patients who suffered from open high-energy contaminated fractures with extensive soft-tissue damage (e.g., blast, war injuries) and combined bone and ligaments injuries.

  20. What Factors are Associated With a Surgical Site Infection After Operative Treatment of an Elbow Fracture?

    Science.gov (United States)

    Claessen, Femke M A P; Braun, Yvonne; van Leeuwen, Wouter F; Dyer, George S; van den Bekerom, Michel P J; Ring, David

    2016-02-01

    Surgical site infections are one of the more common major complications of elbow fracture surgery and can contribute to other adverse outcomes, prolonged hospital stays, and increased healthcare costs. We asked: (1) What are the factors associated with a surgical site infection after elbow fracture surgery? (2) When taking the subset of closed elbow fractures only, what are the factors associated with a surgical site infection? (3) What are the common organisms isolated from an elbow infection after open treatment? One thousand three hundred twenty adult patients underwent surgery for an elbow fracture between January 2002 and July 2014 and were included in our study. Forty-eight of 1320 patients (4%) had a surgical site infection develop. Thirty-four of 1113 patients with a closed fracture (3%) had a surgical site infection develop. For all elbow fractures, use of plate and screw fixation (adjusted odds ratio [OR]= 2.2; 95% CI, 1.0-4.5; p = 0.041) and use of external fixation before surgery (adjusted OR = 4.7; 95% CI, 1.1-21; p = 0.035) were associated with higher infection rates. When subset analysis was performed for closed fractures, only smoking (adjusted OR = 2.2; 95% CI, 1.1-4.5; p = 0.023) was associated with higher infection rates. Staphylococcus aureus was the most common bacteria cultured (59%). The only modifiable risk factor for a surgical site infection after open reduction and internal fixation was cigarette smoking. Plate fixation and temporary external fixation are likely surrogates for more complex injuries, therefore no recommendations should be inferred from this association. Surgeons should counsel patients who smoke. Level IV, prognostic study.

  1. The Posterior Bundle's Effect on Posteromedial Elbow Instability After a Transverse Coronoid Fracture: A Biomechanical Study.

    Science.gov (United States)

    Shukla, Dave R; Golan, Elan; Weiser, Mitch C; Nasser, Philip; Choueka, Jack; Hausman, Michael

    2018-04-01

    There has been increased interest in the role of the posterior bundle of the medial collateral ligament (pMUCL) in the elbow, particularly its effects on posteromedial rotatory stability. The ligament's effect in the context of an unfixable coronoid fracture has not been the focus of any study. The purposes of this biomechanical study were to evaluate the stabilizing effect of the pMUCL with a transverse coronoid fracture and to assess the effect of graft reconstruction of the ligament. We simulated a varus and internal rotatory subluxation in 7 cadaveric elbows at 30°, 60°, and 90° elbow flexion. The amount of ulnar rotation and medial ulnohumeral joint gapping were assessed in the intact elbow after we created a transverse coronoid injury, after we divided the pMUCL, and finally, after we performed a graft reconstruction of the pMUCL. At all angles tested, some stability was lost after cutting the pMUCL once the coronoid had been injured, because mean proximal ulnohumeral joint gapping increased afterward by 2.1, 2.2, and 1.3 mm at 90°, 60°, and 30°, respectively. Ulnar internal rotation significantly increased after pMUCL transection at 90°. At 60° and 30° elbow flexion, ulnar rotation increased after resection of the coronoid but not after pMUCL resection. An uninjured pMUCL stabilizes against varus internal rotatory instability in the setting of a transverse coronoid fracture at higher flexion angles. Further research is needed to optimize graft reconstruction of the pMUCL. The pMUCL is an important secondary stabilizer against posteromedial instability in the coronoid-deficient elbow. In the setting of an unfixable coronoid fracture, the surgeon should examine for posteromedial instability and consider addressing the pMUCL surgically. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  2. Immobilized fluid membranes for gas separation

    Science.gov (United States)

    Liu, Wei; Canfield, Nathan L; Zhang, Jian; Li, Xiaohong Shari; Zhang, Jiguang

    2014-03-18

    Provided herein are immobilized liquid membranes for gas separation, methods of preparing such membranes and uses thereof. In one example, the immobilized membrane includes a porous metallic host matrix and an immobilized liquid fluid (such as a silicone oil) that is immobilized within one or more pores included within the porous metallic host matrix. The immobilized liquid membrane is capable of selective permeation of one type of molecule (such as oxygen) over another type of molecule (such as water). In some examples, the selective membrane is incorporated into a device to supply oxygen from ambient air to the device for electrochemical reactions, and at the same time, to block water penetration and electrolyte loss from the device.

  3. Long-term clinical results in patients treated for recurrent posterolateral elbow joint instability using an ipsilateral triceps tendon graft

    DEFF Research Database (Denmark)

    Kastenskov, Christian; Rasmussen, Jeppe Vejlgaard; Ovesen, Janne

    2017-01-01

    version of Oxford Elbow Score. Furthermore, conventional anteroposterior and side-view radiographs of the elbow were obtained to evaluate osteoarthritis, calcifications in the ligaments, and joint subluxation. We evaluated the radiographs by the size of osteophytes, joint space narrowing, and subchondral...

  4. Work-related risk factors for lateral epicondylitis and other cause of elbow pain in the working population.

    Science.gov (United States)

    Herquelot, Eleonore; Bodin, Julie; Roquelaure, Yves; Ha, Catherine; Leclerc, Annette; Goldberg, Marcel; Zins, Marie; Descatha, Alexis

    2013-04-01

    This study was designed to assess the relationship between work-related combined physical and psychosocial factors and elbow disorders (lateral epicondylitis and non-specific disorders without lateral epicondylitis) in the working population. A total of 3,710 workers (58% men) in a French region in 2002-2005 participated in physical examinations by occupational health physicians and assessed their personal factors and work exposure by self-administered questionnaire. Statistical associations between elbow disorders and risks factors were analyzed using multinomial logistic regression. A total of 389 (10.5%) workers had elbow pain without lateral epicondylitis and 90 (2.4%) workers had lateral epicondylitis. Age, body mass index (>25), and low social support (only for men) were significant risks factors. Hard perceived physical exertion combined with elbow flexion/extension (>2 hr/day) and wrist bending (>2 hr/day) was a strong significant risk factor for elbow pain and epicondylitis: among men, adjusted Odds Ratio (ORa) = 2.6 (1.9-3.7) and ORa = 5.6 (2.8-11.3), respectively; among women, ORa = 1.4 (0.9-2.2) and ORa = 2.9 (1.3-6.5). This study emphasizes the strength of the associations between combined physical exertion and elbow movements and lateral epicondylitis. Certain observed differences in associations with lateral epicondylitis and elbow pain only indicate the need for additional longitudinal studies on different stages of elbow disorders and known risk factors. Copyright © 2012 Wiley Periodicals, Inc.

  5. Imaging of the elbow in children with wrist fracture: an unnecessary source of radiation and use of resources?

    International Nuclear Information System (INIS)

    Golding, Lauren P.; Yasin, Yousef; Singh, Jasmeet; Anthony, Evelyn; Gyr, Bettina M.; Gardner, Alison

    2015-01-01

    Anecdotally accepted practice for evaluation of children with clinically suspected or radiographically proven wrist fracture in many urgent care and primary care settings is concurrent imaging of the forearm and elbow, despite the lack of evidence to support additional images. These additional radiographs may be an unnecessary source of radiation and use of health care resources. Our study assesses the necessity of additional radiographs of the forearm and elbow in children with wrist injury. We reviewed electronic medical records of children 17 and younger in whom wrist fracture was diagnosed in the emergency department. We identified the frequency with which additional radiographs of the proximal forearm and distal humerus demonstrated another site of acute injury. We identified 214 children with wrist fracture. Of those, 129 received additional radiographs of the elbow. Physical examination findings proximal to the wrist were documented in only 16 (12%) of these 129 children. A second injury proximal to the wrist fracture was present in 4 (3%) of these 129 children, all of whom exhibited physical examination findings at the elbow. No fractures were documented in children with a negative physical examination of the elbow. Although elbow fractures occasionally complicate distal forearm fractures in children, our findings indicate that a careful physical evaluation of the elbow is sufficient to guide further radiographic investigation. Routine radiographs of both the wrist and elbow in children with distal forearm fracture appear to be unnecessary when an appropriate physical examination is performed. (orig.)

  6. The effect of a forearm/hand splint compared with an elbow band as a treatment for lateral epicondylitis

    NARCIS (Netherlands)

    van de Streek, M.D.; van der Schans, C.P.; de Greef, M.H.G.; Postema, K.

    2004-01-01

    The aim of the present study was to compare the effect of a new prefabricated Thamert forearm/hand splint with the effect of a simple elbow band as a treatment for lateral epicondylitis. Forty-three (43) patients that met the inclusion criteria were randomly assigned to the elbow band group and the

  7. Phenotypic and genetic evaluation of elbow dysplasia in Dutch Labrador Retrievers, Golden Retrievers, and Bernese Mountain Dogs

    NARCIS (Netherlands)

    Lavrijsen, I.C.M.; Heuven, H.C.M.; Voorhout, G.; Meij, B.P.; Theyse, L.F.H.; Leegwater, P.A.J.; Hazewinkel, H.A.W.

    2012-01-01

    Canine elbow dysplasia encompasses four developmental diseases: ununited anconeal process, osteochondrosis of the medial part of the humeral condyle, fragmented medial coronoid process (FCP), and incongruity of the elbow joint. Four radiographic views per joint were used to evaluate 2693 Labrador

  8. Imaging of the elbow in children with wrist fracture: an unnecessary source of radiation and use of resources?

    Energy Technology Data Exchange (ETDEWEB)

    Golding, Lauren P. [Wake Forest University Baptist Health, Department of Radiology, Winston-Salem, NC (United States); Triad Radiology Associates, Winston-Salem, NC (United States); Yasin, Yousef; Singh, Jasmeet; Anthony, Evelyn [Wake Forest University Baptist Health, Department of Radiology, Winston-Salem, NC (United States); Gyr, Bettina M. [Wake Forest University Baptist Health, Department of Orthopedic Surgery, Winston-Salem, NC (United States); Gardner, Alison [Wake Forest University Baptist Health, Department of Pediatric Emergency Medicine, Winston-Salem, NC (United States)

    2015-08-15

    Anecdotally accepted practice for evaluation of children with clinically suspected or radiographically proven wrist fracture in many urgent care and primary care settings is concurrent imaging of the forearm and elbow, despite the lack of evidence to support additional images. These additional radiographs may be an unnecessary source of radiation and use of health care resources. Our study assesses the necessity of additional radiographs of the forearm and elbow in children with wrist injury. We reviewed electronic medical records of children 17 and younger in whom wrist fracture was diagnosed in the emergency department. We identified the frequency with which additional radiographs of the proximal forearm and distal humerus demonstrated another site of acute injury. We identified 214 children with wrist fracture. Of those, 129 received additional radiographs of the elbow. Physical examination findings proximal to the wrist were documented in only 16 (12%) of these 129 children. A second injury proximal to the wrist fracture was present in 4 (3%) of these 129 children, all of whom exhibited physical examination findings at the elbow. No fractures were documented in children with a negative physical examination of the elbow. Although elbow fractures occasionally complicate distal forearm fractures in children, our findings indicate that a careful physical evaluation of the elbow is sufficient to guide further radiographic investigation. Routine radiographs of both the wrist and elbow in children with distal forearm fracture appear to be unnecessary when an appropriate physical examination is performed. (orig.)

  9. [A new kinematics method of determing elbow rotation axis and evaluation of its feasibility].

    Science.gov (United States)

    Han, W; Song, J; Wang, G Z; Ding, H; Li, G S; Gong, M Q; Jiang, X Y; Wang, M Y

    2016-04-18

    To study a new positioning method of elbow external fixation rotation axis, and to evaluate its feasibility. Four normal adult volunteers and six Sawbone elbow models were brought into this experiment. The kinematic data of five elbow flexion were collected respectively by optical positioning system. The rotation axes of the elbow joints were fitted by the least square method. The kinematic data and fitting results were visually displayed. According to the fitting results, the average moving planes and rotation axes were calculated. Thus, the rotation axes of new kinematic methods were obtained. By using standard clinical methods, the entrance and exit points of rotation axes of six Sawbone elbow models were located under X-ray. And The kirschner wires were placed as the representatives of rotation axes using traditional positioning methods. Then, the entrance point deviation, the exit point deviation and the angle deviation of two kinds of located rotation axes were compared. As to the four volunteers, the indicators represented circular degree and coplanarity of elbow flexion movement trajectory of each volunteer were both about 1 mm. All the distance deviations of the moving axes to the average moving rotation axes of the five volunteers were less than 3 mm. All the angle deviations of the moving axes to the average moving rotation axes of the five volunteers were less than 5°. As to the six Sawbone models, the average entrance point deviations, the average exit point deviations and the average angle deviations of two different rotation axes determined by two kinds of located methods were respectively 1.697 2 mm, 1.838 3 mm and 1.321 7°. All the deviations were very small. They were all in an acceptable range of clinical practice. The values that represent circular degree and coplanarity of volunteer's elbow single curvature movement trajectory are very small. The result shows that the elbow single curvature movement can be regarded as the approximate fixed

  10. Effect of glucocorticosteroid injections in tennis elbow verified on colour Doppler ultrasonography: evidence of inflammation

    DEFF Research Database (Denmark)

    Torp-Pedersen, T.E.; Torp-Pedersen, S.T.; Qvistgaard, E.

    2008-01-01

    were evaluated at baseline before the injection and at 2 weeks of follow-up. Outcome measures were changes in pain score and US parameters (resistive index (RI) and the amount of colour within the CEO). Prognosticators for outcome were: use of computer mouse, symptom duration, elbow strain, RI, colour...... fraction, Likert pain score, pain at rest, pain during activity, age, height, weight, disease in dominant versus nondominant arm. RESULTS: All but one patient experienced improvement of general elbow pain perception at follow-up at 2 weeks. In parallel, Doppler US showed significant reduction in colour...

  11. Evaluation of fatigue-ratcheting damage of a pressurised elbow undergoing damage seismic inputs

    International Nuclear Information System (INIS)

    Dang Van, K.

    2000-01-01

    We present a simplified method to calculate the plastic ratchet of elbow-shaped pipes submitted to seismic loading and an internal pressure. This method is simplified in the sense that the value of the ratchet is obtained without the use of finite element method (FEM) calculations. Here we derive a formula and use it to evaluate the fatigue-ratcheting damage of an elbow. This approach is applicable to complex plastic response appropriately described by non-linear kinematics hardening, which is more realistic for stainless steel such as 316-L. (orig.)

  12. Cause analysis for elbow thinning of the secondary loop feedwater system in PWR NPP

    International Nuclear Information System (INIS)

    Yu Tao; Bian Chunhua; Zhang Wei; Luo Kunjie; Wang Li; Li Yan

    2013-01-01

    Wall thickness of some secondary system pipelines were measured on site during the refueling outages in March 2012. Wall thinning happened in some components of APA system. This paper focused on the cause analysis of an elbow with that phenomenon. Wall thickness was carefully measured in laboratory using ultrasonic thickness meter and found that wall thinning happened nearly all elbows including two abnormal thinning regions. Analytical research was conducted using ICP, stereo microscope, SEM, XRD, ANSYS. The result shows that the cause of wall thinning is flow accelerated corrosion. Based on the analysis result and international research progress, this paper makes some suggestions to avoid and alleviate FAC in the secondary system. (authors)

  13. Thermalhydraulic study of a stratified flow in a piping elbow (Application to the model Coufast)

    International Nuclear Information System (INIS)

    Peniguel, C.; Stephan, J.M.

    1992-11-01

    In PWR's, mechanical damages (cracks) have been detected at the internal faces of steam generator feedwater piping and also in dead legs, when thermal stratification occurs. To gain some understanding on these issues, experimental and numerical programs have been set up at EDF. This paper reports a thermalhydraulic study of an elbow geometry under operating conditions leading to the establishment of a stable stratified flow. Results obtained with ESTET (a three dimensional finite differences-finite volume code solving the averaged Navier-Stokes equations) and comparisons with experimental data obtained on COUFAST (an analytical mock up, scale 1 of a French 900-MW PWR steam generator pipe elbow) are shown

  14. Management of post-traumatic elbow instability after failed radial head excision: A case report

    Directory of Open Access Journals (Sweden)

    Georgios Touloupakis

    2017-02-01

    Full Text Available Radial head excision has always been a safe commonly used surgical procedure with a satisfactory clinical outcome for isolated comminuted radial head fractures. However, diagnosis of elbow instability is still very challenging and often underestimated in routine orthopaedic evaluation. We present the case of a 21-years old female treated with excision after radial head fracture, resulting in elbow instability. The patient underwent revision surgery after four weeks. We believe that ligament reconstruction without radial head substitution is a safe alternative choice for Mason III radial head fractures accompanied by complex ligament lesions.

  15. Flooding in a loop with a vertical and a horizontal tube connected by an elbow

    International Nuclear Information System (INIS)

    Yan Changqi

    1994-01-01

    The experimental research of flooding and flow-reverse in a test loop which a vertical and a horizontal tube connected by an elbow is introduced. According to the experimental results, the effects of the elbow on flooding and flow-reverse is analyzed. The experimental results is compared with the results obtained in vertical tubes. The effect of horizontal tube length and hysteresis in de-flooding are analyzed. Dimensionless parameters was used in data process. The correlations for predicting the flooding point, de-flooding point, completed carry up and flow reverse points are given

  16. Revision allograft reconstruction of the lateral collateral ligament complex in elbows with previous failed reconstruction and persistent posterolateral rotatory instability.

    Science.gov (United States)

    Baghdadi, Yaser M K; Morrey, Bernard F; O'Driscoll, Shawn W; Steinmann, Scott P; Sanchez-Sotelo, Joaquin

    2014-07-01

    Primary reconstruction of the lateral collateral ligament complex (LCLC) using graft tissue restores elbow stability in many, but not all, elbows with acute or chronic posterolateral rotatory instability (PLRI). Revision reconstruction using a tendon allograft is occasionally considered for persistent PLRI, but the outcome of revision ligament reconstruction in this setting is largely unknown. We determined whether revision allograft ligament reconstruction can (1) restore the stability and (2) result in improved elbow scores for patients with persistent PLRI of the elbow after a previous failed primary reconstructive attempt and in the context of the diverse pathology being addressed. Between 2001 and 2011, 160 surgical elbow procedures were performed at our institution for the LCLC reconstruction using allograft tissue. Only patients undergoing revision allograft reconstruction of the LCLC for persistent PLRI with a previous failed primary reconstructive attempt using graft tissue and at least I year of followup were included in the study. Eleven patients (11 elbows) fulfilled our inclusion criteria and formed our study cohort. The cohort consisted of six female patients and five male patients. The mean age at the time of revision surgery was 36 years (range, 14-59 years). The revision allograft reconstruction was carried out after a mean of 3 years (range, 2.5 months to 9 years) from a failed attempted reconstruction of the LCLC. Osseous deficiency to some extent was identified in the preoperative radiographs of eight elbows. Mean followup was 5 years (range, 1-12 years). Revision allograft reconstruction of the LCLC restored elbow stability in eight of the 11 elbows; two of the three elbows with persistent instability were operated on a third time (at 6 and 7 months after allograft revision reconstruction). For elbows with no persistent instability, the mean Mayo Elbow Performance Score at most recent followup was 83 points (range, 60-100 points), and

  17. Poorer elbow proprioception in patients with lateral epicondylitis than in healthy controls: a cross-sectional study

    DEFF Research Database (Denmark)

    Juul-Kristensen, B.; Lund, H.; Hansen, K.

    2008-01-01

    Two groups of women, 15 patients with lateral epicondylitis and 21 healthy controls, were studied to compare proprioception in the elbows and knees between the groups. Outcome measures were absolute error and variable error for joint position sense and for threshold to detection of a passive...... movement. Both absolute error and variable error of threshold to detection of a passive movement were greater in the lateral epicondylitis-diagnosed elbows than in the controls' elbows (lateral epicondylitis, 1.8 degrees vs controls 1.1 degrees, P = .026; lateral epicondylitis, 0.8 degrees vs controls 0.......3 degrees, P = .015), and there was a tendency toward a greater absolute error of joint position sense compared with the control elbows (lateral epicondylitis, 8.2 degrees vs controls, 5.6 degrees; P = .078). Absolute error of joint position sense was greater in the elbows than in the knees of the lateral...

  18. Simultaneous bilateral elbow dislocation with bilateral medial epicondyle fractures in a 13-year-old female gymnast with hyperlaxity

    Science.gov (United States)

    Bauer, Stefan; Dunne, Ben; Whitewood, Colin

    2012-01-01

    Bilateral simultaneous elbow dislocations are extremely rare and have only been described in 12 cases. In the paediatric population unilateral elbow dislocations are rare with 3–6% of all elbow injuries and there are only few studies describing this injury exclusively in children. There is only one case report of a paediatric patient who sustained a simultaneous bilateral elbow dislocation with medial epicondyle fractures. We present a second paediatric case of simultaneous bilateral elbow dislocation with associated displaced bilateral medial epicondyle fractures in a gymnast with joint hyperlaxity (3 of 5 Wynne-Davies criteria) treated with closed reduction and short-term immobilisation (3 weeks). The patient returned to full trampoline gymnastics between 4 and 5 months postinjury and made an uneventful recovery. PMID:23234820

  19. Simplified inelastic (plastic and creep) analysis of pipe elbows subjected to inplane and out-of-plane bending

    International Nuclear Information System (INIS)

    Mello, R.M.; Scheller, J.D.

    1975-01-01

    The inelastic analysis of elbows typical of use in Liquid Metal Fast Reactor piping systems is described. Detailed information on stresses, plastic and creep strains, and deformations throughout the elbow bodies resulting from elastic/plastic, elastic/plastic/creep, and elastic/plastic-creep/relaxation material behavior was obtained for the cases of applied inplane and out-of-plane moment loading on the elbows. Some conclusions are made concerning the nature of the resulting stresses in the elbows. The simplified pipe-bend element in the MARC nonlinear finite element program is used as the analytical tool. This element permits nonlinear analysis of piping elbows and pipeline systems at realistic cost. 16 refs

  20. Cross-cultural adaptation and validation of the Patient-Rated Tennis Elbow Evaluation Questionnaire on lateral elbow tendinopathy for French-speaking patients.

    Science.gov (United States)

    Kaux, Jean-François; Delvaux, François; Schaus, Jean; Demoulin, Christophe; Locquet, Médéa; Buckinx, Fanny; Beaudart, Charlotte; Dardenne, Nadia; Van Beveren, Julien; Croisier, Jean-Louis; Forthomme, Bénédicte; Bruyère, Olivier

    Translation and validation of algo-functional questionnaire. The lateral elbow tendinopathy is a common injury in tennis players and physical workers. The Patient-Rated Tennis Elbow Evaluation (PRTEE) Questionnaire was specifically designed to measure pain and functional limitations in patients with lateral epicondylitis (tennis elbow). First developed in English, this questionnaire has since been translated into several languages. The aims of the study were to translate and cross-culturally adapt the PRTEE questionnaire into French and to evaluate the reliability and validity of this translated version of the questionnaire (PRTEE-F). The PRTEE was translated and cross-culturally adapted into French according to international guidelines. To assess the reliability and validity of the PRTEE-F, 115 participants were asked twice to fill in the PRTEE-F, and once the Disabilities of Arm, Shoulder and Hand Questionnaire (DASH) and the Short Form Health Survey (SF-36). Internal consistency (using Cronbach's alpha), test-retest reliability (using intraclass correlation coefficient (ICC), standard error of measurement and minimal detectable change), and convergent and divergent validity (using the Spearman's correlation coefficients respectively with the DASH and with some subscales of the SF-36) were assessed. The PRTEE was translated into French without any problems. PRTEE-F showed a good test-retest reliability for the overall score (ICC 0.86) and for each item (ICC 0.8-0.96) and a high internal consistency (Cronbach's alpha = 0.98). The correlation analyses revealed high correlation coefficients between PRTEE-F and DASH (convergent validity) and, as expected, a low or moderate correlation with the divergent subscales of the SF-36 (discriminant validity). There was no floor or ceiling effect. The PRTEE questionnaire was successfully cross-culturally adapted into French. The PRTEE-F is reliable and valid for evaluating French-speaking patients with lateral elbow

  1. Comparing Two Exercise Programmes for the Management of Lateral Elbow Tendinopathy (Tennis Elbow/Lateral Epicondylitis—A Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Dimitrios Stasinopoulos

    2013-09-01

    Full Text Available Aim: To compare the effectiveness of supervised exercise programme as proposed by Stasinopoulos and colleagues with home exercise programme as proposed by Pienimaki and his coworkers in the treatment of lateral elbow tendinopathy. Design: Controlled clinical trial. Setting: Physiotherapy and rehabilitation centre. Participants: This trial was carried out with 60 patients, who had lateral elbow tendinopathy. Intervention: Group A (n = 30 had received supervised exercise programme, once per day for 4 weeks. Group B (n = 30 was treated with home exercise programme four to six times daily for 8 weeks. Outcome measures: pain, using a visual analogue scale, function, using a visual analogue scale for elbow function and the pain-free grip strength. Patients were evaluated at baseline, at the end of treatment (week 12, and 3 months (week 24 after the end of treatment. Results: Both the supervised and home exercise programme were found to be significantly effective in the reduction of pain and in the improvement of functional status. The supervised exercise programme resulted in significantly different improvement in comparison to those who received home exercise programme. Conclusion: A specific supervised exercise programme is superior to a specific home exercise programme in reducing pain and improving function in patients with LET at the end of the treatment and at the 3 month follow-up. Further research is needed to confirm our results.

  2. Plutonium Immobilization Can Loading Concepts

    International Nuclear Information System (INIS)

    Kriikku, E.; Ward, C.; Stokes, M.; Randall, B.; Steed, J.; Jones, R.; Hamilton, L.; Rogers, L.; Fiscus, J.; Dyches, G.

    1998-05-01

    The Plutonium Immobilization Facility will encapsulate plutonium in ceramic pucks and seal the pucks inside welded cans. Remote equipment will place these cans in magazines and the magazines in a Defense Waste Processing Facility (DWPF) canister. The DWPF will fill the canister with glass for permanent storage. This report discusses five can loading conceptual designs and the lists the advantages and disadvantages for each concept. This report identifies loading pucks into cans and backfilling cans with helium as the top priority can loading development areas. The can loading welder and cutter are very similar to the existing Savannah River Site (SRS) FB-Line bagless transfer welder and cutter and thus they are a low priority development item

  3. Immobilization of organic liquid wastes

    International Nuclear Information System (INIS)

    Greenhalgh, W.O.

    1985-01-01

    This report describes a portland cement immobilization process for the disposal treatment of radioactive organic liquid wastes which would be generated in a a FFTF fuels reprocessing line. An incineration system already on-hand was determined to be too costly to operate for the 100 to 400 gallons per year organic liquid. Organic test liquids were dispersed into an aqueous phosphate liquid using an emulsifier. A total of 109 gallons of potential and radioactive aqueous immiscible organic liquid wastes from Hanford 300 Area operations were solidified with portland cement and disposed of as solid waste during a 3-month test program with in-drum mixers. Waste packing efficiencies varied from 32 to 40% and included pump oils, mineral spirits, and TBP-NPH type solvents

  4. Radioactive seed immobilization techniques for interstitial brachytherapy

    International Nuclear Information System (INIS)

    Yan, K.; Podder, T.; Buzurovic, I.; Hu, Y.; Dicker, A.; Valicenti, R.; Yu, Y.; Messing, E.; Rubens, D.; Sarkar, N.; Ng, W.

    2008-01-01

    In prostate brachytherapy, seeds can detach from their deposited sites and move locally in the pelvis or migrate to distant sites including the pulmonary and cardiac regions. Undesirable consequences of seed migration include inadequate dose coverage of the prostate and tissue irradiation effects at the site of migration. Thus, it is clinically important to develop seed immobilization techniques. We first analyze the possible causes for seed movement, and propose three potential techniques for seed immobilization: (1) surgical glue, (2) laser coagulation and (3) diathermy coagulation. The feasibility of each method is explored. Experiments were carried out using fresh bovine livers to investigate the efficacy of seed immobilization using surgical glue. Results have shown that the surgical glue can effectively immobilize the seeds. Evaluation of the radiation dose distribution revealed that the non-immobilized seed movement would change the planned isodose distribution considerably; while by using surgical glue method to immobilize the seeds, the changes were negligible. Prostate brachytherapy seed immobilization is necessary and three alternative mechanisms are promising for addressing this issue. Experiments for exploring the efficacy of the other two proposed methods are ongoing. Devices compatible with the brachytherapy procedure will be designed in future. (orig.)

  5. Inertial sensors as measurement tools of elbow range of motion in gerontology

    Directory of Open Access Journals (Sweden)

    Sacco G

    2015-02-01

    Full Text Available G Sacco,1–3,* JM Turpin,3,4,* A Marteu,5 C Sakarovitch,6 B Teboul,2 L Boscher,4,5 P Brocker,4 P Robert,1–3 O Guerin2,3,7 1Memory Center, Claude Pompidou Institut, Department of Geriatrics, University Hospital of Nice, Nice, France; 2Centre d’Innovation et d’Usages en Santé (CIU-S, University Hospital of Nice, Cimiez Hospital, Nice, France; 3CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, Nice Sophia-Antipolis University, Nice, France; 4Rehabilitation Unit, Department of Geriatrics, University Hospital of Nice, Cimiez Hospital, Nice, France; 5Rehabilitation Unit, Department of Neurosciences, University Hospital of Nice, L’Archet Hospital, Nice, France; 6Department of Clinical Research and Innovation, University Hospital of Nice, Cimiez Hospital, Nice, France; 7Acute Geriatrics Unit, Department of Geriatrics, University Hospital of Nice, Cimiez Hospital, Nice, France *These authors contributed equally to this work Background and purpose: Musculoskeletal system deterioration among the aging is a major reason for loss of autonomy and directly affects the quality of life of the elderly. Articular evaluation is part of physiotherapeutic assessment and helps in establishing a precise diagnosis and deciding appropriate therapy. Reference instruments are valid but not easy to use for some joints. The main goal of our study was to determine reliability and intertester reproducibility of the MP-BV, an inertial sensor (the MotionPod® [MP] combined with specific software (BioVal [BV], for elbow passive range-of-motion measurements in geriatrics. Methods: This open, monocentric, randomized study compared inertial sensor to inclinometer in patients hospitalized in an acute, post-acute, and long-term-care gerontology unit. Results: Seventy-seven patients (mean age 83.5±6.4 years, sex ratio 1.08 [male/female] were analyzed. The MP-BV was reliable for each of the three measurements (flexion, pronation, and

  6. Surface cell immobilization within perfluoroalkoxy microchannels

    Energy Technology Data Exchange (ETDEWEB)

    Stojkovič, Gorazd; Krivec, Matic [Faculty of Chemistry and Chemical Technology, University of Ljubljana, Aškerčeva 5, SI-1000 Ljubljana (Slovenia); Vesel, Alenka [Jožef Stefan Institute, Jamova cesta 39, 1000 Ljubljana (Slovenia); Marinšek, Marjan [Faculty of Chemistry and Chemical Technology, University of Ljubljana, Aškerčeva 5, SI-1000 Ljubljana (Slovenia); Žnidaršič-Plazl, Polona, E-mail: polona.znidarsic@fkkt.uni-lj.si [Faculty of Chemistry and Chemical Technology, University of Ljubljana, Aškerčeva 5, SI-1000 Ljubljana (Slovenia)

    2014-11-30

    Graphical abstract: - Highlights: • A very efficient approach for immobilization of cells into microreactors is presented. • It is applicable to various materials, including PFA and cyclic olefin (co)polymers. • It was used to immobilize different prokaryotic and eukaryotic microbes. • Cells were immobilized on the surface in high density and showed good stability. • Mechanisms of APTES interactions with target materials are proposed. - Abstract: Perfluoroalkoxy (PFA) is one of the most promising materials for the fabrication of cheap, solvent resistant and reusable microfluidic chips, which have been recently recognized as effective tools for biocatalytic process development. The application of biocatalysts significantly depends on efficient immobilization of enzymes or cells within the reactor enabling long-term biocatalyst use. Functionalization of PFA microchannels by 3-aminopropyltriethoxysilane (ATPES) and glutaraldehyde was used for rapid preparation of microbioreactors with surface-immobilized cells. X-ray photoelectron spectroscopy and scanning electron microscopy were used to accurately monitor individual treatment steps and to select conditions for cell immobilization. The optimized protocol for Saccharomyces cerevisiae immobilization on PFA microchannel walls comprised ethanol surface pretreatment, 4 h contacting with 10% APTES aqueous solution, 10 min treatment with 1% glutaraldehyde and 20 min contacting with cells in deionized water. The same protocol enabled also immobilization of Escherichia coli, Pseudomonas putida and Bacillus subtilis cells on PFA surface in high densities. Furthermore, the developed procedure has been proved to be very efficient also for surface immobilization of tested cells on other materials that are used for microreactor fabrication, including glass, polystyrene, poly (methyl methacrylate), polycarbonate, and two olefin-based polymers, namely Zeonor{sup ®} and Topas{sup ®}.

  7. COVALENT IMMOBILIZATION OF INVERTASE ON EPOXY-ACTIVATED POLYANILINE FILMS

    Directory of Open Access Journals (Sweden)

    Loredana Vacareanu

    2013-08-01

    Full Text Available The growing interest in manufacturing and use of biosensors is their rapid and selective detection of the target analyte. The immobilization of the enzymes, onto the appropriate matrix is the key-step in the construction of biosensing devices, considerably affecting its performance. In this study, new polyaniline bearing epoxy groups was synthesized by electrochemical polymerization reactions, as adherent, green film deposited on electrode surface, and was further used as immobilization matrix for invertase enzyme. The immobilization was carried out by condensation reactions between the amino groups of the enzyme molecules and the epoxy groups of polyaniline film. The covalent attachment was achieved by simple immersing the epoxy-activated polyaniline in acetate buffer solution (10 mM, pH 6.0 containing 2mg/mL invertase, for 24 h at 4 ºC, by continuous stirring. The polyaniline films thus obtained were analyzed before and after the invertase attachment, by using FT-IR spectroscopy and SEM microscopy. The presence of the invertase was evaluated by measuring their activity, using UV-Vis spectroscopy, in the presence of a known amount of sucrose as a substrate. These tests, performed for three times under the same conditions, revealed that even after five washes of the polyaniline /invertase electrode to remove the unbounded enzyme, the enzyme remain attached on the polyaniline film, being able to hydrolyze the sucrose presented in the assay solutions.

  8. Biodiesel production by transesterification using immobilized lipase.

    Science.gov (United States)

    Narwal, Sunil Kumar; Gupta, Reena

    2013-04-01

    Biodiesel can be produced by transesterification of vegetable or waste oil catalysed by lipases. Biodiesel is an alternative energy source to conventional fuel. It combines environmental friendliness with biodegradability, low toxicity and renewability. Biodiesel transesterification reactions can be broadly classified into two categories: chemical and enzymatic. The production of biodiesel using the enzymatic route eliminates the reactions catalysed under acid or alkali conditions by yielding product of very high purity. The modification of lipases can improve their stability, activity and tolerance to alcohol. The cost of lipases and the relatively slower reaction rate remain the major obstacles for enzymatic production of biodiesel. However, this problem can be solved by immobilizing the enzyme on a suitable matrix or support, which increases the chances of re-usability. The main factors affecting biodiesel production are composition of fatty acids, catalyst, solvents, molar ratio of alcohol and oil, temperature, water content, type of alcohol and reactor configuration. Optimization of these parameters is necessary to reduce the cost of biodiesel production.

  9. Orientation of axes in the elbow and forearm for biomechanical modelling

    NARCIS (Netherlands)

    Veeger, H. E J; Yu, B.

    1996-01-01

    To determine the three-dimensional positions and orientations of axes of rotation for elbow flexion and forearm prosupination, the flexion-extension and prosupination movements were measured for five arms. Four right and one arm were taken from four fresh cadavers. Movement was measured with a

  10. Experimental analysis of austenitic stainless steel straight pipes and elbows under pressure and moment loadings

    International Nuclear Information System (INIS)

    Barrou, A.; Prost, J.P.; Delidais, M.

    1983-08-01

    In order to avoid undesirable plastic response in PWR primary system components, tests were performed on 1/10 scale pipes and elbows made from AISI 316 austenitic stainless steel. L/D ratios were from 0.56 to 4.50 mm, arc angles of elbows were 30 0 , 45 0 , 60 0 and 90 0 . Pipes were subjected to bending moments at 3 internal pressure levels. They were tested to determine the mode of failure and served as a reference for elbows. Elbows were subjected to in-plane (closing and opening) and out-of-plane bending moments, at 3 pressure and 2 temperature levels. During these tests, loadings and displacements of components were monitored. Ovalisation of sections was measured regularly. The experimental plastic collapse moment corresponding to excessive deformation was compared to the maximum allowable moment under Design conditions. The experimental plastic instability moment considered as a limit for functional capability was compared to the maximum allowable moment for level C and D service limits

  11. Experimental stress analysis of four machined 10-in. NPS piping elbows with specified geometric distortions

    International Nuclear Information System (INIS)

    Moore, S.E.; Dodge, W.G.; Bolt, S.E.

    1983-09-01

    Four specially fabricated nominal 10-in. NPS, 90 0 , long-radius, schedule 40, carbon-steel piping elbows, welded to short lengths of straight pipe, were stress analyzed both experimentally and analytically. One elbow had a circular cross section and a uniform wall thickness, while the other three had either a circular or elliptical cross section with either a uniform or variable wall thickness. The objectives of the tests were primarily to study the influence of out of roundness and wall-thickness variations on the stresses in piping elbows under internal pressure and/or applied moment loadings. Analytical studies were made to isolate the various effects by comparing the experimental data with theoretical baseline solutions. Results of the studies showed that analytical solutions based on no-end-effects (NEE) theory capture the major characteristics of the stress distributions for elbows loaded with pressure and/or in-plane, out-of-plane, or torsional moment loadings. Of the four second-order effects addressed in this study, and effects had the most influence on the stresses, followed in order by out of roundness, wall-thickness variations, and pressure-moment interactions. Of these, the only significant increase in maximum stresses above those predicted by NEE theory was for the case of out of roundness with internal-pressure loading

  12. [Imaging of the elbow joint with focus MRI. Part 2: muscles, nerves and synovial membranes].

    Science.gov (United States)

    Rehm, J; Zeifang, F; Weber, M-A

    2014-03-01

    This review article discusses the magnetic resonance imaging (MRI) features and pathological changes of muscles, nerves and the synovial lining of the elbow joint. Typical imaging findings are illustrated and discussed. In addition, the cross-sectional anatomy and anatomical variants, such as accessory muscles and plicae are discussed. Injuries of the muscles surrounding the elbow joint, as well as chronic irritation are particularly common in athletes. Morphological changes in MRI, for example tennis or golfer's elbow are typical and often groundbreaking. By adapting the examination sequences, imaging planes and slices, complete and incomplete tendon ruptures can be reliably diagnosed. Although the clinical and electrophysiological examinations form the basis for the diagnosis of peripheral neuropathies, MRI provides useful additional information about the precise localization due to its high resolution and good soft tissue contrast and helps to rule out differential diagnoses. Synovial diseases, such as inflammatory arthritis, proliferative diseases and also impinging plicae must be considered in the MRI diagnostics of the elbow joint.

  13. Magnetic resonance imaging in the evaluation of treatment response of lateral epicondylitis of the elbow

    International Nuclear Information System (INIS)

    Savnik, Anette; Jensen, Bente; Noerregaard, Jesper; Danneskiold-Samsoee, Bente; Bliddal, Henning; Egund, Niels

    2004-01-01

    The purpose of this study was to investigate the treatment response in lateral epicondylitis (tennis elbow) by MRI. Magnetic resonance imaging was obtained in 30 patients with clinical symptoms of lateral epicondylitis of the elbow using T1-, T2- and T2-weighted fat-saturated (FS) sequences. The patients were randomised to either i.m. corticosteroid injection (n=16) or immobilisation in a wrist splint (n=14). Magnetic resonance imaging of the elbow was performed on a 1.5-T MR system at baseline and after 6 weeks. The extensor carpi radialis (ECRB) tendon, the radial collateral ligament, lateral humerus epicondyle at tendon insertion site, joint fluid and signal intensity changes within brachio-radialis and anconeus muscles were evaluated on the MR unit's workstation before and after 6 weeks of treatment. The MRI was performed once in 22 healthy controls for comparison and all images evaluated by an investigator blinded to the clinical status of the subjects. The MR images showed thickening with separation of the ECRB tendon from the radial collateral ligament and abnormal signal change in 25 of the 30 patients on the T1-weighted sequences at inclusion. The signal intensity of the ECRB tendon was increased in 24 of the 30 patients with lateral epicondylitis of the elbow on the T2-weighted FS sequences. (orig.)

  14. Ultrasound-guided, minimally invasive, percutaneous needle puncture treatment for tennis elbow.

    Science.gov (United States)

    Zhu, Jiaan; Hu, Bing; Xing, Chunyan; Li, Jia

    2008-10-01

    This report evaluates the efficacy of percutaneous needle puncture under sonographic guidance in treating lateral epicondylitis (tennis-elbow). Ultrasound-guided percutaneous needle puncture was performed on 76 patients who presented with persistent elbow pain. Under a local anesthetic and sonographic guidance, a needle was advanced into the calcification foci and the calcifications were mechanically fragmented. This was followed by a local injection of 25 mg prednisone acetate and 1% lidocaine. If no calcification was found then multiple punctures were performed followed by local injection of 25 mg prednisone acetate and 1% lidocaine. A visual analog scale (VAS) was used to evaluate the degree of pain pre-and posttreatment at 1 week to 24 weeks. Elbow function improvement and degree of self-satisfaction were also evaluated. Of the 76 patients, 55% were rated with excellent treatment outcome, 32% good, 11% average, and 3% poor. From 3 weeks posttreatment, VAS scores were significantly reduced compared with the pretreatment score (Ptennis elbow. Sonography can be used to accurately identify the puncture location and monitor changes.

  15. LONG TERM EFFECT OF CYRIAX PHYSIOTHERPY WITH SUPERVISED EXERCISE PROGRAM IN SUBJECTS WITH TENNIS ELBOW

    Directory of Open Access Journals (Sweden)

    Pallavi Shridhar Thakare

    2014-06-01

    Full Text Available Background: The purpose is to find long term effect of Cyriax physiotherapy with supervised exercise program in the reduction of pain and improvement of functional ability for subjects with tennis elbow. Method: An experimental study design, 30 subjects with Tennis Elbow randomized 15 subjects each into Study and Control group. Control group received Supervised Exercise program while Study group received Cyriax Physiotherapy with Supervised exercises program thrice in a week for 4 weeks and post intervention follow up after 2 weeks. Outcome measurements were measured for pain using Visual analogue Scale (VAS and Patient Rated Tennis Elbow Evaluation (PRTEE for functional ability. Results: There is no statistically significant difference in pre- intervention means of VAS and PRTEE when compared between the groups using independent ‘t’ test as a parametric and Mann Whitney U test as a non-parametric test. When means of post intervention and follow-up measurements were compared there is a statistically significant (p<0.05 difference in VAS and PRTEE scores between the groups. However greater percentage of improvements was obtained in study group than control group. Conclusion: It is concluded that there is significant long term effect with greater percentage of improvement in pain and functional ability up to 2 weeks follow-up following 4 weeks of combined Cyriax physiotherapy with supervised exercise program than only supervised exercise program for subjects with tennis elbow.

  16. The predictive value of diagnostic sonography for the effectiveness of conservative treatment of tennis elbow

    NARCIS (Netherlands)

    Struijs, P. A. A.; Spruyt, M.; Assendelft, W. J. J.; van Dijk, C. N.

    2005-01-01

    OBJECTIVE. Tennis elbow is a common complaint. Several treatment strategies have been described, but an optimal strategy has not been identified. Sonographic imaging as a predictive,factor has never been studied. The aim of our study was to determine the value of sonographic findings in predicting

  17. Magnetic resonance imaging in the evaluation of treatment response of lateral epicondylitis of the elbow

    Energy Technology Data Exchange (ETDEWEB)

    Savnik, Anette [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg (Denmark); Department of Radiology, Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg (Denmark); Hovmarksvej 39, 2920, Charlottenlund (Denmark); Jensen, Bente; Noerregaard, Jesper; Danneskiold-Samsoee, Bente; Bliddal, Henning [Parker Institute, Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg (Denmark); Egund, Niels [Department of Radiology, Aarhus University Hospital, 8000, Aarhus C (Denmark)

    2004-06-01

    The purpose of this study was to investigate the treatment response in lateral epicondylitis (tennis elbow) by MRI. Magnetic resonance imaging was obtained in 30 patients with clinical symptoms of lateral epicondylitis of the elbow using T1-, T2- and T2-weighted fat-saturated (FS) sequences. The patients were randomised to either i.m. corticosteroid injection (n=16) or immobilisation in a wrist splint (n=14). Magnetic resonance imaging of the elbow was performed on a 1.5-T MR system at baseline and after 6 weeks. The extensor carpi radialis (ECRB) tendon, the radial collateral ligament, lateral humerus epicondyle at tendon insertion site, joint fluid and signal intensity changes within brachio-radialis and anconeus muscles were evaluated on the MR unit's workstation before and after 6 weeks of treatment. The MRI was performed once in 22 healthy controls for comparison and all images evaluated by an investigator blinded to the clinical status of the subjects. The MR images showed thickening with separation of the ECRB tendon from the radial collateral ligament and abnormal signal change in 25 of the 30 patients on the T1-weighted sequences at inclusion. The signal intensity of the ECRB tendon was increased in 24 of the 30 patients with lateral epicondylitis of the elbow on the T2-weighted FS sequences. (orig.)

  18. Improved CHESS imaging with the use of rice pads: Investigation in the neck, shoulder, and elbow.

    Science.gov (United States)

    Moriya, Susumu; Miki, Yukio; Yokobayashi, Tsuneo; Yamamoto, Akira; Kanagaki, Mitsunori; Komori, Yoshiaki; Fujimoto, Koji; Ishikawa, Mitsunori

    2010-06-01

    To investigate the feasibility of rice pads for improving nonuniform fat suppression in magnetic resonance imaging (MRI) of the neck, shoulder, and elbow using the chemical shift selective (CHESS) technique. CHESS imaging of the neck, shoulder, and elbow was performed on 10 healthy volunteers with and without the use of rice pads. Images were visually assessed by one radiologist and one radiologic technologist using a four-point scale. Results were compared using Wilcoxon's signed rank sum test. Images with and without rice pads were rated 3.9 and 1.5 for the neck (P = 0.002), 3.85 and 2.5 for the shoulder (P = 0.002), and 3.4 and 2.45 for the elbow (P = 0.004). Fat-suppressed images obtained using the CHESS technique were significantly improved by rice pads for the neck, shoulder, and elbow, indicating that image deterioration with CHESS caused by magnetic field nonuniformity can be improved by rice pads in all body areas.

  19. Musculoskeletal Model Development of the Elbow Joint with an Experimental Evaluation

    Directory of Open Access Journals (Sweden)

    Munsur Rahman

    2018-04-01

    Full Text Available A dynamic musculoskeletal model of the elbow joint in which muscle, ligament, and articular surface contact forces are predicted concurrently would be an ideal tool for patient-specific preoperative planning, computer-aided surgery, and rehabilitation. Existing musculoskeletal elbow joint models have limited clinical applicability because of idealizing the elbow as a mechanical hinge joint or ignoring important soft tissue (e.g., cartilage contributions. The purpose of this study was to develop a subject-specific anatomically correct musculoskeletal elbow joint model and evaluate it based on experimental kinematics and muscle electromyography measurements. The model included three-dimensional bone geometries, a joint constrained by multiple ligament bundles, deformable contacts, and the natural oblique wrapping of ligaments. The musculoskeletal model predicted the bone kinematics reasonably accurately in three different velocity conditions. The model predicted timing and number of muscle excitations, and the normalized muscle forces were also in agreement with the experiment. The model was able to predict important in vivo parameters that are not possible to measure experimentally, such as muscle and ligament forces, and cartilage contact pressure. In addition, the developed musculoskeletal model was computationally efficient for body-level dynamic simulation. The maximum computation time was less than 30 min for our 35 s simulation. As a predictive clinical tool, the potential medical applications for this model and modeling approach are significant.

  20. Valgus extension overload syndrome of the elbow in a test cricket ...

    African Journals Online (AJOL)

    tion and showed attenuation of the medial collateral ligament, with medullary oedema at the lateral side of the elbow (Fig. 2). The patient refused arthroscopy, and opted for total abstinence from throwing and fast-bowling for 12 weeks. He started a training programme designed to strengthen his forearm flexor-pronator and.

  1. Local corticosteroid injection versus Cyriax-type physiotherapy for tennis elbow

    NARCIS (Netherlands)

    J.A.N. Verhaar (Jan); G.H.I.M. Walenkamp; H. van Mameren; A.D.M. Kester; A.J. van der Linden

    1996-01-01

    textabstractWe performed a prospective, randomised trial on 106 patients to compare the effects of local corticosteroid injections with physiotherapy as advocated by Cyriax in the treatment of tennis elbow. The main outcome measures were the severity of pain, pain provoked by resisted dorsiflexion

  2. Guided wave propagation and scattering in pipeworks comprising elbows: Theoretical and experimental results

    International Nuclear Information System (INIS)

    Bakkali, M El; Lhémery, A; Baronian, V; Chapuis, B

    2015-01-01

    Elastic guided waves (GW) are used to inspect pipeworks in various industries. Modelling tools for simulating GW inspection are necessary to understand complex scattering phenomena occurring at specific features (welds, elbows, junctions...). In pipeworks, straight pipes coexist with elbows. GW propagation in the former cases is well-known, but is less documented in the latter. Their scattering at junction of straight and curved pipes constitutes a complex phenomenon. When a curved part is joined to two straight parts, these phenomena couple and give rise to even more complex wave structures. In a previous work, the SemiAnalytic Finite Element method extended to curvilinear coordinates was used to handle GW propagation in elbows, combined with a mode matching method to predict their scattering at the junction with a straight pipe. Here, a pipework comprising an arbitrary number of elbows of finite length and of different curvature linking straight pipes is considered. A modal scattering matrix is built by cascading local scattering and propagation matrices. The overall formulation only requires meshing the pipe section to compute both the modal solutions and the integrals resulting from the mode-matching method for computing local scattering matrices. Numerical predictions using this approach are studied and compared to experiments

  3. Resolution of thermal striping issue downstream of a horizontal pipe elbow in stratified pipe flow

    International Nuclear Information System (INIS)

    Kuzay, T.M.; Kasza, K.E.

    1985-01-01

    A thermally stratified pipe flow produced by a thermal transient when passing through a horizontal elbow as a result of secondary flow gives rise to large thermal fluctuations on the inner curvature wall of the downstream piping. These fluctuations were measured in a specially instrumented horizontal pipe and elbow system on a test set-up using water in the Mixing Components Technology Facility (MCTF) at Argonne National Laboratory (ANL). This study is part of a larger program which is studying the influence of thermal buoyancy on general reactor component performance. This paper discusses the influence of pipe flow generated thermal oscillations on the thermal stresses induced in the pipe walls. The instrumentation was concentrated around the exit plane of the 90 0 sweep elbow, since prior tests had indicated that the largest thermal fluctuations would occur within about one hydraulic diameter downstream of the elbow exit. The thermocouples were located along the inner curvature of the piping and measured the near surface fluid temperature. The test matrix involved thermal downramps under turbulent flow conditions

  4. Resolution of thermal striping issue downstream of a horizontal pipe elbow in stratified pipe flow. [LMFBR

    Energy Technology Data Exchange (ETDEWEB)

    Kuzay, T.M.; Kasza, K.E.

    1985-01-01

    A thermally stratified pipe flow produced by a thermal transient when passing through a horizontal elbow as a result of secondary flow gives rise to large thermal fluctuations on the inner curvature wall of the downstream piping. These fluctuations were measured in a specially instrumented horizontal pipe and elbow system on a test set-up using water in the Mixing Components Technology Facility (MCTF) at Argonne National Laboratory (ANL). This study is part of a larger program which is studying the influence of thermal buoyancy on general reactor component performance. This paper discusses the influence of pipe flow generated thermal oscillations on the thermal stresses induced in the pipe walls. The instrumentation was concentrated around the exit plane of the 90/sup 0/ sweep elbow, since prior tests had indicated that the largest thermal fluctuations would occur within about one hydraulic diameter downstream of the elbow exit. The thermocouples were located along the inner curvature of the piping and measured the near surface fluid temperature. The test matrix involved thermal downramps under turbulent flow conditions.

  5. Test-retest reliability of joint position and kinesthetic sense in the elbow of healthy subjects

    DEFF Research Database (Denmark)

    Juul-Kristensen, B.; Lund, Hans Aage; Hansen, K.

    2008-01-01

    Proprioception is an important effect measure in neuromuscular function training in physiotherapy. Reliability studies of methods for measuring proprioception are few on joint position sense (JPS) and threshold to detection of a passive movement (TDPM) on the elbow. The aim was to study test-rete...

  6. Video imaging measurement of interfacial wave velocity in air-water flow through a horizontal elbow

    Science.gov (United States)

    Al-Wazzan, Amir; Than, Cheok F.; Moghavvemi, Mahmoud; Yew, Chia W.

    2001-10-01

    Two-phase flow in pipelines containing elbows represents a common situation in the oil and gas industries. This study deals with the stratified flow regime between the gas and liquid phase through an elbow. It is of interest to study the change in wave characteristics by measuring the wave velocity and wavelength at the inlet and outlet of the elbow. The experiments were performed under concurrent air-water stratified flow in a horizontal transparent polycarbonate pipe of 0.05m diameter and superficial air and water velocities up to 8.97 and 0.0778 m/s respectively. A non-intrusive video imaging technique was applied to capture the waves. For image analysis, a frame by frame direct overlapping method was used to detect for pulsating flow and a pixel shifting method based on the detection of minimum values in the overlap function was used to determine wave velocity and wavelength. Under superficial gas velocity of less than 4.44 m/s, the results suggest a regular pulsating outflow produced by the elbow. At higher gas velocities, more random pulsation was found and the emergence of localized interfacial waves was detected. Wave velocities measured by this technique were found to produce satisfactory agreement with direct measurements.

  7. X-ray diagnostic data on posttraumatic deforming arthrosis and elbow joint contracture

    International Nuclear Information System (INIS)

    Mironchuk, L.V.

    2010-01-01

    To investigate the most common complications of elbow joint injuries and their degree using x-ray findings at various types of traumas. Radiography is the main method of diagnosis of EJ injury consequences, among them the most frequent are arthrosis deformations and contractures, therefore the volume of EJ volume should be considered when determining the disease stages.

  8. A comparison of two portable dynamometers in the assessment of shoulder and elbow strength

    NARCIS (Netherlands)

    Vermeulen, HM; de Bock, GH; van Houwelingen, HC; van der Meer, RL; Mol, MC; Plus, BT; Rozing, PM; Vlieland, TPMV

    Objectives To compare the practical applicability and measurement properties of a hand-held dynamometer (MicroFET2 (R)) and a fixed dynamometer (Isobex2.1 (R)) in determining isometric strength of the shoulder and elbow. Design Muscle strength in four directions (glenohumeral abduction, external

  9. Topsy-turvy locomotion: biomechanical specializations of the elbow in suspended quadrupeds reflect inverted gravitational constraints

    Science.gov (United States)

    Fujiwara, Shin-ichi; Endo, Hideki; Hutchinson, John R

    2011-01-01

    Some tetrapods hang upside down from tree branches when moving horizontally. The ability to walk in quadrupedal suspension has been acquired independently in at least 14 mammalian lineages. During the stance (supportive) phase of quadrupedal suspension, the elbow joint flexor muscles (not the extensors as in upright vertebrates moving overground) are expected to contract to maintain the flexed limb posture. Therefore muscular control in inverted, suspended quadrupeds may require changes of muscle control, and even morphologies, to conditions opposite to those in upright animals. However, the relationships between musculoskeletal morphologies and elbow joint postures during the stance phase in suspended quadrupeds have not been investigated. Our analysis comparing postures and skeletal morphologies in Choloepus (Pilosa), Pteropus (Chiroptera), Nycticebus (Primates) and Cynocephalus (Dermoptera) revealed that the elbow joints of these animals were kept at flexed angles of 70–100 ° during the stance phase of quadrupedal suspension. At these joint angles the moment arms of the elbow joint flexors were roughly maximized, optimizing that component of antigravity support. Our additional measurements from various mammalian species show that suspended quadrupeds have relatively small extensor/flexor ratios in both muscle masses and maximum moment arms. Thus, in contrast to the pattern in normal terrestrial quadrupeds, suspended quadrupeds emphasize flexor over extensor muscles for body support. This condition has evolved independently multiple times, attendant with a loss or reduction of the ability to move in normal upright postures. PMID:21477151

  10. Quantitative trait loci analysis of osteocondrosis traits in the elbow joint of pigs

    DEFF Research Database (Denmark)

    Christensen, O F; Busch, M E; Gregersen, V R

    2010-01-01

    Osteochondrosis is a growth disorder in the cartilage of young animals and is characterised by lesions found in the cartilage and bone. This study identified quantitative trait loci (QTLs) associated with six osteochondrosis lesion traits in the elbow joint of finishing pigs. The traits were: thi...

  11. Validity and cross-cultural adaptation of the persian version of the oxford elbow score.

    Science.gov (United States)

    Ebrahimzadeh, Mohammad H; Kachooei, Amir Reza; Vahedi, Ehsan; Moradi, Ali; Mashayekhi, Zeinab; Hallaj-Moghaddam, Mohammad; Azami, Mehran; Birjandinejad, Ali

    2014-01-01

    Oxford Elbow Score (OES) is a patient-reported questionnaire used to assess outcomes after elbow surgery. The aim of this study was to validate and adapt the OES into Persian language. After forward-backward translation of the OES into Persian, a total number of 92 patients after elbow surgeries completed the Persian OES along with the Persian DASH and SF-36. To assess test-retest reliability, 31 randomly selected patients (34%) completed the Persian OES again after three days while abstaining from all forms of therapeutic regimens. Reliability of the Persian OES was assessed by measuring intraclass correlation coefficient (ICC) for test-retest reliability and Cronbach's alpha for internal consistency. Spearman's correlation coefficient was used to test the construct validity. Cronbach's alpha coefficient was 0.92 showing excellent reliability. Cronbach's alpha for function, pain, and social-psychological subscales was 0.95, 0.86, and 0.85, respectively. Intraclass correlation coefficient (ICC) was 0.85 for the overall questionnaire and 0.90, 0.76, and 0.75 for function, pain, and social-psychological subscales, respectively. Construct validity was confirmed as the Spearman correlation between OES and DASH was 0.80. Persian OES is a valid and reliable patient-reported outcome measure to assess postsurgical elbow status in Persian speaking population.

  12. Hydrodynamic Effect on the Inhibition for the Flow Accelerated Corrosion of an Elbow

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, L.; Zhang, G. A.; Guo, X. P. [Huazhong University of Science and Technology, Wuhan (China)

    2017-02-15

    The inhibition effect of thioureido imidazoline inhibitor (TAI) for flow accelerated corrosion (FAC) at different locations for an X65 carbon steel elbow was studied by array electrode and computational fluid dynamics (CFD) simulations. The distribution of the inhibition efficiency measured by electrochemical impedance spectroscopy (EIS) is in good accordance with the distribution of the hydrodynamic parameters at the elbow. The inhibition efficiencies at the outer wall are higher than those at the inner wall meaning that the lower inhibition efficiency is associated with a higher flow velocity, shear stress, and turbulent kinetic energy at the inner wall of the elbow, as well as secondary flow at the elbow rather than the mass transport of inhibitor molecules. Compared to the static condition, the inhibition efficiency of TAI for FAC was relatively low. It is also due to a drastic turbulence flow and high wall shear stress during the FAC test, which prevents the adsorption of inhibitor and/or damages the adsorbed inhibitor film.

  13. Duloxetine in treatment of refractory chronic tennis elbow: Two case reports

    Directory of Open Access Journals (Sweden)

    Wani Zaid

    2008-09-01

    Full Text Available Abstract Introduction Tennis elbow is a common musculoskeletal disorder; management options include physiotherapeutic, medical, surgical, and other forms of intervention. Some patients remain symptomatic despite best efforts. We present two patients who did not respond to medical and surgical treatments, and whose symptoms were relieved with duloxetine. This is the first report on the use of duloxetine to treat tennis elbow. Case presentation Two mentally healthy young Asian women aged 32 and 27 years, each with tennis elbow of about 18 months duration continued to suffer pain despite treatment with analgesics, local steroid injections, physiotherapy, cryotherapy, ultrasound, and surgical release, among other interventions. Both showed substantial improvement within 4 to 6 weeks of receiving monotherapy with duloxetine 60 mg/day. Both were pain-free with continued treatment at a 6-month follow-up. Conclusion Duloxetine may be a useful treatment option in patients with chronic tennis elbow, even those who have failed conventional medical, physiotherapeutic, surgical, and other forms of management.

  14. Ultrasonographic Characteristics of the Common Extensor Tendon of the Elbow in Asymptomatic Individuals

    DEFF Research Database (Denmark)

    Krogh, Thøger P; Fredberg, Ulrich; Ammitzbøl, Christian

    2017-01-01

    BACKGROUND: Ultrasonography (US) of the common extensor tendon (CET) of the elbow is often part of the assessment of patients with lateral epicondylitis. This US assessment is currently based on general tendinopathy references and not well-defined US entities. PURPOSE: To describe CET thickness...

  15. Optimal Elbow Angle for Extracting sEMG Signals During Fatiguing Dynamic Contraction

    Directory of Open Access Journals (Sweden)

    Mohamed R. Al-Mulla

    2015-09-01

    Full Text Available Surface electromyographic (sEMG activity of the biceps muscle was recorded from 13 subjects. Data was recorded while subjects performed dynamic contraction until fatigue and the signals were segmented into two parts (Non-Fatigue and Fatigue. An evolutionary algorithm was used to determine the elbow angles that best separate (using Davies-Bouldin Index, DBI both Non-Fatigue and Fatigue segments of the sEMG signal. Establishing the optimal elbow angle for feature extraction used in the evolutionary process was based on 70% of the conducted sEMG trials. After completing 26 independent evolution runs, the best run containing the optimal elbow angles for separation (Non-Fatigue and Fatigue was selected and then tested on the remaining 30% of the data to measure the classification performance. Testing the performance of the optimal angle was undertaken on nine features extracted from each of the two classes (Non-Fatigue and Fatigue to quantify the performance. Results showed that the optimal elbow angles can be used for fatigue classification, showing 87.90% highest correct classification for one of the features and on average of all eight features (including worst performing features giving 78.45%.

  16. Smartphone and Universal Goniometer for Measurement of Elbow Joint Motions: A Comparative Study

    Science.gov (United States)

    Behnoush, Behnam; Tavakoli, Nasim; Bazmi, Elham; Nateghi Fard, Fariborz; Pourgharib Shahi, Mohammad Hossein; Okazi, Arash; Mokhtari, Tahmineh

    2016-01-01

    Background Universal goniometer (UG) is commonly used as a standard method to evaluate range of motion (ROM) as part of joint motions. It has some restrictions, such as involvement of both hands of the physician, leads to instability of hands and error. Nowadays smartphones usage has been increasing due to its easy application. Objectives The study was designed to compare the smartphone inclinometer-based app and UG in evaluation of ROM of elbow. Materials and Methods The maximum ROM of elbow in position of flexion and pronation and supination of forearm were examined in 60 healthy volunteers with UG and smartphone. Data were analyzed using SPSS (ver. 16) software and appropriate statistical tests were applied, such as paired t-test, ICC and Bland Altman curves. Results The results of this study showed high reliability and validity of smartphone in regarding UG with ICC > 0.95. The highest reliability for both methods was in elbow supination and the lowest was in the elbow flexion (0.84). Conclusions Smartphones due to ease of access and usage for the physician and the patient, may be good alternatives for UG. PMID:27625754

  17. Mechanically Evoked Torque and Electromyographic Responses During Passive Elbow Extension in Upper Limb Tension Test Position

    Science.gov (United States)

    2001-10-25

    axis during passive elbow extension. A padded shoulder block was placed superior to the subject’s acromioclavicular joint to stabilize the shoulder...girdle position. A pressure sensor was used between the padded shoulder block and the acromioclavicular joint to monitor and standardize the pressure

  18. Arthroscopic R-LCL plication for symptomatic minor instability of the lateral elbow (SMILE).

    Science.gov (United States)

    Arrigoni, Paolo; Cucchi, Davide; D'Ambrosi, Riccardo; Menon, Alessandra; Aliprandi, Alberto; Randelli, Pietro

    2017-07-01

    Minor instability has been proposed as a possible aetiology of lateral elbow pain. This study presents the results of the arthroscopic plication of the radial component of the lateral collateral ligament (R-LCL) to reduce minor instability of the lateral elbow. Twenty-seven patients with recalcitrant lateral epicondylitis who had failed conservative therapy and who had no previous trauma or overt instability, were included. R-LCL plication was performed in the presence of at least one sign of lateral ligamentous patholaxity and one intra-articular abnormal finding. Single-assessment numeric evaluation (SANE), Oxford Elbow Score (OES), quickDASH (Disabilities of the Arm, Shoulder, Hand), patient satisfaction and post-operative range of motion were evaluated. SANE improved from a median of 30 [2-40] points pre-operatively to 90 [80-100] at final follow-up (p instability of the lateral elbow (SMILE) at 2-year median follow-up. A slight limitation in range of motion is a possible undesired consequence of this intervention. Retrospective case series, Level IV.

  19. 78 FR 36308 - Proposed Information Collection (Elbow and Forearm Conditions Disability Benefits Questionnaire...

    Science.gov (United States)

    2013-06-17

    ... and Forearm Conditions Disability Benefits Questionnaire) Activity: Comment Request AGENCY: Veterans... Questionnaire)'' in any correspondence. During the comment period, comments may be viewed online through the... INFORMATION: Title: Elbow and Forearm Conditions Disability Benefits Questionnaire, VA Form 21-0960M-4. OMB...

  20. Occult posterolateral rotatory dislocation of the elbow with olecranon fracture in a child: a case report

    Directory of Open Access Journals (Sweden)

    Fujimori Takahito

    2012-09-01

    Full Text Available Abstract Introduction Acute posterolateral rotator elbow dislocation in a child is rare and can be easily misdiagnosed due to immaturity of the epiphysis. This is the first case of occult posterolateral rotator elbow dislocation in combination with an olecranon fracture. We report our experience with this case, which was not diagnosed correctly by plain radiographs. Case presentation An 11-year-old Asian boy suffered severe pain and swelling of his right elbow after his outstretched arm hit a car dashboard in a motor vehicle accident. Plain radiographs showed only a minimally displaced olecranon fracture and a tiny lateral epicondylar avulsion fracture. However, stress radiographs under general anesthesia revealed severe posterolateral rotatory instability. During surgery, we found that the cartilaginous lateral epicondylar apophysis was much larger than the epicondylar fragment on the radiographs. After the lateral epicondylar osteochondral fragment and lateral collateral ligament complex were fixed, the instability disappeared. Conclusion Our experience with this case shows that it is important to check for instability with pediatric elbow fractures, because a tiny avulsion fracture was able to cause severe posterolateral rotatory instability in a child.