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Sample records for human elbow joint

  1. 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...

  2. 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...

  3. 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...

  4. 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."...

  5. Neuromuscular interfacing: establishing an EMG-driven model for the human elbow joint.

    Science.gov (United States)

    Pau, James W L; Xie, Shane S Q; Pullan, Andrew J

    2012-09-01

    Assistive devices aim to mitigate the effects of physical disability by aiding users to move their limbs or by rehabilitating through therapy. These devices are commonly embodied by robotic or exoskeletal systems that are still in development and use the electromyographic (EMG) signal to determine user intent. Not much focus has been placed on developing a neuromuscular interface (NI) that solely relies on the EMG signal, and does not require modifications to the end user's state to enhance the signal (such as adding weights). This paper presents the development of a flexible, physiological model for the elbow joint that is leading toward the implementation of an NI, which predicts joint motion from EMG signals for both able-bodied and less-abled users. The approach uses musculotendon models to determine muscle contraction forces, a proposed musculoskeletal model to determine total joint torque, and a kinematic model to determine joint rotational kinematics. After a sensitivity analysis and tuning using genetic algorithms, subject trials yielded an average root-mean-square error of 6.53° and 22.4° for a single cycle and random cycles of movement of the elbow joint, respectively. This helps us to validate the elbow model and paves the way toward the development of an NI.

  6. 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.

  7. 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...

  8. 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...

  9. 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

  10. 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...

  11. 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...

  12. 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.

  13. Equilibrium-point control of human elbow-joint movement under isometric environment by using multichannel functional electrical stimulation

    Directory of Open Access Journals (Sweden)

    Kazuhiro eMatsui

    2014-06-01

    Full Text Available Functional electrical stimulation (FES is considered an effective technique for aiding quadriplegic persons. However, the human musculoskeletal system has highly nonlinearity and redundancy. It is thus difficult to stably and accurately control limbs using FES. In this paper, we propose a simple FES method that is consistent with the motion-control mechanism observed in humans. We focus on joint motion by a pair of agonist-antagonist muscles of the musculoskeletal system, and define theelectrical agonist-antagonist muscle ratio (EAA ratio and electrical agonist-antagonist muscle activity (EAA activity in light of the agonist-antagonist muscle ratio and agonist-antagonist muscle activity, respectively, to extract the equilibrium point and joint stiffness from electromyography (EMG signals. These notions, the agonist-antagonist muscle ratio and agonist-antagonist muscle activity, are based on the hypothesis that the equilibrium point and stiffness of the agonist-antagonist motion system are controlled by the central nervous system. We derived the transfer function between the input EAA ratio and force output of the end-point. We performed some experiments in an isometric environment using six subjects. This transfer-function model is expressed as a cascade-coupled dead time element and a second-order system. High-speed, high-precision, smooth control of the hand force were achieved through the agonist-antagonist muscle stimulation pattern determined by this transfer function model.

  14. Equilibrium-point control of human elbow-joint movement under isometric environment by using multichannel functional electrical stimulation.

    Science.gov (United States)

    Matsui, Kazuhiro; Hishii, Yasuo; Maegaki, Kazuya; Yamashita, Yuto; Uemura, Mitsunori; Hirai, Hiroaki; Miyazaki, Fumio

    2014-01-01

    Functional electrical stimulation (FES) is considered an effective technique for aiding quadriplegic persons. However, the human musculoskeletal system has highly non-linearity and redundancy. It is thus difficult to stably and accurately control limbs using FES. In this paper, we propose a simple FES method that is consistent with the motion-control mechanism observed in humans. We focus on joint motion by a pair of agonist-antagonist muscles of the musculoskeletal system, and define the "electrical agonist-antagonist muscle ratio (EAA ratio)" and "electrical agonist-antagonist muscle activity (EAA activity)" in light of the agonist-antagonist muscle ratio and agonist-antagonist muscle activity, respectively, to extract the equilibrium point and joint stiffness from electromyography (EMG) signals. These notions, the agonist-antagonist muscle ratio and agonist-antagonist muscle activity, are based on the hypothesis that the equilibrium point and stiffness of the agonist-antagonist motion system are controlled by the central nervous system. We derived the transfer function between the input EAA ratio and force output of the end-point. We performed some experiments in an isometric environment using six subjects. This transfer-function model is expressed as a cascade-coupled dead time element and a second-order system. High-speed, high-precision, smooth control of the hand force were achieved through the agonist-antagonist muscle stimulation pattern determined by this transfer function model.

  15. 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.

  16. 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.

  17. 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....

  18. 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...

  19. 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

  20. 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)

  1. 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.

  2. 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....

  3. 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.

  4. 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

  5. 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

  6. 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.)

  7. 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....

  8. 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.

  9. [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.

  10. 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 ...

  11. 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

  12. 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...

  13. 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'....

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. Heads, Shoulders, Elbows, Knees, and Toes: Modular Gdf5 Enhancers Control Different Joints in the Vertebrate Skeleton.

    Science.gov (United States)

    Chen, Hao; Capellini, Terence D; Schoor, Michael; Mortlock, Doug P; Reddi, A Hari; Kingsley, David M

    2016-11-01

    Synovial joints are crucial for support and locomotion in vertebrates, and are the frequent site of serious skeletal defects and degenerative diseases in humans. Growth and differentiation factor 5 (Gdf5) is one of the earliest markers of joint formation, is required for normal joint development in both mice and humans, and has been genetically linked to risk of common osteoarthritis in Eurasian populations. Here, we systematically survey the mouse Gdf5 gene for regulatory elements controlling expression in synovial joints. We identify separate regions of the locus that control expression in axial tissues, in proximal versus distal joints in the limbs, and in remarkably specific sub-sets of composite joints like the elbow. Predicted transcription factor binding sites within Gdf5 regulatory enhancers are required for expression in particular joints. The multiple enhancers that control Gdf5 expression in different joints are distributed over a hundred kilobases of DNA, including regions both upstream and downstream of Gdf5 coding exons. Functional rescue tests in mice confirm that the large flanking regions are required to restore normal joint formation and patterning. Orthologs of these enhancers are located throughout the large genomic region previously associated with common osteoarthritis risk in humans. The large array of modular enhancers for Gdf5 provide a new foundation for studying the spatial specificity of joint patterning in vertebrates, as well as new candidates for regulatory regions that may also influence osteoarthritis risk in human populations.

  19. 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...

  20. 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.

  1. 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...

  2. 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...

  3. 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.

  4. 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...

  5. [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.

  6. The impact of elbow and knee joint lesions on abnormal gait and posture of sows

    Directory of Open Access Journals (Sweden)

    Jørgensen Bente

    2008-02-01

    Full Text Available Abstract Background Joint lesions occur widespread in the Danish sow population and they are the most frequent cause for euthanasia. Clinically, it is generally impossible to differentiate between various types of non-inflammatory joint lesions. Consequently, it is often necessary to perform a post mortem examination in order to diagnose these lesions. A study was performed in order to examine the relation of abnormal gait and posture in sows with specific joint lesions, and thereby obtaining a clinical diagnostic tool, to be used by farmers and veterinarians for the evaluation of sows with joint problems. Methods The gait, posture and lesions in elbow- and knee joints of 60 randomly selected sows from one herd were scored clinically and pathologically. Associations between the scorings were estimated. Results The variables 'fore- and hind legs turned out' and 'stiff in front and rear' were associated with lesions in the elbow joint, and the variables 'hind legs turned out' and 'stiff in rear' were associated with lesions in the knee joint. Conclusion It was shown that specified gait and posture variables reflected certain joint lesions. However, further studies are needed to strengthen and optimize the diagnostic tool.

  7. [APPLICATION OF COMPRESSION MINI-SCREWS IN TREATMENT OF PATIENTS WITH INJURY OF ELBOW JOINT BONES].

    Science.gov (United States)

    Neverov, V A; Egorov, K S

    2015-01-01

    A case report presents the experience of application of compression pileateless mini-screws (Gerbert's screws) in treatment of intra-articular fractures, which formed the elbow joint (44 cases). There were performed 32 operations concerning fracture of head of radius, 10 operations on the occasion of fractures of distal section of the humerus and 2 operations on the coronoid process. Long-term treatment results were followed-up in 31 patients during more than 6 months. On basis of analysis of treatment results the authors made a conclusion that the application of mini-screws in case of bone fractures, which formed the elbow joint, allowed realization of stable osteosynthesis after anatomic reposition of articular surfaces, obtaining good anatomical and functional result and shortened the terms of patient's treatment.

  8. Medial Elbow Joint Space Increases With Valgus Stress and Decreases When Cued to Perform A Maximal Grip Contraction.

    Science.gov (United States)

    Pexa, Brett S; Ryan, Eric D; Myers, Joseph B

    2018-04-01

    Previous research indicates that the amount of valgus torque placed on the elbow joint during overhead throwing is higher than the medial ulnar collateral ligament (UCL) can tolerate. Wrist and finger flexor muscle activity is hypothesized to make up for this difference, and in vitro studies that simulated activity of upper extremity musculature, specifically the flexor digitorum superficialis and flexor carpi ulnaris, support this hypothesis. To assess the medial elbow joint space at rest, under valgus stress, and under valgus stress with finger and forearm flexor contraction by use of ultrasonography in vivo. Controlled laboratory study. Participants were 22 healthy males with no history of elbow dislocation or UCL injury (age, 21.25 ± 1.58 years; height, 1.80 ± 0.08 m; weight, 79.43 ± 18.50 kg). Medial elbow joint space was measured by use of ultrasonography during 3 separate conditions: at rest (unloaded), under valgus load (loaded), and with a maximal grip contraction under a valgus load (loaded-contracted) in both limbs. Participants lay supine with their arm abducted 90° and elbow flexed 30° with the forearm in full supination. A handgrip dynamometer was placed in the participants' hand to grip against during the contracted condition. Images were reduced in ImageJ to assess medial elbow joint space. A 2-way (condition × limb) repeated-measures analysis of variance and Cohen's d effect sizes were used to assess changes in medial elbow joint space. Post hoc testing was performed with a Bonferroni adjustment to assess changes within limb and condition. The medial elbow joint space was significantly larger in the loaded condition (4.91 ± 1.16 mm) compared with the unloaded condition (4.26 ± 1.23 mm, P space increases under a valgus load and then decreases when a maximal grip contraction is performed. This indicates that wrist and finger flexor muscle contraction may assist in limiting medial elbow joint space, a result similar to findings of previous

  9. Elbow helical axes of motion are not the same in physiologic and kinetic joint simulators.

    Science.gov (United States)

    Muriuki, Muturi G; Mohagheh-Motlagh, Amin; Smolinski, Patrick J; Miller, Mark Carl

    2012-08-31

    Physiologic and kinetic joint simulators have been widely used for investigations of joint mechanics. The two types of simulator differ in the way joint motion is achieved; through prescribed motions and/or forces in kinetic joint simulators and by tendon loads in physiologic joint simulators. These two testing modalities have produced important insights, as in elucidating the importance of soft tissue structures to joint stability. However, the equivalence of the modalities has not been tested. This study sequentially tested five cadaveric elbows using both a physiologic simulator and a robot/6DOF system. Using position data from markers on the humerus and ulna, we calculated and compared the helical axes of motion of the specimens as the elbows were flexed from full extension. Six step size increments were used in the helical axis calculation. Marker position data at each test's full extension and full flexion point were also used to calculate a datum (overall) helical axis. The angles between the datum axis and step-wise movements were computed and stored. Increasing step size monotonically decreased the variability and the average conical angle encompassing the helical axes; a repeated measures ANOVA using test type (robot or physiologic simulator) and step size found that both type and step caused statistically significant differences (p<0.001). The large changes in helical axis angle observed for small changes in elbow flexion angle, especially in the robot tests, are a caveat for investigators using similar control algorithms. Controllers may need to include increased joint compliance and/or C(1) continuity to reduce variability. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. 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

  11. Role of computed tomography in evaluation of osteochondritis dissecans of the elbow joint

    International Nuclear Information System (INIS)

    Park, Byung Lyul; Kim, Jeong Eun; Jee, Keum Nahn; Park, Yang Hee

    1995-01-01

    To evaluate the role of CT in early detection, location, and extent of osteochondritis dissecans (OCD) of the elbow joint. We reviewed surgically proved 27 cases of 22 patients with osteochondritis dissecans in elbow joint retrospectively. We compared simple x-ray (elbow AP and lateral) with CT on the basis of staging of OCD of talus by simple x-ray. The frequency of location was as follows: fourteen cases of capitellum, 5 cases of olecranon tip, 5 cases of medial epicondyle, 2 cases of trochlea, and 1 case of olecranon base. Among the 4 cases of normal finding on simple x-ray, CT showed 1 case each of stage I, II, III and IV OCD and among the 8 cases of stage I on simple x-ray, CT showed 2 cases of stage I, 1 case of stage II, and 5 cases of stage III. Among the 3 cases of stage II on simple x-ray, CT showed 1 case of stage II and 2 cases of stage III. Among the 5 cases of stage III on simple x-ray, CT showed 1 case of stage II, 2 cases of stage III, and 2 cases of stage IV, but it was difficult to detect the presence or absence of attachment between the articular cartilage of mother bone and osteochondral fragment CT was more accurate than simple x-ray in detection of loose body. CT might be an useful imaging modality in early diagnosis of OCD and evaluation of its anatomic location and extent in elbow joint

  12. Mechanical Simulation of the Extension and Flexion of the Elbow Joint in Rehabilitation

    Directory of Open Access Journals (Sweden)

    Iman Vahdat

    2013-01-01

    Full Text Available Objective: The goal of the present study was to improve the extension and flexion of the elbow joint for rehabilitation purposes, in terms of energy dissipation and of injuries caused by stress imposed on connective tissue by exercise equipments during force transfer , by investigation of viscoelastic property variations during change in speed of motion. Materials & Methods: A sample of five men without any previous neuromuscular impairment of the elbow joint was chosen by the BMI factor. The passive continuous motion test (CPM was performed by the CYBEX isokinetic system in the extension and flexion movements of the elbow joint of the left hand, at 4 different speeds (15, 45, 75 and120 Deg/s during 5 consecutive cycles at the range of motion of about 0 to 130 degrees. The experimental data was exported to the MATLAB software for analysis. In order to determine viscoelastic property effects and biomechanical parameters, we used a passive viscoelastic mechanical model constructed by 3 elements for simulation, and also we used the curve fitting method to derive the elastic and viscose coefficients for the model.,. Results: Results of experiments showed that by increasing the speed of motion, the value of work done, hysteresis and elastic coefficient increased and the value of viscose coefficient decreased. Also, it appeared that by increasing the speed of motion, the effect of viscose resistance on the passive torque curves increased. In addition, there was significant correlation between the action of the mechanical model and the action of the concerned limbs, during the movement. Conclusion: It was concluded that in order to improve motion and to reduce imposed risks and injuries to joints and limbs, rehabilitation exercises better be performed at lower speeds and with rehabilitation equipments supported by viscoelastic resistant force.

  13. 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

  14. Kinematics and Dynamics Analysis of a 3-DOF Upper-Limb Exoskeleton with an Internally Rotated Elbow Joint

    Directory of Open Access Journals (Sweden)

    Xin Wang

    2018-03-01

    Full Text Available The contradiction between self-weight and load capacity of a power-assisted upper-limb exoskeleton for material hanging is unresolved. In this paper, a non-anthropomorphic 3-degree of freedom (DOF upper-limb exoskeleton with an internally rotated elbow joint is proposed based on an anthropomorphic 5-DOF upper-limb exoskeleton for power-assisted activity. The proposed 3-DOF upper-limb exoskeleton contains a 2-DOF shoulder joint and a 1-DOF internally rotated elbow joint. The structural parameters of the 3-DOF upper-limb exoskeleton were determined, and the differences and singularities of the two exoskeletons were analyzed. The workspace, the joint torques and the power consumption of two exoskeletons were analyzed by kinematics and dynamics, and an exoskeleton prototype experiment was performed. The results showed that, compared with a typical anthropomorphic upper-limb exoskeleton, the non-anthropomorphic 3-DOF upper-limb exoskeleton had the same actual workspace; eliminated singularities within the workspace; improved the elbow joint force situation; and the maximum elbow joint torque, elbow external-flexion/internal-extension and shoulder flexion/extension power consumption were significantly reduced. The proposed non-anthropomorphic 3-DOF upper-limb exoskeleton can be applied to a power-assisted upper-limb exoskeleton in industrial settings.

  15. 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 ...

  16. Kinematics and Dynamics Analysis of a 3-DOF Upper-Limb Exoskeleton with an Internally Rotated Elbow Joint

    OpenAIRE

    Xin Wang; Qiuzhi Song; Xiaoguang Wang; Pengzhan Liu

    2018-01-01

    The contradiction between self-weight and load capacity of a power-assisted upper-limb exoskeleton for material hanging is unresolved. In this paper, a non-anthropomorphic 3-degree of freedom (DOF) upper-limb exoskeleton with an internally rotated elbow joint is proposed based on an anthropomorphic 5-DOF upper-limb exoskeleton for power-assisted activity. The proposed 3-DOF upper-limb exoskeleton contains a 2-DOF shoulder joint and a 1-DOF internally rotated elbow joint. The structural parame...

  17. Technical guide to evaluate upper limb joints (shoulder, elbow and wrist) by ultrasound

    International Nuclear Information System (INIS)

    Obregon Baez, Luis Rafael

    2014-01-01

    A guideline to follow is offered to radiologists and residents of radiology service of medical imaging, when evaluating by ultrasound the shoulder joints, elbow, wrist. The importance to performing of musculoskeletal ultrasound by its pathology variable is established. The use of appropriate equipment and effective application of the techniques exposed of echography exploration have made enable the valuation of many pathologies with high sensitivity and specificity. The echography has been the musculoskeletal imaging technique that more rapidly has evolved. Currently, this technique has been replaced by magnetic resonance imaging in various clinical fields and also serves as a complement to other techniques. Exposed techniques have been of great benefit for radiologists medical and residents, obtaining with its use a quick guide for the realization of upper limb musculoskeletal ultrasounds. The appropriate and easy techniques are better known for the evaluation of these structures, and so document both sports injuries, as joint and rheumatic diseases [es

  18. Evaluation of Spasticity Variations at the Elbow Joint of CVA Patients According to the Biomechanical Indices

    Directory of Open Access Journals (Sweden)

    Nima Soleimanzadeh-Ardabili

    2013-10-01

    Full Text Available Objective: The goal of the present study was to evaluate spasticity variations by increase the velocity of motion and MAS value in the elbow flexor and extensor muscles at extension and flexion of CVA patients elbow joint according to the biomechanical indices. Materials & Methods: Fifteen adult patients with a history of stroke and upper-extremity spasticity volunteered to participate in this study and fifteen healthy subjects were recruited in order to establish the control group. The degree of spasticity was evaluated for each patient using the MAS. CPM tests were imposed in elbow extension and flexion and the biomechanical indices were calculated at each of the following velocities: 15, 45, 75 and 120 º/s. Results: It seemed a regular increment of the viscoelastic and viscose stiffness indices by increasing the velocity of motion and the rate of MAS value in both extension and flexion in all test groups and also there was significant regular increment of elastic stiffness index by increasing the velocity in both extension and flexion between the control group and group 1 and also irregular increment between group1 and group 2 and 3 and also the effect of mentioned index was decreased at higher level of MAS. Conclusion: it seemed the more effect of elastic stiffness in spasticity in CVA patients at lower level of MAS and more effect of viscose stiffness in higher level of MAS and also results showed the increment of viscose stiffness by increment of speed of motion and the rate of MAS.

  19. Dynamic Analysis of the Abnormal Isometric Strength Movement Pattern between Shoulder and Elbow Joint in Patients with Hemiplegia.

    Science.gov (United States)

    Liu, Yali; Hong, Yuezhen; Ji, Linhong

    2018-01-01

    Patients with hemiplegia usually have weak muscle selectivity and usually perform strength at a secondary joint (secondary strength) during performing a strength at one joint (primary strength). The abnormal strength pattern between shoulder and elbow joint has been analyzed by the maximum value while the performing process with strength changing from 0 to maximum then to 0 was a dynamic process. The objective of this study was to develop a method to dynamically analyze the strength changing process. Ten patients were asked to perform four group asks (maximum and 50% maximum voluntary strength in shoulder abduction, shoulder adduction, elbow flexion, and elbow extension). Strength and activities from seven muscles were measured. The changes of secondary strength had significant correlation with those of primary strength in all tasks ( R > 0.76, p strength ( R > 0.4, p strength pattern (all p strength pattern. The muscles, deltoid muscles, biceps brachii, triceps brachii, and brachioradialis, much influenced the stereotyped movement pattern between shoulder and elbow joint.

  20. Dynamic Analysis of the Abnormal Isometric Strength Movement Pattern between Shoulder and Elbow Joint in Patients with Hemiplegia

    Directory of Open Access Journals (Sweden)

    Yali Liu

    2018-01-01

    Full Text Available Patients with hemiplegia usually have weak muscle selectivity and usually perform strength at a secondary joint (secondary strength during performing a strength at one joint (primary strength. The abnormal strength pattern between shoulder and elbow joint has been analyzed by the maximum value while the performing process with strength changing from 0 to maximum then to 0 was a dynamic process. The objective of this study was to develop a method to dynamically analyze the strength changing process. Ten patients were asked to perform four group asks (maximum and 50% maximum voluntary strength in shoulder abduction, shoulder adduction, elbow flexion, and elbow extension. Strength and activities from seven muscles were measured. The changes of secondary strength had significant correlation with those of primary strength in all tasks (R>0.76, p0.4, p<0.01. Deltoid muscles, biceps brachii, triceps brachii, and brachioradialis had significant influences on the abnormal strength pattern (all p<0.01. The dynamic method was proved to be efficient to analyze the different influences of muscles on the abnormal strength pattern. The muscles, deltoid muscles, biceps brachii, triceps brachii, and brachioradialis, much influenced the stereotyped movement pattern between shoulder and elbow joint.

  1. Application of rhenium 186 radiosynovectomy in elbow diffuse pigmented villonodular synovitis: Case report with multiple joint involvement

    International Nuclear Information System (INIS)

    Koca, Go Khan; Ozsoy, Ha Kan; Atilgan, Hasan Ikbal; Demirel, Koray; Dincel, Veysel Ercan; Korkmaz, Meliha

    2012-01-01

    After surgical therapy of diffuse pigmented villonodular synovitis (DPVNS), recurrence is seen in almost half of the patients. The effectiveness of radiosynovectomy (RSV)in preventing recurrence and complaints of DPVNS is well known. Elbow involvement in DPVNS is a very rare condition; therefore, RSV in elbow hasn't been experienced widely. The aim of this case report is to show the effectiveness of RSV with rhenium 186 (Re 186)sulfide colloid. We applied Re 186 sulfide colloid to the elbow joint of DPVNS patients six weeks after arthroscopic synovectomy. As a result, the patient did not have any complaints, and our findings are compatible with residue or recurrence on magnetic resonance imaging (MRI)in sixth and twentieth month controls after administration. We concluded that Re 186 is an effective adjuvant therapy for the prevention of recurrence and complaints

  2. Intra-articular Entrapment of Medial Epicondyle Fracture Fragment in Elbow Joint Dislocation Causing Ulnar Neuropraxia: A Case Report

    Directory of Open Access Journals (Sweden)

    Syed J

    2017-03-01

    Full Text Available Traumatic elbow dislocations in children are rare but most of them are complex dislocations, and in such dislocations, medial humerus epicondyle fractureis the most common associated injury. Fracture incarceration in the elbow joint occurs in 5-18% of medial humerus epicondyle fractures but ulnar neuropraxia is very rare. Open reduction internal fixation is indicated in medial humerus epicondyle fracture with fracture incarceration, ulnar neuropraxia, marked instability or open fracture. Operative treatment options include fragment excision and sutures, closed or open reduction and Kirschner wire fixation, open reduction and suture fixation, open reduction and smooth pin fixation, and open reduction and screw fixation. However, ulnar nerve transposition is debatable as good outcome had been reported with and without nerve transposition. We report a case of a 13-year old boy, who presented with right elbow dislocation and intra-articular entrapment of medial humerus epicondyle fracture fragment, complicated with sensory ulnar neuropraxia, following a fall onto his right outstretched hand in a motor vehicle accident. The elbow joint was reduced using close manipulative reduction but the fracture fragment remained entrapped post-reduction. The patient then underwent open reduction and screw fixation of the medial humerus epicondyle fracture without ulnar nerve transposition. He had good functional outcome six weeks after surgical intervention, with complete recovery of ulnar neuropraxia six months later. Currently, he is doing well at school and is active with his sporting activity.

  3. Translational control of a graphically simulated robot arm by kinematic rate equations that overcome elbow joint singularity

    Science.gov (United States)

    Barker, L. K.; Houck, J. A.; Carzoo, S. W.

    1984-01-01

    An operator commands a robot hand to move in a certain direction relative to its own axis system by specifying a velocity in that direction. This velocity command is then resolved into individual joint rotational velocities in the robot arm to effect the motion. However, the usual resolved-rate equations become singular when the robot arm is straightened. To overcome this elbow joint singularity, equations were developed which allow continued translational control of the robot hand even though the robot arm is (or is nearly) fully extended. A feature of the equations near full arm extension is that an operator simply extends and retracts the robot arm to reverse the direction of the elbow bend (difficult maneuver for the usual resolved-rate equations). Results show successful movement of a graphically simulated robot arm.

  4. Olecranon orientation as an indicator of elbow joint angle in the stance phase, and estimation of forelimb posture in extinct quadruped animals.

    Science.gov (United States)

    Fujiwara, Shin-Ichi

    2009-09-01

    Reconstruction of limb posture is a challenging task in assessing functional morphology and biomechanics of extinct tetrapods, mainly because of the wide range of motions possible at each limb joint and because of our poor knowledge of the relationship between posture and musculoskeletal structure, even in the extant taxa. This is especially true for extinct mammals such as the desmostylian taxa Desmostylus and Paleoparadoxia. This study presents a procedure that how the elbow joint angles of extinct quadruped mammals can be inferred from osteological characteristics. A survey of 67 dried skeletons and 113 step cycles of 32 extant genera, representing 25 families and 13 orders, showed that the olecranon of the ulna and the shaft of the humerus were oriented approximately perpendicular to each other during the stance phase. At this angle, the major extensor muscles maximize their torque at the elbow joint. Based on this survey, I suggest that olecranon orientation can be used for inferring the elbow joint angles of quadruped mammals with prominent olecranons, regardless of taxon, body size, and locomotor guild. By estimating the elbow joint angle, it is inferred that Desmostylus would have had more upright forelimbs than Paleoparadoxia, because their elbow joint angles during the stance phase were approximately 165 degrees and 130 degrees , respectively. Difference in elbow joint angles between these two genera suggests possible differences in stance and gait of these two mammals. Copyright 2009 Wiley-Liss, Inc.

  5. 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

  6. Continuous Wavelet Transform Analysis of Surface Electromyography for Muscle Fatigue Assessment on the Elbow Joint Motion

    Directory of Open Access Journals (Sweden)

    Triwiyanto Triwiyanto

    2017-01-01

    Full Text Available Studying muscle fatigue plays an important role in preventing the risks associated with musculoskeletal disorders. The effect of elbow-joint angle on time-frequency parameters during a repetitive motion provides valuable information in finding the most accurate position of the angle causing muscle fatigue. Therefore, the purpose of this study is to analyze the effect of muscle fatigue on the spectral and time-frequency domain parameters derived from electromyography (EMG signals using the Continuous Wavelet Transform (CWT. Four male participants were recruited to perform a repetitive motion (flexion and extension movements from a non-fatigue to fatigue condition. EMG signals were recorded from the biceps muscle. The recorded EMG signals were then analyzed offline using the complex Morlet wavelet. The time-frequency domain data were analyzed using the time-averaged wavelet spectrum (TAWS and the Scale-Average Wavelet Power (SAWP parameters. The spectral domain data were analyzed using the Instantaneous Mean Frequency (IMNF and the Instantaneous Mean Power Spectrum (IMNP parameters. The index of muscle fatigue was observed by calculating the increase of the IMNP and the decrease of the IMNF parameters. After performing a repetitive motion from non-fatigue to fatigue condition, the average of the IMNF value decreased by 15.69% and the average of the IMNP values increased by 84%, respectively. This study suggests that the reliable frequency band to detect muscle fatigue is 31.10-36.19Hz with linear regression parameters of 0.979mV^2Hz^(-1 and 0.0095mV^2Hz^(-1 for R^2 and slope, respectively.

  7. 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

  8. Analysis and Modelling of the Structural Components of the Elbow Joint

    OpenAIRE

    Romero Rey, Gregorio; Martínez Muneta, María Luisa; Gómez, M.; Mera Sánchez De Pedro, José Manuel

    2013-01-01

    A recent application of computer simulation is its use for the human body, which resembles a mechanism that is complemented by torques in the joints that are caused by the action of muscles and tendons. Among others, the application can be used to provide training in surgical procedures or to learn how the body works. Some of the other applications are to make a biped walk upright, to build robots that are designed on the human body or to make prostheses or robot arms to perform specific task...

  9. 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.

  10. 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

  11. 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.

  12. 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 ...

  13. Bio-mechanical Analysis of Human Joints and Extension of the Study to Robot

    OpenAIRE

    S. Parasuraman; Ler Shiaw Pei

    2008-01-01

    In this paper, the bio-mechanical analysis of human joints is carried out and the study is extended to the robot manipulator. This study will first focus on the kinematics of human arm which include the movement of each joint in shoulder, wrist, elbow and finger complexes. Those analyses are then extended to the design of a human robot manipulator. A simulator is built for Direct Kinematics and Inverse Kinematics of human arm. In the simulation of Direct Kinematics, the human joint angles can...

  14. Investigating reduction of dimensionality during single-joint elbow movements: a case study on muscle synergies

    Directory of Open Access Journals (Sweden)

    Enrico eChiovetto

    2013-02-01

    Full Text Available A long standing hypothesis in the neuroscience community is that the CNS generates the muscle activities to accomplish movements by combining a relatively small number of stereotyped patterns of muscle activations, often referred to as muscle synergies. Different definitions of synergies have been given in the literature. The most well-known are those of synchronous, time-varying and temporal muscle synergies. Each one of them is based on a different mathematical model used to factor some EMG array recordings collected during the execution of variety of motor tasks into a well-determined spatial, temporal or spatio-temporal organization. This plurality of definitions and their separate application to complex tasks have so far complicated the comparison and interpretation of the results obtained across studies, and it has always remained unclear why and when one synergistic decomposition should be preferred to another one. By using well-understood motor tasks such as elbow flexions and extensions, we aimed in this study to clarify better what are the motor features characterized by each kind of decomposition and to assess whether, when and why one of them should be preferred to the others. We found that three temporal synergies, each one of them accounting for specific temporal phases of the movements could account for the majority of the data variation. Similar performances could be achieved by two synchronous synergies, encoding the agonist-antagonist nature of the two muscles considered, and by two time-varying muscle synergies, encoding each one a task-related feature of the elbow movements, specifically their direction. Our findings support the notion that each EMG decomposition provides a set of well-interpretable muscle synergies, identifying reduction of dimensionality in different aspects of the movements. Taken together, our findings suggest that all decompositions are not equivalent and may imply different neurophysiological substrates

  15. Movement-related and steady-state electromyographic activity of human elbow flexors in slow transition movements between two equilibrium states.

    Science.gov (United States)

    Tal'nov, A N; Cherkassky, V L; Kostyukov, A I

    1997-08-01

    The electromyograms were recorded in healthy human subjects by surface electrodes from the mm. biceps brachii (caput longum et. brevis), brachioradialis, and triceps brachii (caput longum) during slow transition movements in elbow joint against a weak extending torque. The test movements (flexion transitions between two steady-states) were fulfilled under visual control through combining on a monitor screen a signal from a joint angle sensor with a corresponding command generated by a computer. Movement velocities ranged between 5 and 80 degrees/s, subjects were asked to move forearm without activation of elbow extensors. Surface electromyograms were full-wave rectified, filtered and averaged within sets of 10 identical tests. Amplitudes of dynamic and steady-state components of the electromyograms were determined in dependence on a final value of joint angle, slow and fast movements were compared. An exponential-like increase of dynamic component was observed in electromyograms recorded from m. biceps brachii, the component had been increased with movement velocity and with load increment. In many experiments a statistically significant decrease of static component could be noticed within middle range of joint angles (40-60 degrees) followed by a well expressed increment for larger movements. This pattern of the static component in electromyograms could vary in different experiments even in the same subjects. A steady discharge in m. brachioradialis at ramp phase has usually been recorded only under a notable load. Variable and quite often unpredictable character of the static components of the electromyograms recorded from elbow flexors in the transition movements makes it difficult to use the equilibrium point hypothesis to describe the central processes of movement. It has been assumed that during active muscle shortening the dynamic components in arriving efferent activity should play a predominant role. A simple scheme could be proposed for transition to a

  16. 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 ...

  17. Relationship Between the Range of Motion and Isometric Strength of Elbow and Shoulder Joints and Ball Velocity in Women Team Handball Players.

    Science.gov (United States)

    Schwesig, René; Hermassi, Souhail; Wagner, Herbert; Fischer, David; Fieseler, Georg; Molitor, Thomas; Delank, Karl-Stefan

    2016-12-01

    Schwesig, R, Hermassi, S, Wagner, H, Fischer, D, Fieseler, G, Molitor, T, and Delank, K-S. Relationship between the range of motion and isometric strength of elbow and shoulder joints and ball velocity in women team handball players. J Strength Cond Res 30(12): 3428-3435, 2016-The aims of this study were to investigate relationships between isometric strength and range of motion (ROM) of shoulder and elbow joints and compare 2 different team handball throwing techniques in women team handball. Twenty highly experienced women team handball players (age: 20.7 ± 2.9 years; body mass: 68.4 ± 6.0 kg; and height: 1.74 ± 0.06 m) participated in this study. The isometric strength (hand-held dynamometer) and ROM (goniometer) of shoulder and elbow joints were measured at the beginning of the preseasonal training. After clinical examination, the subjects performed 3 standing throws with run-up (10 m) and 3 jump throws over a hurdle (0.20 m). The mean ball velocity was calculated from 3 attempts and measured using a radar gun. The results showed that the ball velocity of the standing throw with run-up (vST) was significantly higher than that of the jump throw (vJT) (25.5 ± 1.56 vs. 23.2 ± 1.31 m·s; p handball players.

  18. Radiographic and tomographic study of the elbow joint in dogs; Avaliacao morfologica e morfometrica da articulacao umerorradioulnar em caes atraves de exames radiograficos e por tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    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., E-mail: anacarol@usp.br [Universidade de Sao Paulo (FMVZ/USP), SP (Brazil). Faculdade de Medicina Veterinaria e Zootecnia

    2017-02-15

    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)

  19. Multiple linear regression to develop strength scaled equations for knee and elbow joints based on age, gender and segment mass

    DEFF Research Database (Denmark)

    D'Souza, Sonia; Rasmussen, John; Schwirtz, Ansgar

    2012-01-01

    and valuable ergonomic tool. Objective: To investigate age and gender effects on the torque-producing ability in the knee and elbow in older adults. To create strength scaled equations based on age, gender, upper/lower limb lengths and masses using multiple linear regression. To reduce the number of dependent...... flexors. Results: Males were signifantly stronger than females across all age groups. Elbow peak torque (EPT) was better preserved from 60s to 70s whereas knee peak torque (KPT) reduced significantly (PGender, thigh mass and age best...... predicted KPT (R2=0.60). Gender, forearm mass and age best predicted EPT (R2=0.75). Good crossvalidation was established for both elbow and knee models. Conclusion: This cross-sectional study of muscle strength created and validated strength scaled equations of EPT and KPT using only gender, segment mass...

  20. Electrical Properties of PPy-Coated Conductive Fabrics for Human Joint Motion Monitoring

    Directory of Open Access Journals (Sweden)

    Jiyong Hu

    2016-03-01

    Full Text Available Body motion signals indicate several pathological features of the human body, and a wearable human motion monitoring system can respond to human joint motion signal in real time, thereby enabling the prevention and treatment of some diseases. Because conductive fabrics can be well integrated with the garment, they are ideal as a sensing element of wearable human motion monitoring systems. This study prepared polypyrrole conductive fabric by in situ polymerization, and the anisotropic property of the conductive fabric resistance, resistance–strain relationship, and the relationship between resistance and the human knee and elbow movements are discussed preliminarily.

  1. Isometric torque-angle relationship and movement-related activity of human elbow flexors: implications for the equilibrium-point hypothesis.

    Science.gov (United States)

    Hasan, Z; Enoka, R M

    1985-01-01

    Since the moment arms for the elbow-flexor muscles are longest at intermediate positions of the elbow and shorter at the extremes of the range of motion, it was expected that the elbow torque would also show a peak at an intermediate angle provided the activity of the flexor muscles remained constant. We measured the isometric elbow torque at different elbow angles while the subject attempted to keep constant the electromyographic activity (EMG) of the brachioradialis muscle. The torque-angle relationship thus obtained exhibited a peak, as expected, but the shape of the relationship varied widely among subjects. This was due in part to differences in the variation of the biceps brachii EMG with elbow angle among the different subjects. The implications of these observations for the equilibrium-point hypothesis of movement were investigated as follows. The subject performed elbow movements in the presence of an external torque (which tended to extend the elbow joint) provided by a weight-and-pulley arrangement. We found in the case of flexion movements that invariably there was a transient increase in flexor EMG, as would seem necessary for initiating the movement. However, the steady-state EMG after the movement could be greater or less than the pre-movement EMG. Specifically, the least flexor EMG was required for equilibrium in the intermediate range of elbow angles, compared to the extremes of the range of motion. The EMG-angle relationship, however, varied with the muscle and the subject. The observation that the directions of change in the transient and the steady-state EMG are independent of each other militates against the generality of the equilibrium-point hypothesis. However, a form of the hypothesis which includes the effects of the stretch reflex is not contradicted by this observation.

  2. Research on a Nonlinear Robust Adaptive Control Method of the Elbow Joint of a Seven-Function Hydraulic Manipulator Based on Double-Screw-Pair Transmission

    Directory of Open Access Journals (Sweden)

    Gaosheng Luo

    2014-01-01

    Full Text Available A robust adaptive control method with full-state feedback is proposed based on the fact that the elbow joint of a seven-function hydraulic manipulator with double-screw-pair transmission features the following control characteristics: a strongly nonlinear hydraulic system, parameter uncertainties susceptible to temperature and pressure changes of the external environment, and unknown outer disturbances. Combined with the design method of the back-stepping controller, the asymptotic stability of the control system in the presence of disturbances from uncertain systematic parameters and unknown external disturbances was demonstrated using Lyapunov stability theory. Based on the elbow joint of the seven-function master-slave hydraulic manipulator for the 4500 m Deep-Sea Working System as the research subject, a comparative study was conducted using the control method presented in this paper for unknown external disturbances. Simulations and experiments of different unknown outer disturbances showed that (1 the proposed controller could robustly track the desired reference trajectory with satisfactory dynamic performance and steady accuracy and that (2 the modified parameter adaptive laws could also guarantee that the estimated parameters are bounded.

  3. Neuromuscular properties of different spastic human joints vary systematically.

    Science.gov (United States)

    Mirbagheri, M M; Settle, K

    2010-01-01

    We quantified the mechanical abnormalities of the spastic wrist in chronic stroke survivors, and determined whether these findings were representative of those recorded at the elbow and ankle joints. System identification techniques were used to characterize the mechanical abnormalities of these joints and to identify the contribution of intrinsic and reflex stiffness to these abnormalities. Modulation of intrinsic and reflex stiffness with the joint angle was studied by applying PRBS perturbations to the joints at different joint angles over the range of motion. Age-matched healthy subjects were used as control.

  4. Design and characterization of a wearable macrobending fiber optic sensor for human joint angle determination

    Science.gov (United States)

    Silva, Ana S.; Catarino, André; Correia, Miguel V.; Frazão, Orlando

    2013-12-01

    The work presented here describes the development and characterization of intensity fiber optic sensor integrated in a specifically designed piece of garment to measure elbow flexion. The sensing head is based on macrobending incorporated in the garment, and the increase of curvature number was studied in order to investigate which scheme provided a good result in terms of sensitivity and repeatability. Results showed the configuration that assured a higher sensitivity (0.644 dBm/deg) and better repeatability was the one with four loops. Ultimately, this sensor can be used for rehabilitation purposes to monitor human joint angles, namely, elbow flexion on stroke survivors while performing the reach functional task, which is the most common upper-limb human gesture.

  5. Preference and torque asymmetry for elbow joint Preferência e assimetria de torque na articulação do cotovelo

    Directory of Open Access Journals (Sweden)

    Felipe Pivetta Carpes

    2012-06-01

    Full Text Available Extensively unilateral recruitment for daily activities may determine performance asymmetries in favor of the preferred side eliciting functional adaptation. Our study evaluated asymmetries in elbow torque output between preferred and non-preferred limbs. Eighteen subjects performed maximal elbow flexor and extensor isometric contractions at five different elbow joint angles (0º, 30º, 60º, 90º, 120º and five different angular velocities (60, 120, 180, 240, 300º.s-1 on an isokinetic dynamometer. Higher flexor torque in favor of preferred arm was observed at 90º of flexion (pO frequente recrutamento unilateral de membros superiores pode determinar assimetrias de desempenho em favor do lado preferido, resultando em adaptação funcional. Assimetrias no torque gerado pelos músculos do cotovelo entre o membro preferido e não-preferido foram avaliadas. Dezoito sujeitos realizaram contrações máximas de flexo-extensão do cotovelo em cinco ângulos articulares (0º, 30º, 60º, 90º, 120º e cinco velocidades angulares (60, 120, 180, 240, 300º.s-1 em um dinamômetro isocinético. Torque flexor mais elevado em favor do lado preferido foi encontrado no ângulo de 90º (p<0,05, que também correspondeu ao ângulo de maior torque (p<0,05. O fato de o ângulo articular determinar assimetrias no torque (enquanto a velocidade angular não sugere que o recrutamento preferencial dos flexores do cotovelo em um ângulo de 90º nas tarefas da vida diária que requerem força elevada é responsável pela assimetria. Adaptação funcional a estímulos frequentes nesse ângulo articular pode explicar esses resultados em sujeitos saudáveis.

  6. 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

  7. 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.

  8. 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.

  9. Schorzenia w obrębie stawu łokciowego. Łokieć teniststy - schorzenie i współczesne metody leczenia = Diseases within the elbow joint. Tennis elbow - condition and modern methods of treatment

    Directory of Open Access Journals (Sweden)

    Joanna Siminska

    2015-04-01

    lateral epicondyle of the humerus, commonly referred to as "tennis elbow". A patient with this condition shall be reported with felt pain, which is caused by degeneration of the extensor tendons in the area. Also discusses the most common injuries that affect the elbow joint. Now we can distinguish a number of treatments for diseases of inflammation of the lateral epicondyle of the humerus, among others, consisting of injections space causing pain: full blood, steroids and washed platelets. In addition, we can also be used with shock wave therapy and treatment coblation topaz. Keywords: tennis elbow, treatment, humeral lateral epicondyle aches and pains.

  10. 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

  11. [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.

  12. 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;

  13. 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;

  14. The volume of the human knee joint.

    Science.gov (United States)

    Matziolis, Georg; Roehner, Eric; Windisch, Christoph; Wagner, Andreas

    2015-10-01

    Despite its clinical relevance, particularly in septic knee surgery, the volume of the human knee joint has not been established to date. Therefore, the objective of this study was to determine knee joint volume and whether or not it is dependent on sex or body height. Sixty-one consecutive patients (joints) who were due to undergo endoprosthetic joint replacement were enrolled in this prospective study. During the operation, the joint volume was determined by injecting saline solution until a pressure of 200 mmHg was achieved in the joint. The average volume of all knee joints was 131 ± 53 (40-290) ml. The volume was not found to be dependent on sex, but it was dependent on the patients' height (R = 0.312, p = 0.014). This enabled an estimation of the joint volume according to V = 1.6 height - 135. The considerable inter-individual variance of the knee joint volume would suggest that it should be determined or at least estimated according to body height if the joint volume has consequences for the diagnostics or therapy of knee disorders.

  15. The effect of sustained low-intensity contractions on supraspinal fatigue in human elbow flexor muscles

    DEFF Research Database (Denmark)

    Søgaard, Karen; Gandevia, Simon C; Todd, Gabrielle

    2006-01-01

    Subjects quickly fatigue when they perform maximal voluntary contractions (MVCs). Much of the loss of force is from processes within muscle (peripheral fatigue) but some occurs because voluntary activation of the muscle declines (central fatigue). The role of central fatigue during submaximal...... contractions is not clear. This study investigated whether central fatigue developed during prolonged low-force voluntary contractions. Subjects (n=9) held isometric elbow flexions of 15% MVC for 43 min. Voluntary activation was measured during brief MVCs every 3 min. During each MVC, transcranial magnetic...... several minutes while MVC torque only returned to approximately 85% baseline. The resting twitch showed no recovery. Thus, as well as fatigue in the muscle, the prolonged low-force contraction produced progressive central fatigue, and some of this impairment of the subjects' ability to drive the muscle...

  16. Does well maintained graft provide consistent return to play after medial ulnar collateral ligament reconstruction of the elbow joint in elite baseball players?

    Science.gov (United States)

    Park, Jin-Young; Oh, Kyung-Soo; Bahng, Seung-Chul; Chung, Seok-Won; Choi, Jin-Ho

    2014-06-01

    Several studies have reported the clinical outcomes of medial ulnar collateral ligament (MUCL) reconstruction of the elbow joint in throwing athletes, including the rate of return to sports. However, little has been known about the imaging outcomes after MUCL reconstruction. The aim of this study is to report the clinical and imaging outcomes after MUCL reconstruction using figure of eight fashion in the elite and professional baseball players. This study included 17 baseball players, who underwent MUCL reconstruction between July 2007 and May 2010. The average follow-up period was 48.6 months. Imaging assessment consisted of preoperative plain and stress radiographs, magnetic resonance imaging, and postoperative serial ultrasonography. The clinical assessments were composed of visual analogue scale (VAS) for pain, range of motion, and the Conway scale. The mean VAS score was 6.4 (range, 3 to 8) preoperatively and 2.2 (range, 0 to 4) postoperatively (p returned to sports at the same or higher level compared to preinjury. Serial ultrasonography revealed well-maintained grafts at 3 and 12 months in all of the players. Five out of 17 players showed decreased echogenecity in the common flexor tendon at 3 months, which was considered as remaining tissue swelling and resolved completely at 12 months. All grafts are well-maintained until 12-months based on the ultrasonographic findings, although only 53% of the players returned to preinjury level.

  17. 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.

  18. 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.)

  19. 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.

  20. Simultaneous and Continuous Estimation of Shoulder and Elbow Kinematics from Surface EMG Signals

    Directory of Open Access Journals (Sweden)

    Qin Zhang

    2017-05-01

    Full Text Available In this paper, we present a simultaneous and continuous kinematics estimation method for multiple DoFs across shoulder and elbow joint. Although simultaneous and continuous kinematics estimation from surface electromyography (EMG is a feasible way to achieve natural and intuitive human-machine interaction, few works investigated multi-DoF estimation across the significant joints of upper limb, shoulder and elbow joints. This paper evaluates the feasibility to estimate 4-DoF kinematics at shoulder and elbow during coordinated arm movements. Considering the potential applications of this method in exoskeleton, prosthetics and other arm rehabilitation techniques, the estimation performance is presented with different muscle activity decomposition and learning strategies. Principle component analysis (PCA and independent component analysis (ICA are respectively employed for EMG mode decomposition with artificial neural network (ANN for learning the electromechanical association. Four joint angles across shoulder and elbow are simultaneously and continuously estimated from EMG in four coordinated arm movements. By using ICA (PCA and single ANN, the average estimation accuracy 91.12% (90.23% is obtained in 70-s intra-cross validation and 87.00% (86.30% is obtained in 2-min inter-cross validation. This result suggests it is feasible and effective to use ICA (PCA with single ANN for multi-joint kinematics estimation in variant application conditions.

  1. Myofibroblast Upregulators are Elevated in Joint Capsules in Posttraumatic Contractures

    OpenAIRE

    Hildebrand, Kevin A.; Zhang, Mei; Hart, David A.

    2007-01-01

    We hypothesized specific growth factors are increased in the elbow capsules of patients with post traumatic elbow contractures. A model of surgically induced joint contracture in rabbit knees was developed to study the growth factor expression in joint contractures. This study demonstrates this model mimics the human condition and analyzes how the growth factor levels decrease with time in rabbit knees with contractures. Reverse transcription polymerase chain reaction was used to measure mRNA...

  2. 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.

  3. 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.

  4. 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.

  5. 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...

  6. 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.

  7. 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.

  8. 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 ...

  9. 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 ...

  10. 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 ...

  11. 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 ...

  12. Magneto-therapy of human joint cartilage.

    Science.gov (United States)

    Wierzcholski, Krzysztof; Miszczak, Andrzej

    2017-01-01

    The topic of the present paper concerns the human joint cartilage therapy performed by the magnetic induction field. There is proved the thesis that the applied magnetic field for concrete cartilage illness should depend on the proper relative and concrete values of applied magnetic induction, intensity as well the time of treatment duration. Additionally, very important are frequencies and amplitudes of magnetic field as well as magnetic permeability of the synovial fluid. The research methods used in this paper include: magnetic induction field produced by a new Polish and German magneto electronic devices for the therapy of human joint cartilage diseases, stationary and movable magnetic applicators, magnetic bandage, ferrofluid injections, author's experience gained in Germany research institutes and practical results after measurements and information from patients. The results of this paper concern concrete parameters of time dependent electro-magnetic field administration during the joint cartilage therapy duration and additionally concern the corollaries which are implied from reading values gained on the magnetic induction devices. The main conclusions obtained in this paper are as follows: Time dependent magnetic induction field increases the dynamic viscosity of movable synovial fluid and decreases symptoms of cartilage illness for concrete intensity of magnetic field and concrete field line architecture. The ferrofluid therapy and phospholipids bilayer simultaneously with the administrated external electromagnetic field, increases the dynamic viscosity of movable synovial fluid.

  13. 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...

  14. hairy elbows

    Indian Academy of Sciences (India)

    10Human Developmental Genetics, Institute Pasteur, Paris, 75015, France. 11St George's Hospital ... breathing, with a history of cyanotic episodes during sleep, and a sleep study ... testing and mitochondrial DNA sequencing. Several genes.

  15. Finite element analysis of human joints

    Energy Technology Data Exchange (ETDEWEB)

    Bossart, P.L.; Hollerbach, K.

    1996-09-01

    Our work focuses on the development of finite element models (FEMs) that describe the biomechanics of human joints. Finite element modeling is becoming a standard tool in industrial applications. In highly complex problems such as those found in biomechanics research, however, the full potential of FEMs is just beginning to be explored, due to the absence of precise, high resolution medical data and the difficulties encountered in converting these enormous datasets into a form that is usable in FEMs. With increasing computing speed and memory available, it is now feasible to address these challenges. We address the first by acquiring data with a high resolution C-ray CT scanner and the latter by developing semi-automated method for generating the volumetric meshes used in the FEM. Issues related to tomographic reconstruction, volume segmentation, the use of extracted surfaces to generate volumetric hexahedral meshes, and applications of the FEM are described.

  16. Finite element analysis of human joints

    International Nuclear Information System (INIS)

    Bossart, P.L.; Hollerbach, K.

    1996-09-01

    Our work focuses on the development of finite element models (FEMs) that describe the biomechanics of human joints. Finite element modeling is becoming a standard tool in industrial applications. In highly complex problems such as those found in biomechanics research, however, the full potential of FEMs is just beginning to be explored, due to the absence of precise, high resolution medical data and the difficulties encountered in converting these enormous datasets into a form that is usable in FEMs. With increasing computing speed and memory available, it is now feasible to address these challenges. We address the first by acquiring data with a high resolution C-ray CT scanner and the latter by developing semi-automated method for generating the volumetric meshes used in the FEM. Issues related to tomographic reconstruction, volume segmentation, the use of extracted surfaces to generate volumetric hexahedral meshes, and applications of the FEM are described

  17. Human arm stiffness and equilibrium-point trajectory during multi-joint movement.

    Science.gov (United States)

    Gomi, H; Kawato, M

    1997-03-01

    By using a newly designed high-performance manipulandum and a new estimation algorithm, we measured human multi-joint arm stiffness parameters during multi-joint point-to-point movements on a horizontal plane. This manipulandum allows us to apply a sufficient perturbation to subject's arm within a brief period during movement. Arm stiffness parameters were reliably estimated using a new algorithm, in which all unknown structural parameters could be estimated independent of arm posture (i.e., constant values under any arm posture). Arm stiffness during transverse movement was considerably greater than that during corresponding posture, but not during a longitudinal movement. Although the ratios of elbow, shoulder, and double-joint stiffness were varied in time, the orientation of stiffness ellipses during the movement did not change much. Equilibrium-point trajectories that were predicted from measured stiffness parameters and actual trajectories were slightly sinusoidally curved in Cartesian space and their velocity profiles were quite different from the velocity profiles of actual hand trajectories. This result contradicts the hypothesis that the brain does not take the dynamics into account in movement control depending on the neuromuscular servo mechanism; rather, it implies that the brain needs to acquire some internal models of controlled objects.

  18. A joint-constraint model for human joints using signed distance-fields

    DEFF Research Database (Denmark)

    Engell-Nørregård, Morten Pol; Abel, Sarah Maria Niebe; Erleben, Kenny

    2012-01-01

    We present a local joint-constraint model for a single joint which is based on distance fields. Our model is fast, general, and well suited for modeling human joints. In this work, we take a geometric approach and model the geometry of the boundary of the feasible region, i.e., the boundary of all...... allowed poses. A region of feasible poses can be built by embedding motion captured data points in a signed distance field. The only assumption is that the feasible poses form a single connected set of angular values. We show how signed distance fields can be used to generate fast and general joint......-joint dependencies, or joints with more than three degrees of freedom. The resolution of the joint-constraints can be tweaked individually for each degree of freedom, which can be used to optimize memory usage. We perform a comparative study of the key-properties of various joint-constraint models, as well...

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. 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

  6. 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.

  7. Design of artificial human joints & organs

    CERN Document Server

    Pal, Subrata

    2013-01-01

    This book covers the design science and methodology of artificial joints and organs.  It presents the mechanical characterization of the hard and soft tissues as well as the viscoelastic properties of the tissue.

  8. 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

  9. Stiffness of the ligaments of the human wrist joint

    NARCIS (Netherlands)

    Savelberg, H.H.C.M.; Kooloos, J.G.M.; Huiskes, H.W.J.; Kauer, J.M.G.

    1992-01-01

    The stiffnesses of the superficial ligaments of 14 human cadaver wrist joints have been determined. In these experiments the tested, fresh-frozen carpal joints are divided into a number of bone-ligament-bone complexes, which are loaded in a tensile testing machine at a rate of 66% of the ligaments'

  10. Wearable human body joint and posture measuring system

    NARCIS (Netherlands)

    Dunias, P.; Gransier, R.; Jin, A.; Statham, A.; Willems, P.

    2011-01-01

    In many medical applications, especially the orthopaedic setting, ambulatory, monitoring of human joint angles could be of substantial value to improving rehabilitation strategies and unravelling the pathomechanics of many degenerative joint diseases (e.g. knee osteoarthritis). With the ageing of

  11. 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.

  12. 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.)

  13. 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

  14. 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.

  15. Biomechanics of the natural, arthritic, and replaced human ankle joint

    Science.gov (United States)

    2014-01-01

    The human ankle joint complex plays a fundamental role in gait and other activities of daily living. At the same time, it is a very complicated anatomical system but the large literature of experimental and modelling studies has not fully described the coupled joint motion, position and orientation of the joint axis of rotation, stress and strain in the ligaments and their role in guiding and stabilizing joint motion, conformity and congruence of the articular surfaces, patterns of contact at the articular surfaces, patterns of rolling and sliding at the joint surfaces, and muscle lever arm lengths. The present review article addresses these issues as described in the literature, reporting the most recent relevant findings. PMID:24499639

  16. 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

  17. 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.

  18. 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.

  19. Análise isocinética da articulação do cotovelo em crianças com paralisia cerebral Isokinetic analysis of the elbow joint in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Patrícia Martins Franciulli

    2012-03-01

    Full Text Available A quantidade de torque aplicado na articulação é uma medida de aptidão física importante para crianças com paralisia cerebral. O presente estudo analisou parâmetros cinéticos na articulação do cotovelo em crianças saudáveis e com paralisia cerebral. Participaram 10 crianças com paralisia cerebral e 10 crianças sem comprometimento neurológico. Avaliou-se a média do pico de torque, média do ângulo do pico de torque, coeficiente de variação do torque e aceleração angular do movimento de flexo-extensão do cotovelo nas velocidades com um dinamômetro isocinético. A média de pico de torque (extensão, aceleração (flexão e coeficiente de variação (flexão e extensão são diferentes entre grupos. Conclui-se que o torque e aceleração sofreram interferências no movimento de flexo-extensão; as principais diferenças encontradas foram entre os extremos das velocidades; não houve diferenças no ângulo do pico de torque. A espasticidade não interferiu na força dos músculos agonistas do movimento de flexão da articulação do cotovelo.The joint torque is an important variable related to children with cerebral palsy. The present study analyzed kinetic parameters during elbow flexion and extension movements in healthy and cerebral palsy children. Ten healthy and 10 cerebral palsy children participated of the study. An isokinetic dynamometer was used to measure the elbow mean peak torque, mean angle peak torque, coefficient of variation and acceleration during flexion and extension movements at different angular speeds. The mean peak torque on extension movement in healthy children group was significant higher compared to the cerebral palsy group. The coefficient of variation on both flexion and extension movements was significantly higher in cerebral palsy group. However there were significantly difference on both groups compared the lowest and highest velocities. Although the results showed no difference in flexor peak

  20. Modelling of the Human Knee Joint Supported by Active Orthosis

    Science.gov (United States)

    Musalimov, V.; Monahov, Y.; Tamre, M.; Rõbak, D.; Sivitski, A.; Aryassov, G.; Penkov, I.

    2018-02-01

    The article discusses motion of a healthy knee joint in the sagittal plane and motion of an injured knee joint supported by an active orthosis. A kinematic scheme of a mechanism for the simulation of a knee joint motion is developed and motion of healthy and injured knee joints are modelled in Matlab. Angles between links, which simulate the femur and tibia are controlled by Simulink block of Model predictive control (MPC). The results of simulation have been compared with several samples of real motion of the human knee joint obtained from motion capture systems. On the basis of these analyses and also of the analysis of the forces in human lower limbs created at motion, an active smart orthosis is developed. The orthosis design was optimized to achieve an energy saving system with sufficient anatomy, necessary reliability, easy exploitation and low cost. With the orthosis it is possible to unload the knee joint, and also partially or fully compensate muscle forces required for the bending of the lower limb.

  1. Modelling of the Human Knee Joint Supported by Active Orthosis

    Directory of Open Access Journals (Sweden)

    Musalimov V.

    2018-02-01

    Full Text Available The article discusses motion of a healthy knee joint in the sagittal plane and motion of an injured knee joint supported by an active orthosis. A kinematic scheme of a mechanism for the simulation of a knee joint motion is developed and motion of healthy and injured knee joints are modelled in Matlab. Angles between links, which simulate the femur and tibia are controlled by Simulink block of Model predictive control (MPC. The results of simulation have been compared with several samples of real motion of the human knee joint obtained from motion capture systems. On the basis of these analyses and also of the analysis of the forces in human lower limbs created at motion, an active smart orthosis is developed. The orthosis design was optimized to achieve an energy saving system with sufficient anatomy, necessary reliability, easy exploitation and low cost. With the orthosis it is possible to unload the knee joint, and also partially or fully compensate muscle forces required for the bending of the lower limb.

  2. Lubrication of the Human Ankle Joint in Walking

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2010-01-01

    Roč. 132, č. 1 (2010), s. 1-8 ISSN 0742-4787 R&D Projects: GA ČR(CZ) GA103/07/0043 Institutional research plan: CEZ:AV0Z20710524 Keywords : articular cartilage * human ankle joint * lubrication * walking Subject RIV: JJ - Other Materials Impact factor: 0.449, year: 2010

  3. Lubrication of the human ankle joint in running

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2009-01-01

    Roč. 3, č. 5 (2009), s. 619-626 ISSN 1970-8734 R&D Projects: GA ČR(CZ) GA103/07/0043 Institutional research plan: CEZ:AV0Z20710524 Keywords : human ankle joint * lubrication * running Subject RIV: JJ - Other Materials

  4. 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

  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. 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

  7. 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.

  8. 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 ...

  9. Computed tomography of human joints and radioactive waste drums

    International Nuclear Information System (INIS)

    Martz, Harry E.; Roberson, G. Patrick; Hollerbach, Karin; Logan, Clinton M.; Ashby, Elaine; Bernardi, Richard

    1999-01-01

    X- and gamma-ray imaging techniques in nondestructive evaluation (NDE) and assay (NDA) have seen increasing use in an array of industrial, environmental, military, and medical applications. Much of this growth in recent years is attributed to the rapid development of computed tomography (CT) and the use of NDE throughout the life-cycle of a product. Two diverse examples of CT are discussed, 1.) Our computational approach to normal joint kinematics and prosthetic joint analysis offers an opportunity to evaluate and improve prosthetic human joint replacements before they are manufactured or surgically implanted. Computed tomography data from scanned joints are segmented, resulting in the identification of bone and other tissues of interest, with emphasis on the articular surfaces. 2.) We are developing NDE and NDA techniques to analyze closed waste drums accurately and quantitatively. Active and passive computed tomography (A and PCT) is a comprehensive and accurate gamma-ray NDA method that can identify all detectable radioisotopes present in a container and measure their radioactivity

  10. 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)

  11. 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

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  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. 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.

  19. 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...

  20. 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.

  1. 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.

  2. 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.

  3. 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.)

  4. 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.)

  5. 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.

  6. 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

  7. 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.

  8. Nociceptive nerve fibers in the sacroiliac joint in humans

    NARCIS (Netherlands)

    Szadek, K.M.; Hoogland, P.V.J.M.; Zuurmond, W.W.A.; de Lange, J.J.; Perez, R.S.G.M.

    2008-01-01

    Background and Objectives: A positive response to sacroiliac joint intra-articular infiltration with local anesthetics is used to confirm sacroiliac joint pain. However, current anatomical and histological knowledge concerning the anatomy of pain perception within the sacroiliac joint intra- and

  9. 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.

  10. 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.

  11. [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.

  12. 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

  13. Interdependence of torque, joint angle, angular velocity and muscle action during human multi-joint leg extension.

    Science.gov (United States)

    Hahn, Daniel; Herzog, Walter; Schwirtz, Ansgar

    2014-08-01

    Force and torque production of human muscles depends upon their lengths and contraction velocity. However, these factors are widely assumed to be independent of each other and the few studies that dealt with interactions of torque, angle and angular velocity are based on isolated single-joint movements. Thus, the purpose of this study was to determine force/torque-angle and force/torque-angular velocity properties for multi-joint leg extensions. Human leg extension was investigated (n = 18) on a motor-driven leg press dynamometer while measuring external reaction forces at the feet. Extensor torque in the knee joint was calculated using inverse dynamics. Isometric contractions were performed at eight joint angle configurations of the lower limb corresponding to increments of 10° at the knee from 30 to 100° of knee flexion. Concentric and eccentric contractions were performed over the same range of motion at mean angular velocities of the knee from 30 to 240° s(-1). For contractions of increasing velocity, optimum knee angle shifted from 52 ± 7 to 64 ± 4° knee flexion. Furthermore, the curvature of the concentric force/torque-angular velocity relations varied with joint angles and maximum angular velocities increased from 866 ± 79 to 1,238 ± 132° s(-1) for 90-50° knee flexion. Normalised eccentric forces/torques ranged from 0.85 ± 0.12 to 1.32 ± 0.16 of their isometric reference, only showing significant increases above isometric and an effect of angular velocity for joint angles greater than optimum knee angle. The findings reveal that force/torque production during multi-joint leg extension depends on the combined effects of angle and angular velocity. This finding should be accounted for in modelling and optimisation of human movement.

  14. Intra-Articular Entrapment of the Medial Epicondyle following a Traumatic Fracture Dislocation of the Elbow in an Adult

    Science.gov (United States)

    Hassan, Youssef G.; Joukhadar, Nabih I.

    2018-01-01

    Medial epicondyle entrapment after an acute fracture dislocation of the elbow is a common finding in the pediatric population, but a rare finding in adults. We present a case of an adult patient diagnosed with a traumatic fracture dislocation of the elbow joint with intra-articular entrapment of the medial epicondyle. After initial evaluation, closed reduction was done. Stability testing after reduction showed an unstable joint; thus, open reduction and internal fixation was decided. PMID:29666736

  15. METHODS USED FOR THE VIRTUAL HUMAN BONES AND JOINTS RECONSTRUCTION. NORMAL AND PATHOLOGICAL HUMAN JOINTS VIRTUAL SIMULATIONS

    Directory of Open Access Journals (Sweden)

    POPA Laurentiu Dragos

    2015-06-01

    Full Text Available To understand the problems, which appear in every human joint, it is very important to know the anatomy and morphology of the human bones and the way in which the components are working together to realize a normal functionality. For this purpose was used a CAD parametric software which permits to define models with a high degree of difficulty. First, it was used a CT or MRI device to obtain the parallel sections to study each component of the bone. A 3D scanner can be used only for the outer geometry. In the second step the images were transferred to a 2D CAD software, like AutoCAD, where the outer and inner contours of the bone were approximate to polygonal lines composed by many segments. After this, the contours were transferred to a 3D CAD software, like SolidWorks, where, step by step, and section by section, was defined the virtual bone component. Additionally to the main shape can be attached other Loft, Round or Dome shapes. For some components, as vertebrae, mandible or skull bones, can be used a preliminary model obtained by parallel sections. Starting from this, the model can be defined using the main 3D curves and we can get the final virtual solid model. In some simulations, the soft components, as muscles or ligaments, were included in simulations using non-linear virtual springs. Also, sometimes were used implants or prosthetic elements. In the final of the paper, were extracted important conclusions.

  16. 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

  17. 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.

  18. Efeito da posição da articulação do cotovelo no controle de torque de supinação do antebraço em jovens adultos Effects of elbow joint position on forearm supination torque control among young adults

    Directory of Open Access Journals (Sweden)

    C Krás Borges

    2007-12-01

    literature are associated with tasks involving effort and repetitive movements of the arms and hands. Elbow position is known to affect the production of maximum forearm supination torque, and is a critical factor in designing appropriate therapeutic exercises. However, to our knowledge, there are no data on the effects of elbow position on tasks requiring control over submaximal torque levels. OBJECTIVE: This study investigated the effects of elbow position on the production of maximum isometric forearm supination torque, and on constant and continuous torque control at different submaximal torque levels. METHOD: Sixteen young adults (24.7 ± 2.2 years old were asked to perform two tasks: production of maximum lateral pinch torque (thumb and index finger and controlled lateral pinch constant torque. Both tasks were evaluated at four different elbow positions (free position, 0º, 45º and 90º of elbow flexion and three submaximal levels of lateral pinch torque production (20%, 40% and 60%. Maximal torque, variability, irregularity and accuracy of the motor response were used as dependent variables. RESULTS: Greater torque values were found when the elbow joint was not restricted. The torque control tasks were not affected by the elbow position. However, greater variability and irregularity and lower accuracy in torque response were recorded with progressively increased submaximal torque levels. CONCLUSION: The results suggest that elbow position is not a determining factor for rehabilitation exercises that include torque control, in relation to forearm supination.

  19. Principles of human joint replacement design and clinical application

    CERN Document Server

    Buechel, Frederick F

    2015-01-01

    This book is written for the users and designers of joint replacements. In its second extended edition it conveys to the reader the knowledge accumulated by the authors during their forty year effort on the development of replacement devices for the lower limb for the purpose of aiding the reader in their design and evaluation of joint replacement devices. The early chapters describe the engineering, scientific and medical principles needed for replacement joint evaluation. One must understand the nature and performance of the materials involved and their characteristics in vivo, i.e. the response of the body to implant materials. It is also essential to understand the response of the implants to applied loading and motion, particularly in the hostile physiological environment. A chapter describes the design methodology now required for joint replacement in the USA and EU countries. The remaining chapters provide a history of joint replacement, an evaluation of earlier and current devices and sample case hist...

  20. Recent Advances in Computational Mechanics of the Human Knee Joint

    Science.gov (United States)

    Kazemi, M.; Dabiri, Y.; Li, L. P.

    2013-01-01

    Computational mechanics has been advanced in every area of orthopedic biomechanics. The objective of this paper is to provide a general review of the computational models used in the analysis of the mechanical function of the knee joint in different loading and pathological conditions. Major review articles published in related areas are summarized first. The constitutive models for soft tissues of the knee are briefly discussed to facilitate understanding the joint modeling. A detailed review of the tibiofemoral joint models is presented thereafter. The geometry reconstruction procedures as well as some critical issues in finite element modeling are also discussed. Computational modeling can be a reliable and effective method for the study of mechanical behavior of the knee joint, if the model is constructed correctly. Single-phase material models have been used to predict the instantaneous load response for the healthy knees and repaired joints, such as total and partial meniscectomies, ACL and PCL reconstructions, and joint replacements. Recently, poromechanical models accounting for fluid pressurization in soft tissues have been proposed to study the viscoelastic response of the healthy and impaired knee joints. While the constitutive modeling has been considerably advanced at the tissue level, many challenges still exist in applying a good material model to three-dimensional joint simulations. A complete model validation at the joint level seems impossible presently, because only simple data can be obtained experimentally. Therefore, model validation may be concentrated on the constitutive laws using multiple mechanical tests of the tissues. Extensive model verifications at the joint level are still crucial for the accuracy of the modeling. PMID:23509602

  1. 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...

  2. 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.

  3. Principles of Human Joint Replacement Design and Clinical Application

    CERN Document Server

    Buechel, Frederick F

    2012-01-01

    Drs. Buechel, an orthopaedic surgeon, and Pappas, a professor of Mechanical Engineering, are the designers of several successful joint replacement systems. The most well-known of these is the pioneering LCS knee replacement. They have written this book for the users and designers of joint replacements. It is an attempt to convey to the reader the knowledge accumulated by the authors during their thirty five year effort on the development of replacement devices for the lower limb for the purpose of aiding the reader in their design and evaluation of joint replacement devices. The early chapters describe the engineering, scientific and medical principles needed for replacement joint evaluation. One must understand the nature and performance of the materials involved and their characteristics in vivo, i.e. the response of the body to implant materials. It is also essential to understand the response of the implants to applied loading and motion, particularly in the hostile physiological environment. A chapter de...

  4. Tracking a Subset of Skeleton Joints: An Effective Approach towards Complex Human Activity Recognition

    Directory of Open Access Journals (Sweden)

    Muhammad Latif Anjum

    2017-01-01

    Full Text Available We present a robust algorithm for complex human activity recognition for natural human-robot interaction. The algorithm is based on tracking the position of selected joints in human skeleton. For any given activity, only a few skeleton joints are involved in performing the activity, so a subset of joints contributing the most towards the activity is selected. Our approach of tracking a subset of skeleton joints (instead of tracking the whole skeleton is computationally efficient and provides better recognition accuracy. We have developed both manual and automatic approaches for the selection of these joints. The position of the selected joints is tracked for the duration of the activity and is used to construct feature vectors for each activity. Once the feature vectors have been constructed, we use a Support Vector Machines (SVM multiclass classifier for training and testing the algorithm. The algorithm has been tested on a purposely built dataset of depth videos recorded using Kinect camera. The dataset consists of 250 videos of 10 different activities being performed by different users. Experimental results show classification accuracy of 83% when tracking all skeleton joints, 95% when using manual selection of subset joints, and 89% when using automatic selection of subset joints.

  5. 'Soft' human resource management in small international joint ventures

    DEFF Research Database (Denmark)

    Dao, Li

    2012-01-01

    This paper examines the value creation aspects of HRM in international joint ventures of a relatively small size and their implications for strategic management. We assume that HRM in this context is rather a process than a function, and a ‘soft’ – humanistic rather than a ‘hard’, instrumentalist...... of joint venture autonomy. A conceptual framework developed from these empirical insights invites further generalizing efforts, and more importantly, contributes to a dynamic understanding of HRM in small IJVs....

  6. Design of a Virtual Player for Joint Improvisation with Humans in the Mirror Game.

    Science.gov (United States)

    Zhai, Chao; Alderisio, Francesco; Słowiński, Piotr; Tsaneva-Atanasova, Krasimira; di Bernardo, Mario

    2016-01-01

    Joint improvisation is often observed among humans performing joint action tasks. Exploring the underlying cognitive and neural mechanisms behind the emergence of joint improvisation is an open research challenge. This paper investigates jointly improvised movements between two participants in the mirror game, a paradigmatic joint task example. First, experiments involving movement coordination of different dyads of human players are performed in order to build a human benchmark. No designation of leader and follower is given beforehand. We find that joint improvisation is characterized by the lack of a leader and high levels of movement synchronization. Then, a theoretical model is proposed to capture some features of their interaction, and a set of experiments is carried out to test and validate the model ability to reproduce the experimental observations. Furthermore, the model is used to drive a computer avatar able to successfully improvise joint motion with a human participant in real time. Finally, a convergence analysis of the proposed model is carried out to confirm its ability to reproduce joint movements between the participants.

  7. Optical Fiber Sensors For Monitoring Joint Articulation And Chest Expansion Of A Human Body

    Science.gov (United States)

    Muhs, Jeffrey D.; Allison, Stephen W.

    1997-12-23

    Fiber-optic sensors employing optical fibers of elastomeric material are incorporated in devices adapted to be worn by human beings in joint and chest regions for the purpose of monitoring and measuring the extent of joint articulation and chest expansion especially with respect to time.

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. 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

  13. Application of computer-assisted imaging technology in human musculoskeletal joint research

    Directory of Open Access Journals (Sweden)

    Xudong Liu

    2014-01-01

    Full Text Available Computer-assisted imaging analysis technology has been widely used in the musculoskeletal joint biomechanics research in recent years. Imaging techniques can accurately reconstruct the anatomic features of the target joint and reproduce its in vivo motion characters. The data has greatly improved our understanding of normal joint function, joint injury mechanism, and surgical treatment, and can provide foundations for using reverse-engineering methods to develop biomimetic artificial joints. In this paper, we systematically reviewed the investigation of in vivo kinematics of the human knee, shoulder, lumber spine, and ankle using advanced imaging technologies, especially those using a dual fluoroscopic imaging system (DFIS. We also briefly discuss future development of imaging analysis technology in musculoskeletal joint research.

  14. A Pilot Study of Individual Muscle Force Prediction during Elbow Flexion and Extension in the Neurorehabilitation Field

    Directory of Open Access Journals (Sweden)

    Jiateng Hou

    2016-11-01

    Full Text Available This paper proposes a neuromusculoskeletal (NMS model to predict individual muscle force during elbow flexion and extension. Four male subjects were asked to do voluntary elbow flexion and extension. An inertial sensor and surface electromyography (sEMG sensors were attached to subject's forearm. Joint angle calculated by fusion of acceleration and angular rate using an extended Kalman filter (EKF and muscle activations obtained from the sEMG signals were taken as the inputs of the proposed NMS model to determine individual muscle force. The result shows that our NMS model can predict individual muscle force accurately, with the ability to reflect subject-specific joint dynamics and neural control solutions. Our method incorporates sEMG and motion data, making it possible to get a deeper understanding of neurological, physiological, and anatomical characteristics of human dynamic movement. We demonstrate the potential of the proposed NMS model for evaluating the function of upper limb movements in the field of neurorehabilitation.

  15. 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

  16. Stress sonography of the ulnar collateral ligament of the elbow in professional baseball pitchers: a 10-year study.

    Science.gov (United States)

    Ciccotti, Michael G; Atanda, Alfred; Nazarian, Levon N; Dodson, Christopher C; Holmes, Laurens; Cohen, Steven B

    2014-03-01

    An injury to the ulnar collateral ligament (UCL) of the elbow is potentially career threatening for elite baseball pitchers. Stress ultrasound (US) of the elbow allows for evaluation of both the UCL and the ulnohumeral joint space at rest and with stress. Stress US can identify morphological and functional UCL changes and may predict the risk of a UCL injury in elite pitchers. Cross-sectional study; Level of evidence, 3. A total of 368 asymptomatic professional baseball pitchers underwent preseason stress US of their dominant and nondominant elbows over a 10-year period (2002-2012). Stress US examinations were performed in 30° of flexion at rest and with 150 N of valgus stress by a single musculoskeletal radiologist. Ligament thickness, ulnohumeral joint space width, and ligament abnormalities (hypoechoic foci and calcifications) were documented. There were 736 stress US studies. The mean UCL thickness in the dominant elbow (6.15 mm) was significantly greater than that in the nondominant elbow (4.82 mm) (P .05) increases in baseline ligament thickness, ulnohumeral joint space gapping with stress, and incidence of hypoechoic foci and calcifications. More than 1 stress US examination was performed in 131 players, with a mean increase of 0.78 mm in joint space gapping with subsequent evaluations. Stress US indicates that the UCL in the dominant elbow of elite pitchers is thicker, is more likely to have hypoechoic foci and/or calcifications, and has increased laxity with valgus stress over time.

  17. Subspace methods for identification of human ankle joint stiffness.

    Science.gov (United States)

    Zhao, Y; Westwick, D T; Kearney, R E

    2011-11-01

    Joint stiffness, the dynamic relationship between the angular position of a joint and the torque acting about it, describes the dynamic, mechanical behavior of a joint during posture and movement. Joint stiffness arises from both intrinsic and reflex mechanisms, but the torques due to these mechanisms cannot be measured separately experimentally, since they appear and change together. Therefore, the direct estimation of the intrinsic and reflex stiffnesses is difficult. In this paper, we present a new, two-step procedure to estimate the intrinsic and reflex components of ankle stiffness. In the first step, a discrete-time, subspace-based method is used to estimate a state-space model for overall stiffness from the measured overall torque and then predict the intrinsic and reflex torques. In the second step, continuous-time models for the intrinsic and reflex stiffnesses are estimated from the predicted intrinsic and reflex torques. Simulations and experimental results demonstrate that the algorithm estimates the intrinsic and reflex stiffnesses accurately. The new subspace-based algorithm has three advantages over previous algorithms: 1) It does not require iteration, and therefore, will always converge to an optimal solution; 2) it provides better estimates for data with high noise or short sample lengths; and 3) it provides much more accurate results for data acquired under the closed-loop conditions, that prevail when subjects interact with compliant loads.

  18. 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

  19. 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.

  20. TARGETING THE HUMAN DOMAIN: REACHING INTERNAL, JOINT, AND ADVERSARIAL AUDIENCES

    Science.gov (United States)

    2017-04-06

    86th Medical Support Squadron, Ramstein Air Base, Germany . In this capacity, she commanded a 197-person unit providing health care support services to...religion, illustrated via such military- specific rites as the Uniformed Code of Military Justice as a moral compass. This holds for smaller groupings...within a service, as well as for larger joint and international allied warfighting. Correspondingly, service history , rhetoric and literature must focus

  1. Measurement of Resistive Torques in Major Human Joints

    Science.gov (United States)

    1979-04-01

    was assisted by the following graduate students whose names, in the order of the magnitude of their contributions, are: Richard D. Peindl, Manssour...acknowledged by the author, a considerable addi- tional time investment was made by the principal investigator and several graduate students to complete the...Conaill, M.A., "Joint Movement," Physiotherapy (50), 359, 1964. 17. Murphy, W.W., Garcia, D.H. and Bird, R.G., "Measurement of Body Motion," ASME

  2. 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.

  3. 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

  4. A painless and constraint-free method to estimate viscoelastic passive dynamics of limbs' joints to support diagnosis of neuromuscular diseases.

    Science.gov (United States)

    Venture, Gentiane; Nakamura, Yoshihiko; Yamane, Katsu; Hirashima, Masaya

    2007-01-01

    Though seldom identified, the human joints dynamics is important in the fields of medical robotics and medical research. We present a general solution to estimate in-vivo and simultaneously the passive dynamics of the human limbs' joints. It is based on the use of the multi-body description of the human body and its kinematics and dynamics computations. The linear passive joint dynamics of the shoulders and the elbows: stiffness, viscosity and friction, is estimated simultaneously using the linear least squares method. Acquisition of movements is achieved with an optical motion capture studio on one examinee during the clinical diagnosis of neuromuscular diseases. Experimental results are given and discussed.

  5. 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.

  6. Inverse Modeling of Human Knee Joint Based on Geometry and Vision Systems for Exoskeleton Applications

    Directory of Open Access Journals (Sweden)

    Eduardo Piña-Martínez

    2015-01-01

    Full Text Available Current trends in Robotics aim to close the gap that separates technology and humans, bringing novel robotic devices in order to improve human performance. Although robotic exoskeletons represent a breakthrough in mobility enhancement, there are design challenges related to the forces exerted to the users’ joints that result in severe injuries. This occurs due to the fact that most of the current developments consider the joints as noninvariant rotational axes. This paper proposes the use of commercial vision systems in order to perform biomimetic joint design for robotic exoskeletons. This work proposes a kinematic model based on irregular shaped cams as the joint mechanism that emulates the bone-to-bone joints in the human body. The paper follows a geometric approach for determining the location of the instantaneous center of rotation in order to design the cam contours. Furthermore, the use of a commercial vision system is proposed as the main measurement tool due to its noninvasive feature and for allowing subjects under measurement to move freely. The application of this method resulted in relevant information about the displacements of the instantaneous center of rotation at the human knee joint.

  7. 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

  8. 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.

  9. 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

  10. 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.

  11. Cognitive Technologies: The Design of Joint Human-Machine Cognitive Systems

    OpenAIRE

    Woods, David D.

    1985-01-01

    This article explores the implications of one type of cognitive technology, techniques and concepts to develop joint human-machine cognitive systems, for the application of computational technology by examining the joint cognitive system implicit in a hypothetical computer consultant that outputs some form of problem solution. This analysis reveals some of the problems can occur in cognitive system design-e.g., machine control of the interaction, the danger of a responsibility-authority doubl...

  12. Parameters Estimation For A Patellofemoral Joint Of A Human Knee Using A Vector Method

    Science.gov (United States)

    Ciszkiewicz, A.; Knapczyk, J.

    2015-08-01

    Position and displacement analysis of a spherical model of a human knee joint using the vector method was presented. Sensitivity analysis and parameter estimation were performed using the evolutionary algorithm method. Computer simulations for the mechanism with estimated parameters proved the effectiveness of the prepared software. The method itself can be useful when solving problems concerning the displacement and loads analysis in the knee joint.

  13. [Human joint capsule in osteoarthrosis (morpholocical changes) (author's transl)].

    Science.gov (United States)

    Dettmer, N; Barz, B

    1977-07-29

    Morphological investigations of the joint capsules in osteoarthrotic-changed joints have given rise to doubts about the present theory of the causal aetiology of the osteoarthrosis. In every inspected and demonstrated illustration beside the partly normal capsules segments could be found every transition between mild regressive alterations and most massive proliferative changes of the conective tissue and the lining cell layer. It was extraordinary, that the strongly dilated vessels were filled with red blood cells. In another part of the same case was found a massive stricture caused by concentrically deposited substances, which were impregnated with collagenous fibers. Regeneration of the vessels frequently happened adjacent totally obstructed ones. Round-cell infiltrations, granulocytes or other indications of an inflammatory synovitis are found only in a few cases. The intracartilaginous enzymatic reactions, which have been much talked of and which were explained as characteristic of the osteoarthrosis cannot be the cause of the degradation of the cartilage, particularly, because of the normal cell count which is to be found in the synovial fluid. We can answer this problem, if we can prove that the substrates of the chondral metabolism themselves exert a direct or indirect influence on the interstitial connective tissue with induction of the powerful proliferation of the same tissue. The changes in the transit zone would be secondary and their effect on the lining cell layer would increase the progression of the arthrotic events.

  14. 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.

  15. Modeling and simulating the neuromuscular mechanisms regulating ankle and knee joint stiffness during human locomotion.

    Science.gov (United States)

    Sartori, Massimo; Maculan, Marco; Pizzolato, Claudio; Reggiani, Monica; Farina, Dario

    2015-10-01

    This work presents an electrophysiologically and dynamically consistent musculoskeletal model to predict stiffness in the human ankle and knee joints as derived from the joints constituent biological tissues (i.e., the spanning musculotendon units). The modeling method we propose uses electromyography (EMG) recordings from 13 muscle groups to drive forward dynamic simulations of the human leg in five healthy subjects during overground walking and running. The EMG-driven musculoskeletal model estimates musculotendon and resulting joint stiffness that is consistent with experimental EMG data as well as with the experimental joint moments. This provides a framework that allows for the first time observing 1) the elastic interplay between the knee and ankle joints, 2) the individual muscle contribution to joint stiffness, and 3) the underlying co-contraction strategies. It provides a theoretical description of how stiffness modulates as a function of muscle activation, fiber contraction, and interacting tendon dynamics. Furthermore, it describes how this differs from currently available stiffness definitions, including quasi-stiffness and short-range stiffness. This work offers a theoretical and computational basis for describing and investigating the neuromuscular mechanisms underlying human locomotion. Copyright © 2015 the American Physiological Society.

  16. Isolation and Characterization of Human Mesenchymal Stem Cells From Facet Joints and Interspinous Ligaments.

    Science.gov (United States)

    Kristjánsson, Baldur; Limthongkul, Worawat; Yingsakmongkol, Wicharn; Thantiworasit, Pattarawat; Jirathanathornnukul, Napaphat; Honsawek, Sittisak

    2016-01-01

    A descriptive in vitro study on isolation and differentiation of human mesenchymal stem cells (MSCs) derived from the facet joints and interspinous ligaments. To isolate cells from the facet joints and interspinous ligaments and investigate their surface marker profile and differentiation potentials. Lumbar spinal canal stenosis and ossification of the posterior longitudinal ligament are progressive conditions characterized by the hypertrophy and ossification of ligaments and joints within the spinal canal. MSCs are believed to play a role in the advancement of these diseases and the existence of MSCs has been demonstrated within the ligamentum flavum and posterior longitudinal ligament. The aim of this study was to investigate whether these cells could also be found within facet joints and interspinous ligaments. Samples were harvested from 10 patients undergoing spinal surgery. The MSCs from facet joints and interspinous ligaments were isolated using direct tissue explant technique. Cell surface antigen profilings were performed via flow cytometry. Their lineage differentiation potentials were analyzed. The facet joints and interspinous ligaments-derived MSCs have the tri-lineage potential to be differentiated into osteogenic, adipogenic, and chondrogenic cells under appropriate inductions. Flow cytometry analysis revealed both cell lines expressed MSCs markers. Both facet joints and interspinous ligaments-derived MSCs expressed marker genes for osteoblasts, adipocytes, and chondrocytes. The facet joints and interspinous ligaments may provide alternative sources of MSCs for tissue engineering applications. The facet joints and interspinous ligaments-derived MSCs are part of the microenvironment of the human ligaments of the spinal column and might play a crucial role in the development and progression of degenerative spine conditions.

  17. 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.

  18. Dynamic 3D FE modelling of the human temporomandibular joint during whiplash.

    Science.gov (United States)

    Pérez del Palomar, A; Doblaré, M

    2008-07-01

    Rear-end impacts account for more than one-third of vehicle accidents, and nearly 40% of these accidents produce whiplash injuries. Whiplash injury to the neck has often been considered a significant risk factor for the development of temporomandibular disorders (TMD). The objective of this study was to simulate the dynamic response of the temporomandibular joint during two types of impacts: a rear end and a frontal impact. To understand the dynamic forces acting on the joint, we extended a previous human temporomandibular joint model and analyzed the stress distributions in the soft elements of the joint. In the rear-end impact, it could be appreciated that the inertia of the mandible caused it to move posteriorly slower than the head, and this resulted in downward and forward displacements of the disc-condyle complex relative to the cranial base. Consequently, a rapid and big mouth opening occurs. In contrast, during the frontal impact, the mouth hardly opened, because the superior maxilla pushed the mandible to move together. There was not differential movement between bony components of the joint and therefore the soft tissues of the joint were not subjected to high loads. From these results, and despite the limitations of the simulations performed, we could conclude that neither a rear-end impact at low-velocity nor a frontal impact would produce damage to the soft tissues of the joint.

  19. MR imaging of patients with lateral epicondylitis of the elbow: is the common extensor tendon an isolated lesion?

    Directory of Open Access Journals (Sweden)

    Liang Qi

    Full Text Available OBJECTIVE: To investigate whether an injury of the common extensor tendon (CET is associated with other abnormalities in the elbow joint and find the potential relationships between these imaging features by using a high-resolution magnetic resonance imaging (MRI. METHODS: Twenty-three patients were examined with 3.0 T MR. Two reviewers were recruited for MR images evaluation. Image features were recorded in terms of (1 the injury degree of CET; (2 associated injuries in the elbow joint. Spearman's rank correlation analysis was performed to analyze the relationships between the injury degree of CET and associated abnormalities of the elbow joint, correlations were considered significant at p<0.05. RESULTS: Total 24 elbows in 23 patients were included. Various degrees of injuries were found in total 24 CETs (10 mild, 7 moderate and 7 severe. Associated abnormalities were detected in accompaniments of the elbow joints including ligaments, tendons, saccussynovialis and muscles. A significantly positive correlation (r = 0.877,p<0.01 was found in injuries of CET and lateral ulnar collateral ligament (LUCL. CONCLUSION: Injury of the CET is not an isolated lesion for lateral picondylitis, which is mostly accompanied with other abnormalities, of which the LUCL injury is the most commonly seen in lateral epicondylitis, and there is a positive correlation between the injury degree in CET and LUCL.

  20. Robust Control of a Cable-Driven Soft Exoskeleton Joint for Intrinsic Human-Robot Interaction.

    Science.gov (United States)

    Jarrett, C; McDaid, A J

    2017-07-01

    A novel, cable-driven soft joint is presented for use in robotic rehabilitation exoskeletons to provide intrinsic, comfortable human-robot interaction. The torque-displacement characteristics of the soft elastomeric core contained within the joint are modeled. This knowledge is used in conjunction with a dynamic system model to derive a sliding mode controller (SMC) to implement low-level torque control of the joint. The SMC controller is experimentally compared with a baseline feedback-linearised proportional-derivative controller across a range of conditions and shown to be robust to un-modeled disturbances. The torque controller is then tested with six healthy subjects while they perform a selection of activities of daily living, which has validated its range of performance. Finally, a case study with a participant with spastic cerebral palsy is presented to illustrate the potential of both the joint and controller to be used in a physiotherapy setting to assist clinical populations.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. Tumour necrosis factor blockade increases lymphangiogenesis in murine and human arthritic joints

    NARCIS (Netherlands)

    Polzer, K.; Baeten, D.; Soleiman, A.; Distler, J.; Gerlag, D. M.; Tak, P. P.; Schett, G.; Zwerina, J.

    2008-01-01

    OBJECTIVE: To investigate the presence and regulation of lymphatic vessels in inflamed joints of mice with experimental arthritis as well as patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA). METHODS: Lymphatic vessels and blood vessels were assessed in synovial tissue of human

  7. The clinical significance of Epitrochlear lymphadenopathy on elbow radiographs in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Kwon, Bae Ju; Joo, Kyung Bin; Lee, Hak Soo; Song, Ho Taek; Park, Dong Woo; Lee, Seung Ro; Hahm, Chang Kok

    2000-01-01

    To evaluate the radiographic findings of epitrochlear lymphadenopathy with regard to the distribution and severity of the disease and clinal parameters in patients with rheumatoid arthritis. Forty six patients with rheumatoid arthritis in whom epitrochlear oval-shaped densities were seen on radiographs were involved in this study. There were 14 cases of unilateral epitrochlear lymphadenopathy in which bilateral arthritic evidence was revealed by radiographs (mixed group), and 32 of bilateral lymphadenopathy in which there was arthritic evidence (positive group). Twenty-three patients in whom lymphadenopathy was not seen on radiographs of the elbow and who were diagnosed as suffering from rheumatoid arthritis functioned as controls (negative group).For scoring the degree of arthritis using the simplified scoring method proposed by Kaye et al., joints were divided into six groups, as follows: Joint 1, elbow; Joint 2, wrist; Joint 3, radial (1st and 2nd) PIP and MCP; Joint 4, ulnar (3rd, 4th, 5th) PIP and MCP; Joint 5, Joints 1 + 2+ 3 + 4; Joint 6, Joints 1 + 4. For each joint, scores were compared with those on the contralateral side in the mixed group. Differences in clinical parameters ( disease duration, rheumatoid factor, ESR, and CRP), and scores for each joint in each arm were statistically compared between be positive and negative group. The number, mean diameter, and maximal diameter of epitrochlear lymph nodes were calculated and correlated with clinical parameters and scores for each joint. To evaluate the incidence of epitrochlear lymphadenopathy without radiographic evidence of arthritis in 46 patients (78 arms) with lymphadenopathy, the frequency of cases in which the score for the joint was zero was assessed. In the mixed group, the mean score for Joint 6 of the arm with epitrochlear lymphadenopathy was significantly higher than that for the contralateral side in the mixed group (p=3D0.022). Only CRP was significantly higher in the positive group than

  8. O papel do ligamento oblíquo no comportamento mecânico do ligamento colateral medial da articulação do cotovelo de cães SRD – alguns aspectos biomecânicos - DOI: 10.4025/actascibiolsci.v27i2.1323 The role of the oblique ligament in the mechanical behavior of the medial collateral ligament of the mongrel dog elbow joint – some biomechanical aspects - DOI: 10.4025/actascibiolsci.v27i2.1323

    Directory of Open Access Journals (Sweden)

    Juliana Regina Rossi

    2005-03-01

    Full Text Available O propósito deste trabalho foi analisar a contribuição mecânica do ligamento oblíquo frente ao ligamento colateral medial na articulação do cotovelo do cão. Quinze cães foram utilizados para a realização de ensaio de tração para a análise da carga, alongamento e tenacidade dos ligamentos colateral medial e oblíquo, isolados ou associados. A carga máxima e o valor da tenacidade suportada pelo ligamento colateral medial isolado foram significativamente maiores em relação ao ligamento oblíquo isolado. Quando associados, apresentaram um incremento na carga máxima, no alongamento e na tenacidade em relação aos ligamentos analisados isoladamente. Concluiu-se, portanto, que o ligamento oblíquo tem um importante papel na estabilidade da articulação do cotovelo do cão, já que aumenta a resistência à tração do ligamento colateral medial, um dos principais estabilizadores da referida articulaçãoThis study investigated the oblique ligament mechanical contribution to the medial collateral ligament of the canine elbow joint. Fifteen dogs were used for the study of the failure load, displacement, and energy absorption of the medial collateral and oblique ligaments of the canine elbow joint, associate and separately in the joint. Medial collateral ligament failure load and energy absorption were significantly higher in relation to the isolated oblique ligament. When the ligaments were associated in the joint, they presented an increment in failure load, displacement and energy absorption in relation to the ligaments analyzed separately. It was concluded, therefore, that the oblique ligament could have an important paper in the stability of the canine elbow joint, as it favors the medial collateral ligament resistance to the tensile load, one of the main stabilizer of the elbow joint

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. Contribution of facet joints, axial compression, and composition to human lumbar disc torsion mechanics.

    Science.gov (United States)

    Bezci, Semih E; Eleswarapu, Ananth; Klineberg, Eric O; O'Connell, Grace D

    2018-02-12

    Stresses applied to the spinal column are distributed between the intervertebral disc and facet joints. Structural and compositional changes alter stress distributions within the disc and between the disc and facet joints. These changes influence the mechanical properties of the disc joint, including its stiffness, range of motion, and energy absorption under quasi-static and dynamic loads. There have been few studies evaluating the role of facet joints in torsion. Furthermore, the relationship between biochemical composition and torsion mechanics is not well understood. Therefore, the first objective of this study was to investigate the role of facet joints in torsion mechanics of healthy and degenerated human lumbar discs under a wide range of compressive preloads. To achieve this, each disc was tested under four different compressive preloads (300-1200 N) with and without facet joints. The second objective was to develop a quantitative structure-function relationship between tissue composition and torsion mechanics. Facet joints have a significant contribution to disc torsional stiffness (∼60%) and viscoelasticity, regardless of the magnitude of axial compression. The findings from this study demonstrate that annulus fibrosus GAG content plays an important role in disc torsion mechanics. A decrease in GAG content with degeneration reduced torsion mechanics by more than an order of magnitude, while collagen content did not significantly influence disc torsion mechanics. The biochemical-mechanical and compression-torsion relationships reported in this study allow for better comparison between studies that use discs of varying levels of degeneration or testing protocols and provide important design criteria for biological repair strategies. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  14. Modeling of the incudo-malleolar joint within a biomechanical model of the human ear

    International Nuclear Information System (INIS)

    Ihrle, Sebastian; Eiber, Albrecht; Eberhard, Peter

    2017-01-01

    Under large quasi-static loads, the incudo-malleolar joint (IM joint), connecting the malleus and the incus, is highly mobile. It can be classified as a mechanical filter decoupling large quasi-static motions while transferring small dynamic excitations. To investigate the influence of the behavior of the IM joint, a detailed simulation model of the IM-complex is created. Mathematical modeling of the IM joint behavior under quasi-static excitation requires adequate modeling of the mechanics of the diarthrodial joint. Therefore, the geometry of the articular surfaces, the ligaments, as well as their viscoelastic properties have to be included in the model. The contact of the articular surfaces is implemented using a penalty based contact formulation utilizing the geometric information obtained from micro computer tomography (micro-CT) scans. The ligaments of the joint capsule are modeled by distributing force elements along the joint capsule, with the position and orientation derived from the micro-CT scans. It is shown that the effects which were observed in measurements on human temporal bones are described adequately by the model, if the contact of the articular surfaces and the preload of the viscoelastic fibers are taken into account in the simulation model. In the following, the detailed model is implemented in an elastic multibody system of the entire ear. The model allows the study of different quasi-static load cases of the ossicles, such as it occurs in the reconstruction of the middle ear and form the basis for future simulative studies of sound transmission in natural or reconstructed ears.

  15. Modeling of the incudo-malleolar joint within a biomechanical model of the human ear

    Energy Technology Data Exchange (ETDEWEB)

    Ihrle, Sebastian; Eiber, Albrecht; Eberhard, Peter, E-mail: peter.eberhard@itm.uni-stuttgart.de [University of Stuttgart, Institute of Engineering and Computational Mechanics (Germany)

    2017-04-15

    Under large quasi-static loads, the incudo-malleolar joint (IM joint), connecting the malleus and the incus, is highly mobile. It can be classified as a mechanical filter decoupling large quasi-static motions while transferring small dynamic excitations. To investigate the influence of the behavior of the IM joint, a detailed simulation model of the IM-complex is created. Mathematical modeling of the IM joint behavior under quasi-static excitation requires adequate modeling of the mechanics of the diarthrodial joint. Therefore, the geometry of the articular surfaces, the ligaments, as well as their viscoelastic properties have to be included in the model. The contact of the articular surfaces is implemented using a penalty based contact formulation utilizing the geometric information obtained from micro computer tomography (micro-CT) scans. The ligaments of the joint capsule are modeled by distributing force elements along the joint capsule, with the position and orientation derived from the micro-CT scans. It is shown that the effects which were observed in measurements on human temporal bones are described adequately by the model, if the contact of the articular surfaces and the preload of the viscoelastic fibers are taken into account in the simulation model. In the following, the detailed model is implemented in an elastic multibody system of the entire ear. The model allows the study of different quasi-static load cases of the ossicles, such as it occurs in the reconstruction of the middle ear and form the basis for future simulative studies of sound transmission in natural or reconstructed ears.

  16. One-degree-of-freedom spherical model for the passive motion of the human ankle joint.

    Science.gov (United States)

    Sancisi, Nicola; Baldisserri, Benedetta; Parenti-Castelli, Vincenzo; Belvedere, Claudio; Leardini, Alberto

    2014-04-01

    Mathematical modelling of mobility at the human ankle joint is essential for prosthetics and orthotic design. The scope of this study is to show that the ankle joint passive motion can be represented by a one-degree-of-freedom spherical motion. Moreover, this motion is modelled by a one-degree-of-freedom spherical parallel mechanism model, and the optimal pivot-point position is determined. Passive motion and anatomical data were taken from in vitro experiments in nine lower limb specimens. For each of these, a spherical mechanism, including the tibiofibular and talocalcaneal segments connected by a spherical pair and by the calcaneofibular and tibiocalcaneal ligament links, was defined from the corresponding experimental kinematics and geometry. An iterative procedure was used to optimize the geometry of the model, able to predict original experimental motion. The results of the simulations showed a good replication of the original natural motion, despite the numerous model assumptions and simplifications, with mean differences between experiments and predictions smaller than 1.3 mm (average 0.33 mm) for the three joint position components and smaller than 0.7° (average 0.32°) for the two out-of-sagittal plane rotations, once plotted versus the full flexion arc. The relevant pivot-point position after model optimization was found within the tibial mortise, but not exactly in a central location. The present combined experimental and modelling analysis of passive motion at the human ankle joint shows that a one degree-of-freedom spherical mechanism predicts well what is observed in real joints, although its computational complexity is comparable to the standard hinge joint model.

  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. Histological study of the human temporo-mandibular joint and its surrounding muscles.

    Science.gov (United States)

    Bravetti, P; Membre, H; El Haddioui, A; Gérard, H; Fyard, J P; Mahler, P; Gaudy, J F

    2004-10-01

    This is a histological study of the human temporo-mandibular joint and its surrounding muscles. Using a microscopic study of serial sections from anatomical specimens from six subjects, the detailed anatomy of the joint is presented with particular regard to the histology. This study has allowed, in particular, the description of the ligaments and capsule as well as the insertions of the masticatory muscles (temporalis, masseter, lateral pterygoid) on this joint. These observations are then compared with the anatomical and histological data already reported on this subject. This study shows that the bulk of the muscular fibres of the lateral pterygoid passes under the foot of the disc is attached over the whole height of the condylar, unite and extend as far as the medial pole of the joint under the insertion of the articular disc. An insertion of the temporo-masseter musculo-tendinous complex on the anterior and lateral capsulo-discal structures was observed. The lateral pterygoid is composed of a succession of tendinous and fleshy fibres. This study confirms the thickening of the lateral capsule that corresponds to a lateral collateral ligament, and the absence of a medial collateral ligament. Medial stability is conferred by the lateral ligament of the contralateral joint.

  19. Dynamic properties of human incudostapedial joint-Experimental measurement and finite element modeling.

    Science.gov (United States)

    Jiang, Shangyuan; Gan, Rong Z

    2018-04-01

    The incudostapedial joint (ISJ) is a synovial joint connecting the incus and stapes in the middle ear. Mechanical properties of the ISJ directly affect sound transmission from the tympanic membrane to the cochlea. However, how ISJ properties change with frequency has not been investigated. In this paper, we report the dynamic properties of the human ISJ measured in eight samples using a dynamic mechanical analyzer (DMA) for frequencies from 1 to 80 Hz at three temperatures of 5, 25 and 37 °C. The frequency-temperature superposition (FTS) principle was used to extrapolate the results to 8 kHz. The complex modulus of ISJ was measured with a mean storage modulus of 1.14 MPa at 1 Hz that increased to 3.01 MPa at 8 kHz, and a loss modulus that increased from 0.07 to 0.47 MPa. A 3-dimensional finite element (FE) model consisting of the articular cartilage, joint capsule and synovial fluid was then constructed to derive mechanical properties of ISJ components by matching the model results to experimental data. Modeling results showed that mechanical properties of the joint capsule and synovial fluid affected the dynamic behavior of the joint. This study contributes to a better understanding of the structure-function relationship of the ISJ for sound transmission. Copyright © 2018. Published by Elsevier Ltd.

  20. Subfracture insult to the human cadaver patellofemoral joint produces occult injury.

    Science.gov (United States)

    Atkinson, P J; Haut, R C

    1995-11-01

    The current criterion used by the automotive industry for injury to the lower extremity is based on visible bone fracture. Studies suggest, however, that chronic joint degeneration may occur after subfracture impact loads on the knee. We hypothesized that subfracture loading of the patellofemoral joint could result in previously undocumented microtrauma in areas of high contact pressure. In the current study, seven patellofemoral joints from human cadavers were subjected to impact with successively greater energy until visible fracture was noted. Transverse and comminuted fractures of the patella were noted at 6.7 kN of load. Approximately 45% of the impact energy then was delivered to the contralateral joint. Subfracture loads of 5.2 kN resulted in no gross bone fracture in five of seven specimens. Histological examination of the patellae horizontal split fracture in the subchondral bone, at the tidemark, or at the interface of calcified cartilage and subchondral bone. The trauma appeared predominantly on the lateral facet, adjacent to or directly beneath preexisting fibrillation of the articular surface. Surface fibrillation was noted in histological sections of control patellae (not subjected to impact loading), but occult damages were not observed. Although the mechanism of this occult trauma is unknown, similar damage has been shown to occur from direct shear loading. As these microcracks can potentiate a disease process in the joint, this study may suggest that the current criterion for injury, based on bone fracture alone, is not sufficiently conservative.

  1. Topographic variation in redifferentiation capacity of chondrocytes in the adult human knee joint.

    Science.gov (United States)

    Stenhamre, H; Slynarski, K; Petrén, C; Tallheden, T; Lindahl, A

    2008-11-01

    The aim of this study was to investigate the topographic variation in matrix production and cell density in the adult human knee joint. Additionally, we have examined the redifferentiation potential of chondrocytes expanded in vitro from the different locations. Full thickness cartilage-bone biopsies were harvested from seven separate anatomical locations of healthy knee joints from deceased adult human donors. Chondrocytes were isolated, expanded in vitro and redifferentiated in a pellet mass culture. Biochemical analysis of total collagen, proteoglycans and cellular content as well as histology and immunohistochemistry were performed on biopsies and pellets. In the biochemical analysis of the biopsies, we found lower proteoglycan to collagen (GAG/HP) ratio in the non-weight bearing (NWB) areas compared to the weight bearing (WB) areas. The chondrocytes harvested from different locations in femur showed a significantly better attachment and proliferation ability as well as good post-expansion chondrogenic capacity in pellet mass culture compared with the cells harvested from tibia. These results demonstrate that there are differences in extra cellular content within the adult human knee in respect to GAG/HP ratio. Additionally, the data show that clear differences between chondrocytes harvested from femur and tibia from healthy human knee joints exist and that the differences are not completely abolished during the process of de- and redifferentiation. These findings emphasize the importance of the understanding of topographic variation in articular cartilage biology when approaching new cartilage repair strategies.

  2. Human Activity Recognition in Real-Times Environments using Skeleton Joints

    Directory of Open Access Journals (Sweden)

    Ajay Kumar

    2016-06-01

    Full Text Available In this research work, we proposed a most effective noble approach for Human activity recognition in real-time environments. We recognize several distinct dynamic human activity actions using kinect. A 3D skeleton data is processed from real-time video gesture to sequence of frames and getter skeleton joints (Energy Joints, orientation, rotations of joint angles from selected setof frames. We are using joint angle and orientations, rotations information from Kinect therefore less computation required. However, after extracting the set of frames we implemented several classification techniques Principal Component Analysis (PCA with several distance based classifiers and Artificial Neural Network (ANN respectively with some variants for classify our all different gesture models. However, we conclude that use very less number of frame (10-15% for train our system efficiently from the entire set of gesture frames. Moreover, after successfully completion of our classification methods we clinch an excellent overall accuracy 94%, 96% and 98% respectively. We finally observe that our proposed system is more useful than comparing to other existing system, therefore our model is best suitable for real-time application such as in video games for player action/gesture recognition.

  3. Increased expression of damage-associated molecular patterns (DAMPs) in osteoarthritis of human knee joint compared to hip joint.

    Science.gov (United States)

    Rosenberg, John H; Rai, Vikrant; Dilisio, Matthew F; Sekundiak, Todd D; Agrawal, Devendra K

    2017-12-01

    Osteoarthritis (OA) is a degenerative disease characterized by the destruction of cartilage. The greatest risk factors for the development of OA include age and obesity. Recent studies suggest the role of inflammation in the pathogenesis of OA. The two most common locations for OA to occur are in the knee and hip joints. The knee joint experiences more mechanical stress, cartilage degeneration, and inflammation than the hip joint. This could contribute to the increased incidence of OA in the knee joint. Damage-associated molecular patterns (DAMPs), including high-mobility group box-1, receptor for advanced glycation end products, and alarmins (S100A8 and S100A9), are released in the joint in response to stress-mediated chondrocyte and cartilage damage. This facilitates increased cartilage degradation and inflammation in the joint. Studies have documented the role of DAMPs in the pathogenesis of OA; however, the comparison of DAMPs and its influence on OA has not been discussed. In this study, we compared the DAMPs between OA knee and hip joints and found a significant difference in the levels of DAMPs expressed in the knee joint compared to the hip joint. The increased levels of DAMPs suggest a difference in the underlying pathogenesis of OA in the knee and the hip and highlights DAMPs as potential therapeutic targets for OA in the future.

  4. Anterior Femoral Bow and Possible Effect on the Stifle Joint: A Comparison between Humans and Dogs.

    Science.gov (United States)

    Ocal, M K; Sabanci, S S; Cobanoglu, M; Enercan, M

    2017-08-01

    The aim of the study was to compare the anterior bow of the femur between dogs and humans in terms of the possible impact on the stifle joint. The femoral radiographs obtained retrospectively were used to determine the angles and positions of the anterior bow in both dogs (n = 135) and humans (n = 57). Descriptive statistics and Pearson's correlation analysis were used for the statistical analyses of the variables. The mean anterior bow angle (ABA) was 18.3 ± 2.02° and 4.88 ± 1.24° in dogs and humans, respectively. The bow position was at the distal shaft in dogs (64.9 ± 2.04%) and almost at the mid-shaft of the bone (46.5 ± 5.52%) in humans. The ABA was related to the bow position in both humans and dogs. Additionally, the angle correlated with age in humans, while it was correlated with weight and breed in dogs. In conclusion, it is suggested that the anterior bow should be used as a landmark on the femoral axis for the biomechanical research of stifle joint, and dog stifle could be used as a suitable model for human knee in experimental studies for clinicians, while making sure that ethical principles are fully respected. © 2017 Blackwell Verlag GmbH.

  5. A elasticidade do ligamento colateral medial da articulação do cotovelo de cão não advém de elastina The elasticity of the medial collateral ligament of the canine elbow joint does not come from elastin

    Directory of Open Access Journals (Sweden)

    Paloma Souza Costa

    2008-09-01

    determine whether the stretching of this ligament is due to the presence of elastic fibers, the elastic property of the collagen or the combination of both. Four joints were used from males and females in equal proportion, taking the medial collateral ligaments for the histological examination. To detect the presence of elastic fibers, sections were stained using the Weigert method. However, light microscopy revealed no elastic fibers. It was concluded that the elasticity of the canine elbow medial collateral ligament is mainly due to the undulated pattern of the collagen fibers, considering the trace amount or inexistence of elastic fibers in this structure.

  6. 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.

  7. Body position reproducibility and joint alignment stability criticality on a muscular strength research device

    Science.gov (United States)

    Nunez, F.; Romero, A.; Clua, J.; Mas, J.; Tomas, A.; Catalan, A.; Castellsaguer, J.

    2005-08-01

    MARES (Muscle Atrophy Research and Exercise System) is a computerized ergometer for neuromuscular research to be flown and installed onboard the International Space Station in 2007. Validity of data acquired depends on controlling and reducing all significant error sources. One of them is the misalignment of the joint rotation axis with respect to the motor axis.The error induced on the measurements is proportional to the misalignment between both axis. Therefore, the restraint system's performance is critical [1]. MARES HRS (Human Restraint System) assures alignment within an acceptable range while performing the exercise (results: elbow movement:13.94mm+/-5.45, Knee movement: 22.36mm+/- 6.06 ) and reproducibility of human positioning (results: elbow movement: 2.82mm+/-1.56, Knee movement 7.45mm+/-4.8 ). These results allow limiting measurement errors induced by misalignment.

  8. Global changes in Staphylococcus aureus gene expression during human prosthetic joint infection

    DEFF Research Database (Denmark)

    Xu, Yijuan; Nielsen, Per Halkjær; Nielsen, Jeppe Lund

    2016-01-01

    and Environmental Engineering, Aalborg University, Denmark 2: Danish Technological Institute, Aarhus, Denmark Aim: ”The aim of this study was to gain insight into the in vivo expression of virulence and metabolic genes of Staphylococcus aureus in a prosthetic joint infection in a human subject” Method: ”Deep RNA......Global changes in Staphylococcus aureus gene expression during human prosthetic joint infection Xu, Yijuan1; Nielsen, Per H.1; Nielsen, Jeppe L.1; Thomsen, Trine R. 1,2; Nielsen, Kåre L.1 and the PRIS study group 1: Center for Microbial Communities, Department of Biotechnology, Chemistry...... involved overexpression of various enzymes related to cell-wall synthesis and multidrug efflux pumps. Interestingly, these efflux pumps are only known to be related to fluoroquinolone resistance. Many of the genes encoding virulence factors were upregulated, including toxins and superantigen-like proteins...

  9. Laser radiation in tennis elbow treatment: a new minimally invasive alternative

    Science.gov (United States)

    Paganini, Stefan; Thal, Dietmar R.; Werkmann, Klaus

    1998-01-01

    The epicondylitis humeri radialis (EHR) (tennis elbow), is a common disease in elbow joint pain syndromes. We treated patients with chronic pain for at least one year and no improvement with conservative or operative therapies with a new minimal invasive method, the EHR-Laser radiation (EHR- LR). With this method periepicondylar coagulations were applied to the trigger points of the patients. For this the previously established technique of facet joint coagulation with the Nd:Yag-laser was modified. In a follow-up study of between 6 weeks and 2 years all patients reported either a significant pain reduction or were symptom free. EHR-LR is a new method situated between conservative and surgical treatments for minimal invasive therapy of EHR. Several therapeutic rationales were discussed for the resulting pain reduction.

  10. Development and Control of Compliant Hybrid Joints for Human-Symbiotic Mobile Manipulators

    Directory of Open Access Journals (Sweden)

    Zhijun Li

    2007-03-01

    Full Text Available In this paper, we develop a robot with the ability to secure human safety in human-robot collisions arising in our living and working environments. The human-symbiotic service robot using compliant hybrid joints realizes human safety, absorbs impact force, and fulfills task. In unexpected or expected collisions with human, the arising impulse force is attenuated effectively by the proposed physical model. Owing to the displacement of the links, several recovery controls have been developed for the end-effector to maintain its desired task position after the collision. The force attenuation property has been verified through collision simulations and experiments in that the capability of the proposed passive arm in overcoming the limitations of active compliance control has been demonstrated.

  11. Design and clinical outcome of a novel 3D-printed prosthetic joint replacement for the human temporomandibular joint.

    Science.gov (United States)

    Ackland, David; Robinson, Dale; Lee, Peter Vee Sin; Dimitroulis, George

    2018-05-11

    Stock prosthetic temporomandibular joint replacements come in limited sizes, and do not always encompass the joint anatomy that presents clinically. The aims of this study were twofold. Firstly, to design a personalized prosthetic total joint replacement for the treatment of a patient's end-stage temporomandibular joint osteoarthritis, to implant the prosthesis into the patient, and assess clinical outcome 12-months post-operatively; and secondly, to evaluate the influence of changes in prosthetic condyle geometry on implant load response during mastication. A 48-year-old female patient with Grade-5 osteoarthritis to the left temporomandibular joint was recruited, and a prosthesis developed to match the native temporomandibular joint anatomy. The prosthesis was 3D printed, sterilized and implanted into the patient, and pain and function measured 12-months post-operatively. The prosthesis load response during a chewing-bite and maximum-force bite was evaluated using a personalized multi-body musculoskeletal model. Simulations were performed after perturbing condyle thickness, neck length and head sphericity. Increases in prosthetic condyle neck length malaligned the mandible and perturbed temporomandibular joint force. Changes in condylar component thickness greatly influenced fixation screw stress response, while a more eccentric condylar head increased prosthetic joint-contact loading. Post-operatively, the prosthetic temporomandibular joint surgery reduced patient pain from 7/10 to 1/10 on a visual analog scale, and increased intercisal opening distance from 22 mm to 38 mm. This study demonstrates effectiveness of a personalized prosthesis that may ultimately be adapted to treat a wide-range of end-stage temporomandibular joint conditions, and highlights sensitivity of prosthesis load response to changes in condylar geometry. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. 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

  13. 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.

  14. Predictive Simulations of Neuromuscular Coordination and Joint-Contact Loading in Human Gait.

    Science.gov (United States)

    Lin, Yi-Chung; Walter, Jonathan P; Pandy, Marcus G

    2018-04-18

    We implemented direct collocation on a full-body neuromusculoskeletal model to calculate muscle forces, ground reaction forces and knee contact loading simultaneously for one cycle of human gait. A data-tracking collocation problem was solved for walking at the normal speed to establish the practicality of incorporating a 3D model of articular contact and a model of foot-ground interaction explicitly in a dynamic optimization simulation. The data-tracking solution then was used as an initial guess to solve predictive collocation problems, where novel patterns of movement were generated for walking at slow and fast speeds, independent of experimental data. The data-tracking solutions accurately reproduced joint motion, ground forces and knee contact loads measured for two total knee arthroplasty patients walking at their preferred speeds. RMS errors in joint kinematics were joint kinematics, ground forces, knee contact loads and muscle activation patterns measured for slow and fast walking. The results demonstrate the feasibility of performing computationally-efficient, predictive, dynamic optimization simulations of movement using full-body, muscle-actuated models with realistic representations of joint function.

  15. Acromioclavicular joint dislocations: radiological correlation between Rockwood classification system and injury patterns in human cadaver species.

    Science.gov (United States)

    Eschler, Anica; Rösler, Klaus; Rotter, Robert; Gradl, Georg; Mittlmeier, Thomas; Gierer, Philip

    2014-09-01

    The classification system of Rockwood and Young is a commonly used classification for acromioclavicular joint separations subdividing types I-VI. This classification hypothesizes specific lesions to anatomical structures (acromioclavicular and coracoclavicular ligaments, capsule, attached muscles) leading to the injury. In recent literature, our understanding for anatomical correlates leading to the radiological-based Rockwood classification is questioned. The goal of this experimental-based investigation was to approve the correlation between the anatomical injury pattern and the Rockwood classification. In four human cadavers (seven shoulders), the acromioclavicular and coracoclavicular ligaments were transected stepwise. Radiological correlates were recorded (Zanca view) with 15-kg longitudinal tension applied at the wrist. The resulting acromio- and coracoclavicular distances were measured. Radiographs after acromioclavicular ligament transection showed joint space enlargement (8.6 ± 0.3 vs. 3.1 ± 0.5 mm, p acromioclavicular joint space width increased to 16.7 ± 2.7 vs. 8.6 ± 0.3 mm, p acromioclavicular joint lesions higher than Rockwood type I and II. The clinical consequence for reconstruction of low-grade injuries might be a solely surgical approach for the acromioclavicular ligaments or conservative treatment. High-grade injuries were always based on additional structural damage to the coracoclavicular ligaments. Rockwood type V lesions occurred while muscle attachments were intact.

  16. Repositioning the knee joint in human body FE models using a graphics-based technique.

    Science.gov (United States)

    Jani, Dhaval; Chawla, Anoop; Mukherjee, Sudipto; Goyal, Rahul; Vusirikala, Nataraju; Jayaraman, Suresh

    2012-01-01

    Human body finite element models (FE-HBMs) are available in standard occupant or pedestrian postures. There is a need to have FE-HBMs in the same posture as a crash victim or to be configured in varying postures. Developing FE models for all possible positions is not practically viable. The current work aims at obtaining a posture-specific human lower extremity model by reconfiguring an existing one. A graphics-based technique was developed to reposition the lower extremity of an FE-HBM by specifying the flexion-extension angle. Elements of the model were segregated into rigid (bones) and deformable components (soft tissues). The bones were rotated about the flexion-extension axis followed by rotation about the longitudinal axis to capture the twisting of the tibia. The desired knee joint movement was thus achieved. Geometric heuristics were then used to reposition the skin. A mapping defined over the space between bones and the skin was used to regenerate the soft tissues. Mesh smoothing was then done to augment mesh quality. The developed method permits control over the kinematics of the joint and maintains the initial mesh quality of the model. For some critical areas (in the joint vicinity) where element distortion is large, mesh smoothing is done to improve mesh quality. A method to reposition the knee joint of a human body FE model was developed. Repositions of a model from 9 degrees of flexion to 90 degrees of flexion in just a few seconds without subjective interventions was demonstrated. Because the mesh quality of the repositioned model was maintained to a predefined level (typically to the level of a well-made model in the initial configuration), the model was suitable for subsequent simulations.

  17. Deficits in glenohumeral passive range of motion increase risk of elbow injury in professional baseball pitchers: a prospective study.

    Science.gov (United States)

    Wilk, Kevin E; Macrina, Leonard C; Fleisig, Glenn S; Aune, Kyle T; Porterfield, Ron A; Harker, Paul; Evans, Timothy J; Andrews, James R

    2014-09-01

    Injuries to the elbow joint in baseball pitchers appear common. There appears to be a correlation between shoulder range of motion and elbow injuries. To prospectively determine whether decreased ROM of the throwing shoulder is correlated with the onset of elbow injuries in professional baseball pitchers. Cohort study; Level of evidence, 2. For 8 consecutive years (2005-2012), passive range of motion of both the throwing and nonthrowing shoulders of all major and minor league pitchers within a single professional baseball organization were measured by using a bubble goniometer during spring training. In total, 505 examinations were conducted on 296 pitchers. Glenohumeral external rotation and internal rotation were assessed in the supine position with the arm at 90° of abduction and in the plane of the scapula. The scapula was stabilized per methods previously established. Total rotation was defined as the sum of external rotation and internal rotation. Passive shoulder flexion was assessed with the subject supine and the scapula stabilized per methods previously established. Elbow injuries and days missed because of elbow injuries were assessed and recorded by the medical staff of the team. Throwing and nonthrowing shoulder measurements were compared by using Student t tests; 1-tailed Fisher exact tests were performed to identify significant associations between shoulder motion and elbow injury. Nominal logistic regression was performed to determine the odds of elbow injury. Significant differences were noted during side-to-side comparisons within subjects. There were 49 elbow injuries and 8 surgeries in 38 players, accounting for a total of 2551 days missed. Neither glenohumeral internal rotation deficit nor external rotation insufficiency was correlated with elbow injuries. Pitchers with deficits of >5° in total rotation in their throwing shoulders had a 2.6 times greater risk for injury. Pitchers with deficit of ≥5° in flexion of the throwing shoulder had

  18. Investigation of the effects of human body stability on joint angles’ prediction

    Energy Technology Data Exchange (ETDEWEB)

    Pasha Zanoosi, A. A., E-mail: aliakbar.pasha@yahoo.com, E-mail: aliakbar.pasha@qiau.ac.ir [Islamic Azad University, Faculty of Industrial & Mechanical Engineering, Qazvin Branch (Iran, Islamic Republic of); Naderi, D.; Sadeghi-Mehr, M.; Feri, M. [Bu Ali-Sina University, Mechanical Engineering Department, Faculty of Engineering (Iran, Islamic Republic of); Beheshtiha, A. Sh. [Leibniz Universität Hannover, Institute of Mechanics and Computational Mechanics (Germany); Fallahnejad, K. [Flinders University, Discipline of Mechanical Engineering, School of Computer Science, Engineering and Mathematics (Australia)

    2015-10-15

    Loosing stability control in elderly or paralyzed has motivated researchers to study how a stability control system works and how to determine its state at every time instant. Studying the stability of a human body is not only an important problem from a scientific viewpoint, but also finally leads to new designs of prostheses and orthoses and rehabilitation methods. Computer modeling enables researchers to study and describe the reactions and propose a suitable and optimized motion pattern to strengthen the neuromuscular system and helps a human body maintain its stability. A perturbation as a tilting is exposed to an underfoot plate of a musculoskeletal model of the body to study the stability. The studied model of a human body included four links and three degrees of freedom with eight muscles in the sagittal plane. Lagrangian dynamics was used for deriving equations of motion and muscles were modeled using Hill’s model. Using experimental data of joint trajectories for a human body under tilting perturbation, forward dynamics has been applied to predict joint trajectories and muscle activation. This study investigated the effects of stability on predicting body joints’ motion. A new stability function for a human body, based on the zero moment point, has been employed in a forward dynamics procedure using a direct collocation method. A multi-objective optimization based on genetic algorithm has been proposed to employ stability as a robotic objective function along with muscle stresses as a biological objective function. The obtained results for joints’ motion were compared to experimental data. The results show that, for this type of perturbations, muscle stresses are in conflict with body stability. This means that more body stability requires more stresses in muscles and reverse. Results also show the effects of the stability objective function in better prediction of joint trajectories.

  19. Investigation of the effects of human body stability on joint angles’ prediction

    International Nuclear Information System (INIS)

    Pasha Zanoosi, A. A.; Naderi, D.; Sadeghi-Mehr, M.; Feri, M.; Beheshtiha, A. Sh.; Fallahnejad, K.

    2015-01-01

    Loosing stability control in elderly or paralyzed has motivated researchers to study how a stability control system works and how to determine its state at every time instant. Studying the stability of a human body is not only an important problem from a scientific viewpoint, but also finally leads to new designs of prostheses and orthoses and rehabilitation methods. Computer modeling enables researchers to study and describe the reactions and propose a suitable and optimized motion pattern to strengthen the neuromuscular system and helps a human body maintain its stability. A perturbation as a tilting is exposed to an underfoot plate of a musculoskeletal model of the body to study the stability. The studied model of a human body included four links and three degrees of freedom with eight muscles in the sagittal plane. Lagrangian dynamics was used for deriving equations of motion and muscles were modeled using Hill’s model. Using experimental data of joint trajectories for a human body under tilting perturbation, forward dynamics has been applied to predict joint trajectories and muscle activation. This study investigated the effects of stability on predicting body joints’ motion. A new stability function for a human body, based on the zero moment point, has been employed in a forward dynamics procedure using a direct collocation method. A multi-objective optimization based on genetic algorithm has been proposed to employ stability as a robotic objective function along with muscle stresses as a biological objective function. The obtained results for joints’ motion were compared to experimental data. The results show that, for this type of perturbations, muscle stresses are in conflict with body stability. This means that more body stability requires more stresses in muscles and reverse. Results also show the effects of the stability objective function in better prediction of joint trajectories

  20. Phase synchronisation of the three leg joints in quiet human stance.

    Science.gov (United States)

    Günther, Michael; Putsche, Peter; Leistritz, Lutz; Grimmer, Sten

    2011-03-01

    Quiet human stance is a dynamic multi-segment phenomenon. In literature, coupled ankle and hip actions are in the focus and examinations are usually restricted to frequency contributions below 4 Hz. Very few studies point to the knee playing an active role, and just one study gives evidence of higher frequency contributions. In order to investigate the dynamic coupling of all three leg joints in more depth, we revisited an experimental data set on quiet human stance. Since phase synchronisation is a strong indicator of non-linear coupling behind, we used the phase synchronisation index (PSI) to quantify the degree of leg joint coupling as a function of frequency. One main result is that we did not find any synchronisation between ankle and hip across the whole frequency range examined up to 8 Hz. In contrast, there is significant synchronisation between ankle and knee at a couple of frequencies between 1.25 Hz and 8 Hz when looking at the kinematics. Their joint torques rather synchronise below 2 Hz. There is also synchronisation between knee and hip kinematics above 6 Hz, however, only significant at one frequency bin in our data set. From this, we would infer that the multiple mechanical degrees of freedom contributing to quiet human stance should be chosen according to, thus map, physiology. Thereby, the knee is indispensable and bi-articular muscles play a central role in organising quiet human stance. Examining the non-stationarity of phase synchronisations will probably advance the understanding of self-organisation of quiet human stance. Copyright © 2010 Elsevier B.V. All rights reserved.

  1. 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...

  2. 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

  3. [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

  4. In vivo cartilage contact deformation in the healthy human tibiofemoral joint.

    Science.gov (United States)

    Bingham, J T; Papannagari, R; Van de Velde, S K; Gross, C; Gill, T J; Felson, D T; Rubash, H E; Li, G

    2008-11-01

    In vivo cartilage contact deformation is instrumental for understanding human joint function and degeneration. This study measured the total deformation of contacting articular cartilage in the human tibiofemoral joint during in vivo weight-bearing flexion. Eleven healthy knees were magnetic resonance (MR) scanned and imaged with a dual fluoroscopic system while the subject performed a weight-bearing single-leg lunge. The tibia, femur and associated articulating cartilage were constructed from the MR images and combined with the dual fluoroscopic images to determine in vivo cartilage contact deformation from full extension to 120 degrees of flexion. In both compartments, minimum peak compartmental contact deformation occurred at 30 degrees of flexion (24 +/- 6% medial, 17 +/- 7% lateral) and maximum peak compartmental deformation occurred at 120 degrees of flexion (30 +/- 13% medial, 30 +/- 10% lateral) during the weight-bearing flexion from full extension to 120 degrees. Average medial contact areas and peak contact deformations were significantly greater than lateral compartment values (P In addition, cartilage thickness in regions of contact was on average 1.4- and 1.1-times thicker than the average thickness of the tibial and femoral cartilage surfaces, respectively (P line knowledge for investigating the effects of various knee injuries on joint contact biomechanics and the aetiology of cartilage degeneration.

  5. 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.)

  6. 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.)

  7. Does ankle joint power reflect type of muscle action of soleus and gastrocnemius during walking in cats and humans?

    Science.gov (United States)

    Cronin, Neil J; Prilutsky, Boris I; Lichtwark, Glen A; Maas, Huub

    2013-04-26

    The main objective of this paper is to highlight the difficulties of identifying shortening and lengthening contractions based on analysis of power produced by resultant joint moments. For that purpose, we present net ankle joint powers and muscle fascicle/muscle-tendon unit (MTU) velocities for medial gastrocnemius (MG) and soleus (SO) muscles during walking in species of different size (humans and cats). For the cat, patterns of ankle joint power and MTU velocity of MG and SO during stance were similar: negative power (ankle moment×angular velocityankle joint power and fascicle velocity patterns were observed for MG muscle. In humans, like cats, the patterns of ankle joint power and MTU velocity of SO and MG were similar. Unlike the cat, there were substantial differences between patterns of fascicle velocity and ankle joint power during stance in both muscles. These results indicate that during walking, only a small fraction of mechanical work of the ankle moment is either generated or absorbed by the muscle fascicles, thus confirming the contribution of in-series elastic structures and/or energy transfer via two-joint muscles. We conclude that ankle joint negative power does not necessarily indicate eccentric action of muscle fibers and that positive power cannot be exclusively attributed to muscle concentric action, especially in humans. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Attribute And-Or Grammar for Joint Parsing of Human Pose, Parts and Attributes.

    Science.gov (United States)

    Park, Seyoung; Nie, Xiaohan; Zhu, Song-Chun

    2017-07-25

    This paper presents an attribute and-or grammar (A-AOG) model for jointly inferring human body pose and human attributes in a parse graph with attributes augmented to nodes in the hierarchical representation. In contrast to other popular methods in the current literature that train separate classifiers for poses and individual attributes, our method explicitly represents the decomposition and articulation of body parts, and account for the correlations between poses and attributes. The A-AOG model is an amalgamation of three traditional grammar formulations: (i)Phrase structure grammar representing the hierarchical decomposition of the human body from whole to parts; (ii)Dependency grammar modeling the geometric articulation by a kinematic graph of the body pose; and (iii)Attribute grammar accounting for the compatibility relations between different parts in the hierarchy so that their appearances follow a consistent style. The parse graph outputs human detection, pose estimation, and attribute prediction simultaneously, which are intuitive and interpretable. We conduct experiments on two tasks on two datasets, and experimental results demonstrate the advantage of joint modeling in comparison with computing poses and attributes independently. Furthermore, our model obtains better performance over existing methods for both pose estimation and attribute prediction tasks.

  9. Rhythm Patterns Interaction - Synchronization Behavior for Human-Robot Joint Action

    Science.gov (United States)

    Mörtl, Alexander; Lorenz, Tamara; Hirche, Sandra

    2014-01-01

    Interactive behavior among humans is governed by the dynamics of movement synchronization in a variety of repetitive tasks. This requires the interaction partners to perform for example rhythmic limb swinging or even goal-directed arm movements. Inspired by that essential feature of human interaction, we present a novel concept and design methodology to synthesize goal-directed synchronization behavior for robotic agents in repetitive joint action tasks. The agents’ tasks are described by closed movement trajectories and interpreted as limit cycles, for which instantaneous phase variables are derived based on oscillator theory. Events segmenting the trajectories into multiple primitives are introduced as anchoring points for enhanced synchronization modes. Utilizing both continuous phases and discrete events in a unifying view, we design a continuous dynamical process synchronizing the derived modes. Inverse to the derivation of phases, we also address the generation of goal-directed movements from the behavioral dynamics. The developed concept is implemented to an anthropomorphic robot. For evaluation of the concept an experiment is designed and conducted in which the robot performs a prototypical pick-and-place task jointly with human partners. The effectiveness of the designed behavior is successfully evidenced by objective measures of phase and event synchronization. Feedback gathered from the participants of our exploratory study suggests a subjectively pleasant sense of interaction created by the interactive behavior. The results highlight potential applications of the synchronization concept both in motor coordination among robotic agents and in enhanced social interaction between humanoid agents and humans. PMID:24752212

  10. A hybrid joint based controller for an upper extremity exoskeleton

    Science.gov (United States)

    Mohd Khairuddin, Ismail; Taha, Zahari; Majeed, Anwar P. P. Abdul; Hakeem Deboucha, Abdel; Azraai Mohd Razman, Mohd; Aziz Jaafar, Abdul; Mohamed, Zulkifli

    2016-02-01

    This paper presents the modelling and control of a two degree of freedom upper extremity exoskeleton. The Euler-Lagrange formulation was used in deriving the dynamic modelling of both the human upper limb as well as the exoskeleton that consists of the upper arm and the forearm. The human model is based on anthropometrical measurements of the upper limb. The proportional-derivative (PD) computed torque control (CTC) architecture is employed in this study to investigate its efficacy performing joint-space control objectives specifically in rehabilitating the elbow and shoulder joints along the sagittal plane. An active force control (AFC) algorithm is also incorporated into the PD-CTC to investigate the effectiveness of this hybrid system in compensating disturbances. It was found that the AFC- PD-CTC performs well against the disturbances introduced into the system whilst achieving acceptable trajectory tracking as compared to the conventional PD-CTC control architecture.

  11. A hybrid joint based controller for an upper extremity exoskeleton

    International Nuclear Information System (INIS)

    Khairuddin, Ismail Mohd; Taha, Zahari; Majeed, Anwar P.P. Abdul; Deboucha, Abdel Hakeem; Razman, Mohd Azraai Mohd; Jaafar, Abdul Aziz; Mohamed, Zulkifli

    2016-01-01

    This paper presents the modelling and control of a two degree of freedom upper extremity exoskeleton. The Euler-Lagrange formulation was used in deriving the dynamic modelling of both the human upper limb as well as the exoskeleton that consists of the upper arm and the forearm. The human model is based on anthropometrical measurements of the upper limb. The proportional-derivative (PD) computed torque control (CTC) architecture is employed in this study to investigate its efficacy performing joint-space control objectives specifically in rehabilitating the elbow and shoulder joints along the sagittal plane. An active force control (AFC) algorithm is also incorporated into the PD-CTC to investigate the effectiveness of this hybrid system in compensating disturbances. It was found that the AFC- PD-CTC performs well against the disturbances introduced into the system whilst achieving acceptable trajectory tracking as compared to the conventional PD-CTC control architecture. (paper)

  12. 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.

  13. Displacement of the medial meniscus within the passive motion characteristics of the human knee joint: an RSA study in human cadaver knees.

    NARCIS (Netherlands)

    Tienen, T. van; Buma, P.; Scholten, J.G.; Kampen, A. van; Veth, R.P.H.; Verdonschot, N.J.J.

    2005-01-01

    The objective of this study was to validate an in vitro human cadaver knee-joint model for the evaluation of the meniscal movement during knee-joint flexion. The question was whether our model showed comparable meniscal displacements to those found in earlier meniscal movement studies in vivo.

  14. 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.

  15. 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.

  16. 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.

  17. Development and Control of Compliant Hybrid Joints for Human-Symbiotic Mobile Manipulators

    Directory of Open Access Journals (Sweden)

    Zhijun Li

    2008-11-01

    Full Text Available In this paper, we develop a robot with the ability to secure human safety in humanrobot collisions arising in our living and working environments. The humansymbiotic service robot using compliant hybrid joints realizes human safety, absorbs impact force, and fulfills task. In unexpected or expected collisions with human, the arising impulse force is attenuated effectively by the proposed physical model. Owing to the displacement of the links, several recovery controls have been developed for the endeffector to maintain its desired task position after the collision. The force attenuation property has been verified through collision simulations and experiments in that the capability of the proposed passive arm in overcoming the limitations of active compliance control has been demonstrated.

  18. An Evaluation of Automotive Interior Packages Based on Human Ocular and Joint Motor Properties

    Science.gov (United States)

    Tanaka, Yoshiyuki; Rakumatsu, Takeshi; Horiue, Masayoshi; Miyazaki, Tooru; Nishikawa, Kazuo; Nouzawa, Takahide; Tsuji, Toshio

    This paper proposes a new evaluation method of an automotive interior package based on human oculomotor and joint-motor properties. Assuming the long-term driving situation in the express high way, the three evaluation indices were designed on i) the ratio of head motion at gazing the driving items; ii) the load torque for maintaining the standard driving posture; and iii) the human force manipulability at the end-point of human extremities. Experiments were carried out for two different interior packages with four subjects who have the special knowledge on the automobile development. Evaluation results demonstrate that the proposed method can quantitatively analyze the driving interior in good agreement with the generally accepted subjective opinion in the automobile industry.

  19. Viability of pHEMA Hydrogels as Coating in Human Synovial Joint Prosthesis

    Directory of Open Access Journals (Sweden)

    V.P. Bavaresco

    2002-10-01

    Full Text Available In artificial joints, the bone part is usually substituted by a metallic component with high corrosion and strength resistance while the articular cartilage is replaced by a polymer. Use of thin layer of a compliant material acting as a bearing surface in human replacement joints has recently generated considerable interest. This work analyses the coating of a solid porous substrate of Ultra High Molecular Weight Polyethylene (UHMWPE with a poly (2-hydroxyethyl methacrylate (pHEMA and two sIPN-type blends: pHEMA-cellulose acetate butyrate (CAB and pHEMA-poly (ethyl methacrylate (PEM using 5.0% (w/w of the crosslinking agent and 11.0% (w/w of the linear reinforcing polymer. The wear resistance of the coating materials was evaluated in a TRI PIN ON DISK type equipment and the damage extension was characterized by Scanning Electron Microscopy (SEM. Preliminary qualitative tests were performed with the goal to identifying the hydrogels show the minimal required properties concerning wear strength. The pHEMA coating was completely destroyed during the first wear cycles, characterizing its low shear strength. By the other hand, after the complete experiment, both pHEMA-CAB and pHEMA-PEM blends showed a slightly improvement of abrasive and adhesive wear. This result indicates that the studied blends are promising materials to be used as compliant surfaces in joint prosthesis.

  20. A joint-space numerical model of metabolic energy expenditure for human multibody dynamic system.

    Science.gov (United States)

    Kim, Joo H; Roberts, Dustyn

    2015-09-01

    Metabolic energy expenditure (MEE) is a critical performance measure of human motion. In this study, a general joint-space numerical model of MEE is derived by integrating the laws of thermodynamics and principles of multibody system dynamics, which can evaluate MEE without the limitations inherent in experimental measurements (phase delays, steady state and task restrictions, and limited range of motion) or muscle-space models (complexities and indeterminacies from excessive DOFs, contacts and wrapping interactions, and reliance on in vitro parameters). Muscle energetic components are mapped to the joint space, in which the MEE model is formulated. A constrained multi-objective optimization algorithm is established to estimate the model parameters from experimental walking data also used for initial validation. The joint-space parameters estimated directly from active subjects provide reliable MEE estimates with a mean absolute error of 3.6 ± 3.6% relative to validation values, which can be used to evaluate MEE for complex non-periodic tasks that may not be experimentally verifiable. This model also enables real-time calculations of instantaneous MEE rate as a function of time for transient evaluations. Although experimental measurements may not be completely replaced by model evaluations, predicted quantities can be used as strong complements to increase reliability of the results and yield unique insights for various applications. Copyright © 2015 John Wiley & Sons, Ltd.

  1. Wearable Inertial Sensors Allow for Quantitative Assessment of Shoulder and Elbow Kinematics in a Cadaveric Knee Arthroscopy Model.

    Science.gov (United States)

    Rose, Michael; Curtze, Carolin; O'Sullivan, Joseph; El-Gohary, Mahmoud; Crawford, Dennis; Friess, Darin; Brady, Jacqueline M

    2017-12-01

    To develop a model using wearable inertial sensors to assess the performance of orthopaedic residents while performing a diagnostic knee arthroscopy. Fourteen subjects performed a diagnostic arthroscopy on a cadaveric right knee. Participants were divided into novices (5 postgraduate year 3 residents), intermediates (5 postgraduate year 4 residents), and experts (4 faculty) based on experience. Arm movement data were collected by inertial measurement units (Opal sensors) by securing 2 sensors to each upper extremity (dorsal forearm and lateral arm) and 2 sensors to the trunk (sternum and lumbar spine). Kinematics of the elbow and shoulder joints were calculated from the inertial data by biomechanical modeling based on a sequence of links connected by joints. Range of motion required to complete the procedure was calculated for each group. Histograms were used to compare the distribution of joint positions for an expert, intermediate, and novice. For both the right and left upper extremities, skill level corresponded well with shoulder abduction-adduction and elbow prono-supination. Novices required on average 17.2° more motion in the right shoulder abduction-adduction plane than experts to complete the diagnostic arthroscopy (P = .03). For right elbow prono-supination (probe hand), novices required on average 23.7° more motion than experts to complete the procedure (P = .03). Histogram data showed novices had markedly more variability in shoulder abduction-adduction and elbow prono-supination compared with the other groups. Our data show wearable inertial sensors can measure joint kinematics during diagnostic knee arthroscopy. Range-of-motion data in the shoulder and elbow correlated inversely with arthroscopic experience. Motion pattern-based analysis shows promise as a metric of resident skill acquisition and development in arthroscopy. Wearable inertial sensors show promise as metrics of arthroscopic skill acquisition among residents. Copyright © 2017

  2. 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.

  3. Treatment of complex osteoarticular injuries of the elbow with external unilateral articulated fixator

    International Nuclear Information System (INIS)

    Cuellar Gallo, Lazaro; Portilla Carrillo, Armando; Calderon Uribe, Oscar; Calvache Currea, Gustavo Adolfo; Satizabal Azuero, Carlos Arnulfo

    2001-01-01

    Previous observations suggest that conventional treatment of complex injuries about the elbow such as open; reduction and internal Fixation might lead, to bad functional outcome. The authors present a descriptive, observational and prospective study of a series of cases, on 8 patients, average age 37.8 years (25-28 years) 6 men and 2 women with complex injury of the elbow. Due to trauma which etiology is summarized as follows intraarticular comminuted open fracture secondary to gunshot wound 5 patients (62.5%); luxofracture 2 patients (25%), lntraarticular comminuted closed fracture 1 patient (12.5%). The patients where followed for 8 to 20 months. Were performed en 75% of patients open reduction, internal fixation of radial resection of radial head en 25% when comminute fracture of the head was found. All patients were treated with an external unilateral articulated fixation on the elbow, in order to protect the internal fixation, allow early joint motion and give early mobility. All patients were evaluated with Mayo scale, obtaining good results, with externals fixation treatment. In one case (12.5%) a dyaphiseal fracture of the humerus, occurred as an inherent complication secondary to the use of the external fixation, after it's withdrawal. This patient was treated with open reduction and internal fixation of the fracture, without significant impairment of the final result. Early results suggest that the use of unilateral articulated external fixator for the treatment of complex fractures about the elbow has great advantages over the other treatment techniques, such as the early motion of the elbow, dynamic protection of the internal fixation and preservation of the articulate stability, even when ligament injury is present

  4. Prolonged blockade of the brachial plexus for the early rehabilitation of children with posttraumatic elbow contractures

    Directory of Open Access Journals (Sweden)

    D. V. Zabolotsky

    2015-01-01

    Full Text Available Objective. Improvement of surgical treatment outcomes in children with post-traumatic elbow contractures. Materials and methods. The study is based on the diagnostic findings of 48 children with post-traumatic elbow contractures who were treated at the Turner Scientific and Research Institute for Children’s Orthopedics. All children underwent complex rehabilitation after reconstructive intra-articular surgery to work out passive motions in the elbow using ARTROMOT-E2 device. The patients of the study group started rehabilitation in the first days after reconstructive intra-articular surgery in the background of prolonged blockade of the brachial plexus. In the control group, the rehabilitation was carried out traditionally on the 6th day after surgery without regional anesthesia. The patients of the study group were supplied with Contiplex SU perinural catheters for prolonged blockade of the brachial plexus using ultrasound (Edge SonoSite and neurostimulation (Stimuplex® HNS12 before surgery. For perioperative blockade of the brachial plexus we used intermittent injection of 0.5% ropivacaine (2 mg / kg. The severity of pain at the stages of rehabilitation was assessed using 10-point grading scale (FPS-R. The range of active and passive motions in the joints was evaluated by measuring the range of motions with a fleximeter. Results. Intermittent injection of ropivacaine before rehabilitation allowed to correct post-traumatic elbow contractures in children in the first days after surgery associated with the minimum subjective pain level and stable hemodynamic parameteres, accompanied with a significant increase of the elbow motion range in comparison with the group of the patients who were not performed regional anesthesia . Conclusion. Prolonged blockade of the brachial plexus in rehabilitation treatment of children with post-traumatic contractures provides appropriate analgesic and myoneural block components from the 1st day after intra

  5. Subject-specific computer simulation model for determining elbow loading in one-handed tennis backhand groundstrokes.

    Science.gov (United States)

    King, Mark A; Glynn, Jonathan A; Mitchell, Sean R

    2011-11-01

    A subject-specific angle-driven computer model of a tennis player, combined with a forward dynamics, equipment-specific computer model of tennis ball-racket impacts, was developed to determine the effect of ball-racket impacts on loading at the elbow for one-handed backhand groundstrokes. Matching subject-specific computer simulations of a typical topspin/slice one-handed backhand groundstroke performed by an elite tennis player were done with root mean square differences between performance and matching simulations of elbow loading for a topspin and slice one-handed backhand groundstroke is relatively small. In this study, the relatively small differences in elbow loading may be due to comparable angle-time histories at the wrist and elbow joints with the major kinematic differences occurring at the shoulder. Using a subject-specific angle-driven computer model combined with a forward dynamics, equipment-specific computer model of tennis ball-racket impacts allows peak internal loading, net impulse, and shock due to ball-racket impact to be calculated which would not otherwise be possible without impractical invasive techniques. This study provides a basis for further investigation of the factors that may increase elbow loading during tennis strokes.

  6. Magnetostrictive energy generator for harvesting the rotation of human knee joint

    Directory of Open Access Journals (Sweden)

    Baiping Yan

    2018-05-01

    Full Text Available This paper presents the design and fabrication of a rotary-impact magnetostrictive energy generator, used to harvest the rotation of human knee joint. The harvester consists of twelve movable Terfenol-D rods, surrounded by the picked up coils respectively, and alternate permanent magnet (PM array sandwiched in each part of the shell. Rotational electromagnetic power generating effect and impacted magnetostrictive power generating effect are designed in the harvester. Modeling and simulation are used to validate the concept. Then, magnetic field and leakage of the harvester are analyzed, electromagnetic force in the harvester is simulated. A prototype of harvester is fabricated, and subjected to the experimental characterization. It can be concluded that huge induced voltage generated in the short-time impact situation and that induced voltage in the harvester can reach up to 60-80 volts at 0.91Hz low frequency rotation. Also, the presented harvester has good harvesting effects at low frequency human walking and periodic swing crus situation, which are suitable to be used for future researches of wearable knee joint applications.

  7. A spectroscopic approach to imaging and quantification of cartilage lesions in human knee joints

    International Nuclear Information System (INIS)

    Johansson, A; Oeberg, P A; Sundqvist, T; Kuiper, J-H

    2011-01-01

    We have previously described a technology based on diffuse reflectance of broadband light for measuring joint articular cartilage thickness, utilizing that optical absorption is different in cartilage and subchondral bone. This study is the first evaluation of the technology in human material. We also investigated the prospects of cartilage lesion imaging, with the specific aim of arthroscopic integration. Cartilage thickness was studied ex vivo in a number of sites (n = 87) on human knee joint condyles, removed from nine patients during total knee replacement surgery. A reflectance spectrum was taken at each site and the cartilage thickness was estimated using the blue, green, red and near-infrared regions of the spectrum, respectively. Estimated values were compared with reference cartilage thickness values (taken after sample slicing) using an exponential model. Two-dimensional Monte Carlo simulations were performed in a theoretical analysis of the experimental results. The reference cartilage thickness of the investigated sites was 1.60 ± 1.30 mm (mean ± SD) in the range 0-4.2 mm. Highest correlation coefficients were seen for the calculations based on the near-infrared region after normalization to the red region (r = 0.86) and for the green region (r = 0.80).

  8. Magnetostrictive energy generator for harvesting the rotation of human knee joint

    Science.gov (United States)

    Yan, Baiping; Zhang, Chengming; Li, Liyi

    2018-05-01

    This paper presents the design and fabrication of a rotary-impact magnetostrictive energy generator, used to harvest the rotation of human knee joint. The harvester consists of twelve movable Terfenol-D rods, surrounded by the picked up coils respectively, and alternate permanent magnet (PM) array sandwiched in each part of the shell. Rotational electromagnetic power generating effect and impacted magnetostrictive power generating effect are designed in the harvester. Modeling and simulation are used to validate the concept. Then, magnetic field and leakage of the harvester are analyzed, electromagnetic force in the harvester is simulated. A prototype of harvester is fabricated, and subjected to the experimental characterization. It can be concluded that huge induced voltage generated in the short-time impact situation and that induced voltage in the harvester can reach up to 60-80 volts at 0.91Hz low frequency rotation. Also, the presented harvester has good harvesting effects at low frequency human walking and periodic swing crus situation, which are suitable to be used for future researches of wearable knee joint applications.

  9. A personalized 3D-printed prosthetic joint replacement for the human temporomandibular joint: From implant design to implantation.

    Science.gov (United States)

    Ackland, David C; Robinson, Dale; Redhead, Michael; Lee, Peter Vee Sin; Moskaljuk, Adrian; Dimitroulis, George

    2017-05-01

    Personalized prosthetic joint replacements have important applications in cases of complex bone and joint conditions where the shape and size of off-the-shelf components may not be adequate. The objective of this study was to design, test and fabricate a personalized 3D-printed prosthesis for a patient requiring total joint replacement surgery of the temporomandibular joint (TMJ). The new 'Melbourne' prosthetic TMJ design featured a condylar component sized specifically to the patient and fixation screw positions that avoid potential intra-operative damage to the mandibular nerve. The Melbourne prosthetic TMJ was developed for a 58-year-old female recipient with end-stage osteoarthritis of the TMJ. The load response of the prosthesis during chewing and a maximum-force bite was quantified using a personalized musculoskeletal model of the patient's masticatory system developed using medical images. The simulations were then repeated after implantation of the Biomet Microfixation prosthetic TMJ, an established stock device. The maximum condylar stresses, screw stress and mandibular stress at the screw-bone interface were lower in the Melbourne prosthetic TMJ (259.6MPa, 312.9MPa and 198.4MPa, respectively) than those in the Biomet Microfixation device (284.0MPa, 416.0MPa and 262.2MPa, respectively) during the maximum-force bite, with similar trends also observed during the chewing bite. After trialing surgical placement and evaluating prosthetic TMJ stability using cadaveric specimens, the prosthesis was fabricated using 3D printing, sterilized, and implanted into the female recipient. Six months post-operatively, the prosthesis recipient had a normal jaw opening distance (40.0 mm), with no complications identified. The new design features and immediate load response of the Melbourne prosthetic TMJ suggests that it may provide improved clinical and biomechanical joint function compared to a commonly used stock device, and reduce risk of intra-operative nerve damage

  10. An unusual case of posterior elbow dislocation with proximal radioulnar translocation.

    Science.gov (United States)

    Gómez Robledo, J; Díez Lizuaín, M L

    2018-03-07

    We present a 9-year-old girl who suffered a posterior dislocation of the right elbow with a proximal translocation between the ulna and the radius. It is a type of exceptional dislocation which in our case was not accompanied by lesions of the joint surfaces of the elbow unlike most cases already published. This article stresses the importance of making an early diagnosis of this variety of dislocation; this is the best way to prevent it from going unnoticed. The use of Computed Tomography (CT) helped this early diagnosis, enabling an immediate closed orthopaedic reduction and achieving a cure without sequelae. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Mechanical design of EFW Exo II: A hybrid exoskeleton for elbow-forearm-wrist rehabilitation.

    Science.gov (United States)

    Bian, Hui; Chen, Ziye; Wang, Hao; Zhao, Tieshi

    2017-07-01

    The use of rehabilitation exoskeleton has become an important means for the treatment of stroke patients. A hybrid exoskeleton named EFW Exo II is developed for the motor function rehabilitation of elbow, forearm and wrist. The EFW Exo II is based on a parallel 2-URR/RRS mechanism and a serial R mechanism. It could fit both left and right arms for the symmetrical and open structure, and the distance between the elbow and wrist could automatically adjust for different forearm length. Details of the mechanical design are introduced. Brushless DC servo motors with planetary gear reducer are used as the actuators of the exoskeleton. Gear drive and belt drive are used for power transmission. A three dimensional force sensor is mounted in the handle to regulate the interaction between the exoskeleton and patient. The EFW Exo II can realize rehabilitation exercise for each joint and the ranges of motion meet the rehabilitation demands of daily living.

  12. 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.

  13. Proximal versus distal control of two-joint planar reaching movements in the presence of neuromuscular noise.

    Science.gov (United States)

    Nguyen, Hung P; Dingwell, Jonathan B

    2012-06-01

    Determining how the human nervous system contends with neuro-motor noise is vital to understanding how humans achieve accurate goal-directed movements. Experimentally, people learning skilled tasks tend to reduce variability in distal joint movements more than in proximal joint movements. This suggests that they might be imposing greater control over distal joints than proximal joints. However, the reasons for this remain unclear, largely because it is not experimentally possible to directly manipulate either the noise or the control at each joint independently. Therefore, this study used a 2 degree-of-freedom torque driven arm model to determine how different combinations of noise and/or control independently applied at each joint affected the reaching accuracy and the total work required to make the movement. Signal-dependent noise was simultaneously and independently added to the shoulder and elbow torques to induce endpoint errors during planar reaching. Feedback control was then applied, independently and jointly, at each joint to reduce endpoint error due to the added neuromuscular noise. Movement direction and the inertia distribution along the arm were varied to quantify how these biomechanical variations affected the system performance. Endpoint error and total net work were computed as dependent measures. When each joint was independently subjected to noise in the absence of control, endpoint errors were more sensitive to distal (elbow) noise than to proximal (shoulder) noise for nearly all combinations of reaching direction and inertia ratio. The effects of distal noise on endpoint errors were more pronounced when inertia was distributed more toward the forearm. In contrast, the total net work decreased as mass was shifted to the upper arm for reaching movements in all directions. When noise was present at both joints and joint control was implemented, controlling the distal joint alone reduced endpoint errors more than controlling the proximal joint

  14. 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.

  15. Tennis players show a lower coactivation of the elbow antagonist muscles during isokinetic exercises.

    Science.gov (United States)

    Bazzucchi, Ilenia; Riccio, Maria Elena; Felici, Francesco

    2008-10-01

    Previous studies have suggested that muscle coactivation could be reduced by a recurrent activity (training, daily activities). If this was correct, skilled athletes should show a specific muscle activation pattern with a low level of coactivation of muscles which are typically involved in their discipline. In particular, the aim of this study was to verify the hypothesis that the amount of antagonist activation of biceps brachii (BB) and triceps brachii (TB) is different between tennis players and non-players individuals during maximal isokinetic contractions. Ten young healthy men and eight male tennis players participated in the study. The surface electromyographic signals (sEMG) were recorded from the BB and TB muscles during three maximal voluntary isometric contractions (MVC) of elbow flexors and extensors and a set of three maximal elbow flexions and extensions at 15 degrees , 30 degrees , 60 degrees , 120 degrees , 180 degrees and 240 degrees /s. Normalized root mean square (RMS) of sEMG was calculated as an index of sEMG amplitude. Antagonist activation (%RMSmax) of TB was significantly lower in tennis players (from 14.0+/-7.9% at MVC to 16.3+/-8.9% at 240 degrees /s) with respect to non-players (from 27.7+/-19.7% at MVC to 38.7+/-17.6% at 240 degrees /s) at all angular velocities. Contrary to non-players, tennis players did not show any difference in antagonist activation between BB and TB muscles. Tennis players, with a constant practice in controlling forces around the elbow joint, learn how to reduce coactivation of muscles involved in the control of this joint. This has been shown by the lower antagonist muscular activity of triceps brachii muscle during isokinetic elbow flexion found in tennis players with respect to non-players.

  16. Interobserver and intraobserver agreement of ligamentous injuries on conventional MRI after simple elbow dislocation

    Directory of Open Access Journals (Sweden)

    Marc Schnetzke

    2017-02-01

    Full Text Available Abstract Background The primary objective of this study was to assess the interobserver and intraobserver agreement on ligamentous injuries on conventional magnetic resonance imaging (MRI in acute simple elbow dislocation. The secondary objectives were to determine the interobserver agreement on the assessment of joint congruity, joint effusion, loose bodies and chondral lesions on conventional MRI. Methods Conventional MRIs (1.5 Tesla, elbow specific surface coil of 30 patients (40.7 years; range 14–72 with simple elbow dislocations were evaluated by four blinded examiners. An analysis of the interobserver agreement of all raters and for several subgroups (radiologists, orthopaedics, experienced, non-experienced was performed. The examiners assessed the integrity (intact, partial tear, complete tear of the lateral collateral ligament (LCL, medial collateral ligament (MCL, extensor and flexor tendons, as well as the presence of joint congruity, joint effusion, loose bodies and chondral lesions. Agreement strength, correlation and proportion of exact agreement were determined for interobserver agreement, and intraobserver agreement analyses. Results Interobserver agreement of all examiners was fair to moderate for collateral ligaments (LCL: 0.441, MCL: 0.275. Exact agreement of all raters was found in 33.3% for the LCL and in 26.7% for the MCL. The both experienced examiners showed highest agreement strength for the LCL (0.619 and the radiologists showed highest agreement strength for the MCL (0.627, the proportion of exact agreement was 60.0% in both categories. A high proportion of exact agreement regarding joint congruity (90%, joint effusion (100%, loose bodies (96.7% and chondral lesion (80% was found among the radiologists. The evaluation of the intraobserver agreement revealed slight to substantial agreement (0.227 to 0.718 for the collateral ligaments. Conclusions This study shows difficulties in the evaluation of ligaments by

  17. New total ossicular replacement prostheses with a resilient joint: experimental data from human temporal bones.

    Science.gov (United States)

    Arechvo, Irina; Bornitz, Matthias; Lasurashvili, Nikoloz; Zahnert, Thomas; Beleites, Thomas

    2012-01-01

    New flexible total ossicular prostheses with an integrated microjoint can compensate for large static displacements in the reconstructed ossicular chain. When properly designed, they can mimic the function of the joints of the intact chain and ensure good vibration transfer in both straight and bent conditions. Prosthesis dislocations and extrusions are frequently observed after middle ear surgery. They are mainly related to the altered distance between the coupling points because of large static eardrum displacements. The new prostheses consist of 2 titanium shafts, which are incorporated into a silicone body. The sound transfer function and stapes footplate displacement at static loads were evaluated in human temporal bones after ossicular reconstruction using prostheses with 2 different silicones with different hardness values. The stiffness and bending characteristics of the prostheses were investigated with a quasi-static load. The sound transfer properties of the middle ears with the prostheses inserted under uncompressed conditions were comparable with those of ears with intact ossicular chains. The implant with the soft silicone had improved acoustic transfer characteristics over the implant with the hard silicone in a compressed state. In the quasi-static experiments, the minimum medial footplate displacement was found with the same implant. The bending characteristics depended on the silicone stiffness and correlated closely with the point and angle of the load incidence. The titanium prostheses with a resilient joint that were investigated in this study had good sound transfer characteristics under optimal conditions as well as in a compressed state. As a result of joint bending, the implants compensate for the small changes in length of the ossicular chain that occur under varying middle ear pressure. The implants require a stable support at the stapes footplate to function properly.

  18. 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.

  19. Image-assisted non-invasive and dynamic biomechanical analysis of human joints

    International Nuclear Information System (INIS)

    Muhit, Abdullah A; Pickering, Mark R; Scarvell, Jennifer M; Ward, Tom; Smith, Paul N

    2013-01-01

    Kinematic analysis provides a strong link between musculoskeletal injuries, chronic joint conditions, treatment planning/monitoring and prosthesis design/outcome. However, fast and accurate 3D kinematic analysis still remains a challenge in order to translate this procedure into clinical scenarios. 3D computed tomography (CT) to 2D single-plane fluoroscopy registration is a promising non-invasive technology for biomechanical examination of human joints. Although this technique has proven to be very precise in terms of in-plane translation and rotation measurements, out-of-plane motion estimations have been a difficulty so far. Therefore, to enable this technology into clinical translation, precise and fast estimation of both in-plane and out-of-plane movements is crucial, which is the aim of this paper. Here, a fast and accurate 3D/2D registration technique is proposed to evaluate biomechanical/kinematic analysis. The proposed algorithm utilizes a new multi-modal similarity measure called ‘sum of conditional variances’, a coarse-to-fine Laplacian of Gaussian filtering approach for robust gradient-descent optimization and a novel technique for the analytic calculation of the required gradients for out-of-plane rotations. Computer simulations and in vitro experiments showed that the new approach was robust in terms of the capture range, required significantly less iterations to converge and achieved good registration and kinematic accuracy when compared to existing techniques and to the ‘gold-standard’ Roentgen stereo analysis. (paper)

  20. Evaluation of an intact, an ACL-deficient, and a reconstructed human knee joint finite element model.

    Science.gov (United States)

    Vairis, Achilles; Stefanoudakis, George; Petousis, Markos; Vidakis, Nectarios; Tsainis, Andreas-Marios; Kandyla, Betina

    2016-02-01

    The human knee joint has a three-dimensional geometry with multiple body articulations that produce complex mechanical responses under loads that occur in everyday life and sports activities. Understanding the complex mechanical interactions of these load-bearing structures is of use when the treatment of relevant diseases is evaluated and assisting devices are designed. The anterior cruciate ligament (ACL) in the knee is one of four main ligaments that connects the femur to the tibia and is often torn during sudden twisting motions, resulting in knee instability. The objective of this work is to study the mechanical behavior of the human knee joint and evaluate the differences in its response for three different states, i.e., intact, ACL-deficient, and surgically treated (reconstructed) knee. The finite element models corresponding to these states were developed. For the reconstructed model, a novel repair device was developed and patented by the author in previous work. Static load cases were applied, as have already been presented in a previous work, in order to compare the calculated results produced by the two models the ACL-deficient and the surgically reconstructed knee joint, under the exact same loading conditions. Displacements were calculated in different directions for the load cases studied and were found to be very close to those from previous modeling work and were in good agreement with experimental data presented in literature. The developed finite element model for both the intact and the ACL-deficient human knee joint is a reliable tool to study the kinematics of the human knee, as results of this study show. In addition, the reconstructed human knee joint model had kinematic behavior similar to the intact knee joint, showing that such reconstruction devices can restore human knee stability to an adequate extent.

  1. FAO-OIE-WHO Joint Technical Consultation on Avian Influenza at the Human-Animal Interface.

    Science.gov (United States)

    Anderson, Tara; Capua, Ilaria; Dauphin, Gwenaëlle; Donis, Ruben; Fouchier, Ron; Mumford, Elizabeth; Peiris, Malik; Swayne, David; Thiermann, Alex

    2010-05-01

    For the past 10 years, animal health experts and human health experts have been gaining experience in the technical aspects of avian influenza in mostly separate fora. More recently, in 2006, in a meeting of the small WHO Working Group on Influenza Research at the Human Animal Interface (Meeting report available from: http://www.who.int/csr/resources/publications/influenza/WHO_CDS_EPR_GIP_2006_3/en/index.html) in Geneva allowed influenza experts from the animal and public health sectors to discuss together the most recent avian influenza research. Ad hoc bilateral discussions on specific technical issues as well as formal meetings such as the Technical Meeting on HPAI and Human H5N1 Infection (Rome, June, 2007; information available from: http://www.fao.org/avianflu/en/conferences/june2007/index.html) have increasingly brought the sectors together and broadened the understanding of the topics of concern to each sector. The sectors have also recently come together at the broad global level, and have developed a joint strategy document for working together on zoonotic diseases (Joint strategy available from: ftp://ftp.fao.org/docrep/fao/011/ajl37e/ajl37e00.pdf). The 2008 FAO-OIE-WHO Joint Technical Consultation on Avian Influenza at the Human Animal Interface described here was the first opportunity for a large group of influenza experts from the animal and public health sectors to gather and discuss purely technical topics of joint interest that exist at the human-animal interface. During the consultation, three influenza-specific sessions aimed to (1) identify virological characteristics of avian influenza viruses (AIVs) important for zoonotic and pandemic disease, (2) evaluate the factors affecting evolution and emergence of a pandemic influenza strain and identify existing monitoring systems, and (3) identify modes of transmission and exposure sources for human zoonotic influenza infection (including discussion of specific exposure risks by affected countries). A

  2. Analysis of Human Osteological Remains Multi-County Areas, North Dakota.

    Science.gov (United States)

    1983-03-01

    suggested diagno- sis for this lesion complex is degenerative arthritis involving the ster- noclavicular, acromioclavicular , shoulder, and elbow joints...irregular marginal lipping. The lesion complex is suggestive of degen- erative arthritis involving the acromioclavicular , shoulder, and elbow joints. A...enlarged by exostosis. This lesion complex is diagnosed as degenerative arthritis involving the sterno- clavicular, acromioclavicular , and shoulder joints

  3. Human movement analysis using stereophotogrammetry. Part 4: assessment of anatomical landmark misplacement and its effects on joint kinematics.

    Science.gov (United States)

    Della Croce, Ugo; Leardini, Alberto; Chiari, Lorenzo; Cappozzo, Aurelio

    2005-02-01

    Estimating the effects of different sources of error on joint kinematics is crucial for assessing the reliability of human movement analysis. The goal of the present paper is to review the different approaches dealing with joint kinematics sensitivity to rotation axes and the precision of anatomical landmark determination. Consistent with the previous papers in this series, the review is limited to studies performed with video-based stereophotogrammetric systems. Initially, studies dealing with estimates of precision in determining the location of both palpable and internal anatomical landmarks are reviewed. Next, the effects of anatomical landmark position uncertainty on anatomical frames are shown. Then, methods reported in the literature for estimating error propagation from anatomical axes location to joint kinematics are described. Interestingly, studies carried out using different approaches reported a common conclusion: when joint rotations occur mainly in a single plane, minor rotations out of this plane are strongly affected by errors introduced at the anatomical landmark identification level and are prone to misinterpretation. Finally, attempts at reducing joint kinematics errors due to anatomical landmark position uncertainty are reported. Given the relevance of this source of errors in the determination of joint kinematics, it is the authors' opinion that further efforts should be made in improving the reliability of the joint axes determination.

  4. Immunohistochemical study of extracellular matrices and elastic fibers in a human sternoclavicular joint.

    Science.gov (United States)

    Shimada, K; Takeshige, N; Moriyama, H; Miyauchi, Y; Shimada, S; Fujimaki, E

    1997-12-01

    In this study, we clarified the distribution of elastic and oxytalan fibers in a human sternoclavicular joint (SCJ) using a color image system and in extracellular matrices using immunoperoxidase staining. Fine elastic fibers (EFs) were scattered in the fibrous layer of the sternoclavicular disk. This articular disk was composed of a collagenous bundle on the sternum side of the articular disk in the SCJ and cellular components including connective tissue on the clavicular side of the articular disk. The thickness of the disk gradually increased from the inferior to superior portion. Collagen fibers type I, III and V and other extracellular matrices (ECMs) were detected in the hypertrophic zone in the clavicular and sternum side of the SCJ and in the connective tissue of the articulatio condylar. On the cervical surface of the articular disk, cellular activity was higher than on the sternum surface.

  5. Computational stability of human knee joint at early stance in Gait: Effects of muscle coactivity and anterior cruciate ligament deficiency.

    Science.gov (United States)

    Sharifi, M; Shirazi-Adl, A; Marouane, H

    2017-10-03

    As one of the most complex and vulnerable structures of body, the human knee joint should maintain dynamic equilibrium and stability in occupational and recreational activities. The evaluation of its stability and factors affecting it is vital in performance evaluation/enhancement, injury prevention and treatment managements. Knee stability often manifests itself by pain, hypermobility and giving-way sensations and is usually assessed by the passive joint laxity tests. Mechanical stability of both the human knee joint and the lower extremity at early stance periods of gait (0% and 5%) were quantified here for the first time using a hybrid musculoskeletal model of the lower extremity. The roles of muscle coactivity, simulated by setting minimum muscle activation at 0-10% levels and ACL deficiency, simulated by reducing ACL resistance by up to 85%, on the stability margin as well as joint biomechanics (contact/muscle/ligament forces) were investigated. Dynamic stability was analyzed using both linear buckling and perturbation approaches at the final deformed configurations in gait. The knee joint was much more stable at 0% stance than at 5% due to smaller ground reaction and contact forces. Muscle coactivity, when at lower intensities (knee joint at the heel strike. It also markedly diminishes forces in lateral hamstrings (by up to 39%) and contact forces on the lateral plateau (by up to 17%). Current work emphasizes the need for quantification of the lower extremity stability margin in gait. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. 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.

  7. 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.

  8. 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.

  9. [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.

  10. Luxação lateral bilateral isolada do cotovelo Elbow bilateral lateral dislocation

    Directory of Open Access Journals (Sweden)

    Leandro José Reckers

    2006-01-01

    Full Text Available Os autores apresentam um caso de luxação lateral bilateral isolada de cotovelo em uma paciente do sexo feminino de 48 anos. Optou-se pelo tratamento conservador através de redução fechada sob anestesia geral. Ambos os cotovelos foram imobilizados com gesso axilo-palmar e mantidos a 90º de flexão por três semanas, quando se iniciou a reabilitação. No seguimento de dezoito meses observou-se boa estabilidade e recuperação do arco de movimento de ambos os cotovelos.The authors present an isolated case of bilateral lateral dislocation of the elbow joint in a 48-year old female patient. The conservative treatment was chosen, through closed reduction under general anesthesia. Both elbows were placed in an axillopalmar splint cast and held at a 90 degree angle of flexion for three weeks when rehabilitation began. In the eighteen-month follow-up period, good stability as well as the recovery of the range of motion was observed in both elbows

  11. The effects of forearm fatigue on baseball fastball pitching, with implications about elbow injury.

    Science.gov (United States)

    Wang, Lin-Hwa; Lo, Kuo-Cheng; Jou, I-Ming; Kuo, Li-Chieh; Tai, Ta-Wei; Su, Fong-Chin

    2016-01-01

    This study investigated the contribution of flexor muscles to the forearm through fatigue; therefore, the differences in forearm mechanisms on the pitching motion in fastball were analysed. Fifteen baseball pitchers were included in this study. Ultrasonographical examination of participants' ulnar nerve in the cubital tunnel with the elbow extended and at 45°, 90° and 120° of flexion was carried. A three-dimensional motion analysis system with 14 reflective markers attached on participants was used for motion data collection. The electromyography system was applied over the flexor carpi ulnaris, flexor carpi radialis and extensor carpi radialis muscles of the dominant arm. Flexor carpi ulnaris muscle activity showed a significant difference during the acceleration phase, with a peak value during fastball post-fatigue (P = 0.02). Significant differences in the distance between ulnar nerve and medial condyle on throwing arm and non-throwing arm were observed as the distance increased with the elbow movement from 0° to 120° of flexion (P = 0.01). The significant increase of the flexor carpi ulnaris muscle activity might be responsible for maintaining the stability of the wrist joint. The increased diameter might compress the ulnar nerve and cause several pathological changes. Therefore, fatigue in baseball pitchers still poses a threat to the ulnar nerve because the flexor carpi ulnaris and flexor carpi radialis all originate from the medial side of the elbow, and the swelling tendons after fatigue might be a key point.

  12. Quantifying selective elbow movements during an exergame in children with neurological disorders: a pilot study.

    Science.gov (United States)

    van Hedel, Hubertus J A; Häfliger, Nadine; Gerber, Corinna N

    2016-10-21

    It is difficult to distinguish between restorative and compensatory mechanisms underlying (pediatric) neurorehabilitation, as objective measures assessing selective voluntary motor control (SVMC) are scarce. We aimed to quantify SVMC of elbow movements in children with brain lesions. Children played an airplane game with the glove-based YouGrabber system. Participants were instructed to steer an airplane on a screen through a cloud-free path by correctly applying bilateral elbow flexion and extension movements. Game performance measures were (i) % time on the correct path and (ii) similarity between the ideal flight path and the actually flown path. SVMC was quantified by calculating a correlation coefficient between the derivative of the ideal path and elbow movements. A therapist scored whether the child had used compensatory movements. Thirty-three children with brain lesions (11 girls; 12.6 ± 3.6 years) participated. Clinical motor and cognitive scores correlated moderately with SVMC (0.50-0.74). Receiver Operating Characteristics analyses showed that SVMC could differentiate well and better than clinical and game performance measures between compensatory and physiological movements. We conclude that a simple measure assessed while playing a game appears promising in quantifying SVMC. We propose how to improve the methodology, and how this approach can be easily extended to other joints.

  13. Motor impairments related to brain injury timing in early hemiparesis. Part II: abnormal upper extremity joint torque synergies.

    Science.gov (United States)

    Sukal-Moulton, Theresa; Krosschell, Kristin J; Gaebler-Spira, Deborah J; Dewald, Julius P A

    2014-01-01

    Extensive neuromotor development occurs early in human life, and the timing of brain injury may affect the resulting motor impairment. In Part I of this series, it was demonstrated that the distribution of weakness in the upper extremity depended on the timing of brain injury in individuals with childhood-onset hemiparesis. The goal of this study was to characterize how timing of brain injury affects joint torque synergies, or losses of independent joint control. Twenty-four individuals with hemiparesis were divided into 3 groups based on the timing of their injury: before birth (PRE-natal, n = 8), around the time of birth (PERI-natal, n = 8), and after 6 months of age (POST-natal, n = 8). Individuals with hemiparesis and 8 typically developing peers participated in maximal isometric shoulder, elbow, wrist, and finger torque generation tasks while their efforts were recorded by a multiple degree-of-freedom load cell. Motor output in 4 joints of the upper extremity was concurrently measured during 8 primary torque generation tasks to quantify joint torque synergies. There were a number of significant coupling patterns identified in individuals with hemiparesis that differed from the typically developing group. POST-natal differences were most noted in the coupling of shoulder abductors with elbow, wrist, and finger flexors, while the PRE-natal group demonstrated significant distal joint coupling with elbow flexion. The torque synergies measured provide indirect evidence for the use of bulbospinal pathways in the POST-natal group, while those with earlier injury may use relatively preserved ipsilateral corticospinal motor pathways.

  14. A martial arts exploration of elbow anatomy: Ikkyo (Aikido's first teaching).

    Science.gov (United States)

    Seitz, F C; Olson, G D; Stenzel, T E

    1991-12-01

    The Martial Art of Aikido, based on several effective anatomical principles, is used to subdue a training partner. One of these methods is Ikkyo (First Teaching). According to Saotome, the original intent of Ikkyo was to "break the elbow joint" of an enemy. Nowadays the intent is to secure or pin a training partner to the mat. This investigation focused on examining Ikkyo with the purpose of describing the nerves, bones, and muscles involved in receiving this technique. Particular focus was placed on the locations and sources of the reported pain.

  15. 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.

  16. 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

  17. 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

  18. 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...

  19. 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)

  20. 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

  1. 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...

  2. The synovial microenvironment of osteoarthritic joints alters RNA-seq expression profiles of human primary articular chondrocytes

    Science.gov (United States)

    Lewallen, Eric A.; Bonin, Carolina A.; Li, Xin; Smith, Jay; Karperien, Marcel; Larson, A. Noelle; Lewallen, David G.; Cool, Simon M.; Westendorf, Jennifer J.; Krych, Aaron J.; Leontovich, Alexey A.; Im, Hee-Jeong; van Wijnen, Andre J.

    2018-01-01

    Osteoarthritis (OA) is a disabling degenerative joint disease that prompts pain with limited treatment options. To permit early diagnosis and treatment of OA, a high resolution mechanistic understanding of human chondrocytes in normal and diseased states is necessary. In this study, we assessed the biological effects of OA-related changes in the synovial microenvironment on chondrocytes embedded within anatomically intact cartilage from joints with different pathological grades by next generation RNA-sequencing (RNA-seq). We determined the transcriptome of primary articular chondrocytes derived from pristine knees and ankles, as well as from joints affected by OA. The GALAXY bioinformatics platform was used to facilitate biological interpretations. Comparisons of patient samples by k-means, hierarchical clustering and principal component analysis reveal that primary chondrocytes exhibit OA grade-related differences in gene expression, including genes involved in cell-adhesion, ECM production and immune response. We conclude that diseased synovial microenvironments in joints with different histopathological OA grades directly alter gene expression in chondrocytes. One ramification of this finding is that sampling anatomically intact cartilage from OA joints is not an ideal source of healthy chondrocytes, nor should they be used to generate a normal baseline for the molecular characterization of diseased joints. PMID:27378743

  3. 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

  4. 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.

  5. 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

  6. 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

  7. X-ray changes in the bones and joints in arthropatic psoriasis

    International Nuclear Information System (INIS)

    Spuzyak, M.Yi.; Olyijnik, Yi.O.

    2009-01-01

    Dynamic x-ray investigation was performed in 136 patients aged 16-64/ It included radiography of the spine, hands, feet, pelvis, hip, knee, ankle, radiocarpal, metatarsal and sometimes shoulder and elbow joints.

  8. MR Imaging of Patients with Lateral Epicondylitis of the Elbow: Is the Common Extensor Tendon an Isolated Lesion?

    Science.gov (United States)

    Li, Feng; Wang, Ren-Fa

    2013-01-01

    Objective To investigate whether an injury of the common extensor tendon (CET) is associated with other abnormalities in the elbow joint and find the potential relationships between these imaging features by using a high-resolution magnetic resonance imaging (MRI). Methods Twenty-three patients were examined with 3.0 T MR. Two reviewers were recruited for MR images evaluation. Image features were recorded in terms of (1) the injury degree of CET; (2) associated injuries in the elbow joint. Spearman’s rank correlation analysis was performed to analyze the relationships between the injury degree of CET and associated abnormalities of the elbow joint, correlations were considered significant at plateral ulnar collateral ligament (LUCL). Conclusion Injury of the CET is not an isolated lesion for lateral picondylitis, which is mostly accompanied with other abnormalities, of which the LUCL injury is the most commonly seen in lateral epicondylitis, and there is a positive correlation between the injury degree in CET and LUCL. PMID:24244512

  9. Synovial osteochondromatosis of the temporomandibular joint

    International Nuclear Information System (INIS)

    Nemnon, Jorge; Nemnon, Marcelo; Staffieri, Roberto; Villavicencio, C.; Marconi, G.; Masjoan, Diego

    2004-01-01

    Synovial osteochondromatosis (SO) is a meta plastic process by which synovial mesenchymal cells transform into chondroblasts and chondrocytes. This disease affects most frequently the knee, the hip, the elbow, and uncommonly the temporomandibular joint (TMJ). The authors present 2 cases of synovial osteochondromatosis of the TMJ. (author)

  10. 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.

  11. 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

  12. Estimation of Human Arm Joints Using Two Wireless Sensors in Robotic Rehabilitation Tasks

    Directory of Open Access Journals (Sweden)

    Arturo Bertomeu-Motos

    2015-12-01

    Full Text Available This paper presents a novel kinematic reconstruction of the human arm chain with five degrees of freedom and the estimation of the shoulder location during rehabilitation therapy assisted by end-effector robotic devices. This algorithm is based on the pseudoinverse of the Jacobian through the acceleration of the upper arm, measured using an accelerometer, and the orientation of the shoulder, estimated with a magnetic angular rate and gravity (MARG device. The results show a high accuracy in terms of arm joints and shoulder movement with respect to the real arm measured through an optoelectronic system. Furthermore, the range of motion (ROM of 50 healthy subjects is studied from two different trials, one trying to avoid shoulder movements and the second one forcing them. Moreover, the shoulder movement in the second trial is also estimated accurately. Besides the fact that the posture of the patient can be corrected during the exercise, the therapist could use the presented algorithm as an objective assessment tool. In conclusion, the joints’ estimation enables a better adjustment of the therapy, taking into account the needs of the patient, and consequently, the arm motion improves faster.

  13. A synopsis of the Joint Environment and Human Health Programme in the UK.

    Science.gov (United States)

    Moore, Michael N; Kempton, Pamela D

    2009-12-21

    The Joint Environment and Human Health (E&HH) Programme has explored how both man-made and natural changes to the environment can influence human health. Scientists have tackled the complicated mix of environmental, social and economic factors that influence health, particularly focusing on naturally occurring toxins, man-made pollutants, nanoparticles and pathogens to see:* how they spread within the environment* how their properties change as they interact with other substances or organisms* how we become exposed to them, and* their impact on human health.The Programme has not only succeeded in bringing together scientists from a broad range of environmental, social and biomedical backgrounds, but also fostered new relationships with end users and policy makers. This new community is helping to provide the multidisciplinary capacity able to respond in an interdisciplinary way to resolve problems that are intrinsically interfacial in character. Many of these questions relate to complex issues such as the environmental biology and geochemistry of soils and how these influence the transport, accessibility and bioavailability of chemical pollutants and infectivity of pathogens. The dispersion of harmful particles in the atmosphere is another area of major concern where the E&HH Programme has broken new ground by showing how the chemical and physical properties of such particles influence their environmental behaviour and may govern their toxicity and resultant pathological reactions induced following inhalation. Working groups and networks have identified potential health problems concerning the transport and emergence of human pathogens associated with food, soil, air and water. The consequence(s) of global and regional climate change for the environmental behaviours of pollutants and pathogens have been considered by a number of the projects supported by the E&HH programme.The selection of articles in this supplement reflect the broad scope of the E&HH programme

  14. Complications of treating terrible triad injury of the elbow: a systematic review.

    Directory of Open Access Journals (Sweden)

    Hong-wei Chen

    Full Text Available Terrible triad injury of the elbow (TTIE, comprising elbow dislocation with radial head and coronoid process fracture, is notoriously challenging to treat and has typically been associated with complications and poor outcomes. The objective of this systematic review was to summarize the most recent available evidence regarding functional outcomes and complications following surgical management of TTIE.Medline, EMBASE, Cochrane Library, and Google Scholar were searched to identify relevant studies, which were included if they were retrospective or prospective in design, involved participants who had TTIE, and were published in English. Outcomes of interest were functional outcomes and complications.Sixteen studies, involving 312 patients, were included in the systematic review. Mean follow up after surgery was typically 25 to 30 months. Mean Mayo elbow performance scores ranged from 78 to 95. Mean Broberg-Morrey scores ranged from 76 to 90. Mean DASH scores ranged from 9 to 31. The proportion of patients who required reoperation due to complications ranged from 0 to 54.5% (overall  = 70/312 [22.4%]. Most of these complications were related to hardware fixation problems, joint stiffness, joint instability, and ulnar neuropathy. The most common complications that did not require reoperation were heterotopic ossification (39/312 [12.5%] patients and arthrosis (35/312 [11.2%] patients.The results of this systematic review indicate that functional outcomes after surgery for TTIE are generally satisfactory and that complications are common. Further research is warranted to determine which surgical techniques optimize functional outcomes and reduce the risk of complications.

  15. Articular surface approximation in equivalent spatial parallel mechanism models of the human knee joint: an experiment-based assessment.

    Science.gov (United States)

    Ottoboni, A; Parenti-Castelli, V; Sancisi, N; Belvedere, C; Leardini, A

    2010-01-01

    In-depth comprehension of human joint function requires complex mathematical models, which are particularly necessary in applications of prosthesis design and surgical planning. Kinematic models of the knee joint, based on one-degree-of-freedom equivalent mechanisms, have been proposed to replicate the passive relative motion between the femur and tibia, i.e., the joint motion in virtually unloaded conditions. In the mechanisms analysed in the present work, some fibres within the anterior and posterior cruciate and medial collateral ligaments were taken as isometric during passive motion, and articulating surfaces as rigid. The shapes of these surfaces were described with increasing anatomical accuracy, i.e. from planar to spherical and general geometry, which consequently led to models with increasing complexity. Quantitative comparison of the results obtained from three models, featuring an increasingly accurate approximation of the articulating surfaces, was performed by using experimental measurements of joint motion and anatomical structure geometries of four lower-limb specimens. Corresponding computer simulations of joint motion were obtained from the different models. The results revealed a good replication of the original experimental motion by all models, although the simulations also showed that a limit exists beyond which description of the knee passive motion does not benefit considerably from further approximation of the articular surfaces.

  16. Acupuncture for lateral epicondylitis (tennis elbow): study protocol for a randomized, practitioner-assessor blinded, controlled pilot clinical trial.

    Science.gov (United States)

    Shin, Kyung-Min; Kim, Joo-Hee; Lee, Seunghoon; Shin, Mi-Suk; Kim, Tae-Hun; Park, Hyo-Ju; Lee, Min-Hee; Hong, Kwon-Eui; Lee, Seungdeok; Choi, Sun-Mi

    2013-06-14

    Lateral epicondylitis is the most frequent cause of pain around the elbow joint. It causes pain in the region of the elbow joint and results in dysfunction of the elbow and deterioration of the quality of life. The purpose of this study is to compare the effects of ipsilateral acupuncture, contralateral acupuncture and sham acupuncture on lateral epicondylitis. Forty-five subjects with lateral epicondylitis will be randomized into three groups: the ipsilateral acupuncture group, contralateral acupuncture group and the sham acupuncture group. The inclusion criteria will be as follows: (1) age between 19 and 65 years with pain due to one-sided lateral epicondylitis that persisted for at least four weeks, (2) with tenderness on pressure limited to regions around the elbow joint, (3) complaining of pain during resistive extension of the middle finger or the wrist, (4) with average pain of NRS 4 or higher during the last one week at a screening visit and (5) voluntarily agree to this study and sign a written consent. Acupuncture treatment will be given 10 times in total for 4 weeks to all groups. Follow up observations will be conducted after the completion of the treatment, 8 weeks and 12 weeks after the random assignment. Ipsilateral acupuncture group and contralateral acupuncture group will receive acupuncture on LI4, TE5, LI10, LI11, LU5, LI12 and two Ashi points. The sham acupuncture group will receive treatment on acupuncture points not related to the lateral epicondylitis using a non-invasive method. The needles will be maintained for 20 minutes. The primary outcome will be differences in the visual analogue scale (VAS) for elbow pain between the groups. The secondary outcome will be differences in patient-rated tennis elbow evaluation (PRTEE), pain-free/maximum grip strength (Dynamometer), pressure pain threshold, clinically relevant improvement, patient global assessment, and the EQ-5D. The data will be analyzed with the paired t-test and ANCOVA (P <0.05). The

  17. 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.

  18. 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)

  19. Estimation of Human Hip and Knee Multi-Joint Dynamics Using the LOPES Gait Trainer

    NARCIS (Netherlands)

    Koopman, Hubertus F.J.M.; van Asseldonk, Edwin H.F.; van der Kooij, Herman

    2016-01-01

    In this study, we present and evaluate a novel method to estimate multi-joint leg impedance, using a robotic gait training device. The method is based on multi-input–multi-output system identification techniques and is designed for continuous torque perturbations at the hip and knee joint

  20. Storing live embryonic and adult human cartilage grafts for transplantation using a joint simulating device.

    Science.gov (United States)

    Cohen, I; Robinson, D; Cohen, N; Nevo, Z

    2000-11-01

    Cartilage transplantation as a means to replace damaged articular surfaces is of interest. A major obstacle is the long-term preservation of cartilage grafts. The commonly used technique of freezing the grafts inevitably leads to cellular death. The current study compares the technique to an innovative approach using a pulsed-pressure perfusion system termed a joint simulating device (JSD), intended to simulate intra-articular mechanical forces. Human articular cartilage explants were harvested from both embryonic epiphyseal tissue and femoral heads of elderly women (over 70 years of age) undergoing a partial joint replacement (hemi-arthroplasty) and were divided in two groups: half of the samples were incubated in the JSD while the remaining half were grown in static culture within tissue culture plates. After 10 days all samples were evaluated for: (a) cell vitality as assessed by image analysis and XTT assay; (b) biosynthetic activity as expressed by radioactive sulfate incorporation into glycosaminoglycans (GAG's); and (c) proteoglycan content as assessed by alcian blue staining intensity. A 10-fold increase in sulfate incorporation in samples held in the JSD compared to the static culture group was observed in embryonic cartilage. In adult cartilage culture in the JSD elevated sulfate incorporation by threefold as compared to static culture. Central necrosis was observed in specimens grown in the static culture plates, while it did not occur in the samples held in the JSD. Cell vitality as assessed by XTT assay was significantly better in the JSD group as compared to static culture. The difference was more pronounced in the embryonic specimens as compared to adult cartilage. The specimens cultured within the JSD retained proteoglycans significantly better than those cultured in static culture. Maintenance of cartilage specimens in a JSD was highly effective in keeping the vitality of cartilage explants in vitro over a 10-day period. A possible future

  1. 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...

  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. The Joint Military Medical Executive Skills initiative: an impressive response to changing human resource management rules of engagement.

    Science.gov (United States)

    Kerr, Bernard J

    2007-01-01

    Confronted with a sudden and substantial change in the rules regarding who could command a military medical treatment facility (MTF), the Military Health System (MHS) responded to the challenge with an impressive human resource management solution-the Joint Medical Executive Skills Program. The history, emergence, and continuing role of this initiative exemplifies the MHS's capacity to fulfill the spirit and intent of an arduous Congressional mandate while enhancing professional development and sustaining the career opportunities of medical officers. The MHS response to the Congressional requirement that candidates for MTF command demonstrate professional administrative skills was decisive, creative, and consistent with the basic principles of human resource management. The Joint Medical Executive Skills Program is a management success story that demonstrates how strategic planning, well-defined skills requirements, and structured training can assure a ready supply of qualified commanders for the military's MTFs.

  4. Learning dictionaries of sparse codes of 3D movements of body joints for real-time human activity understanding.

    Directory of Open Access Journals (Sweden)

    Jin Qi

    Full Text Available Real-time human activity recognition is essential for human-robot interactions for assisted healthy independent living. Most previous work in this area is performed on traditional two-dimensional (2D videos and both global and local methods have been used. Since 2D videos are sensitive to changes of lighting condition, view angle, and scale, researchers begun to explore applications of 3D information in human activity understanding in recently years. Unfortunately, features that work well on 2D videos usually don't perform well on 3D videos and there is no consensus on what 3D features should be used. Here we propose a model of human activity recognition based on 3D movements of body joints. Our method has three steps, learning dictionaries of sparse codes of 3D movements of joints, sparse coding, and classification. In the first step, space-time volumes of 3D movements of body joints are obtained via dense sampling and independent component analysis is then performed to construct a dictionary of sparse codes for each activity. In the second step, the space-time volumes are projected to the dictionaries and a set of sparse histograms of the projection coefficients are constructed as feature representations of the activities. Finally, the sparse histograms are used as inputs to a support vector machine to recognize human activities. We tested this model on three databases of human activities and found that it outperforms the state-of-the-art algorithms. Thus, this model can be used for real-time human activity recognition in many applications.

  5. Learning dictionaries of sparse codes of 3D movements of body joints for real-time human activity understanding.

    Science.gov (United States)

    Qi, Jin; Yang, Zhiyong

    2014-01-01

    Real-time human activity recognition is essential for human-robot interactions for assisted healthy independent living. Most previous work in this area is performed on traditional two-dimensional (2D) videos and both global and local methods have been used. Since 2D videos are sensitive to changes of lighting condition, view angle, and scale, researchers begun to explore applications of 3D information in human activity understanding in recently years. Unfortunately, features that work well on 2D videos usually don't perform well on 3D videos and there is no consensus on what 3D features should be used. Here we propose a model of human activity recognition based on 3D movements of body joints. Our method has three steps, learning dictionaries of sparse codes of 3D movements of joints, sparse coding, and classification. In the first step, space-time volumes of 3D movements of body joints are obtained via dense sampling and independent component analysis is then performed to construct a dictionary of sparse codes for each activity. In the second step, the space-time volumes are projected to the dictionaries and a set of sparse histograms of the projection coefficients are constructed as feature representations of the activities. Finally, the sparse histograms are used as inputs to a support vector machine to recognize human activities. We tested this model on three databases of human activities and found that it outperforms the state-of-the-art algorithms. Thus, this model can be used for real-time human activity recognition in many applications.

  6. Active elbow flexion is possible in C4 quadriplegia using hybrid assistive limb (HAL®) technology: A case study.

    Science.gov (United States)

    Shimizu, Yukiyo; Kadone, Hideki; Kubota, Shigeki; Ikumi, Akira; Abe, Tetsuya; Marushima, Aiki; Ueno, Tomoyuki; Endo, Ayumu; Kawamoto, Hiroaki; Saotome, Kousaku; Matsushita, Akira; Matsumura, Akira; Sankai, Yoshiyuki; Hada, Yasushi; Yamazaki, Masashi

    2017-07-01

    Patients with complete quadriplegia after high cervical spinal cord injury are fully dependent with activities of daily living. Assistive technology can improve their quality of life. We examined the use of a hybrid assistive limb for single joints (HAL-SJ) in a 19-year-old man with complete C4 quadriplegia due to chronic spinal cord injury to restore function of active elbow flexion. This is the first report on the use of the HAL-SJ in a patient with spinal cord injury. The HAL-SJ intervention for each elbow was administered in 10 sessions. Clinical assessment using surface EMG was conducted to evaluate muscle activity of the trapezius, biceps brachii, infraspinatus, and triceps brachii muscle before, and during the 2nd, 3rd, 6th, and 9th interventions. Surface electromyography (EMG) before intervention showed no contraction in the upper arms, but in the bilateral trapezius. The HAL-SJ used motion intention from the right trapezius for activation. After the 6th and 7th session, respectively, biceps EMG showed that voluntary contraction and right elbow flexion could be performed by motion intention from the right biceps. After the 10th session, voluntary bicep contraction was possible. HAL-SJ treatment on the left elbow was performed using the same protocol with a similar outcome. After completing treatment on both upper extremities, both biceps contracted voluntarily, and he could operate a standard wheelchair for a short distance independently. HAL-SJ intervention is feasible and effective in restoring elbow flexor function in a patient with C4 chronic spinal cord injury and complete quadriplegia.

  7. Squeeze-Film Lubrication of the Human Ankle Joint Subjected to the Cyclic Loading Encountered in Walking

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2005-01-01

    Roč. 127, č. 1 (2005), s. 141-147 ISSN 0742-4787 R&D Projects: GA ČR(CZ) GA103/04/0150 Institutional research plan: CEZ:AV0Z20710524 Keywords : cyclic loading * human ankle joint * squeeze-film lubrication * synovial fluid filtration * synovial gel formation Subject RIV: JJ - Other Materials Impact factor: 0.682, year: 2005

  8. The Plastic Nature of the Human Bone-Periodontal Ligament-Tooth Fibrous Joint

    Science.gov (United States)

    Ho, Sunita P.; Kurylo, Michael P.; Grandfield, Kathryn; Hurng, Jonathan; Herber, Ralf-Peter; Ryder, Mark I.; Altoe, Virginia; Aloni, Shaul; Feng, Jian Q. (Jerry); Webb, Samuel; Marshall, Grayson W.; Curtis, Donald; Andrews, Joy C.; Pianetta, Piero

    2014-01-01

    This study investigates bony protrusions within a narrowed periodontal ligament space (PDL-space) of a human bone-PDL-tooth fibrous joint by mapping structural, biochemical, and mechanical heterogeneity. Higher resolution structural characterization was achieved via complementary atomic force microscopy (AFM), nano transmission X-ray microscopy (nano-TXM), and micro tomography (Micro XCT™). Structural heterogeneity was correlated to biochemical and elemental composition, illustrated via histochemistry and microprobe X-ray fluorescence analysis (μ-XRF), and mechanical heterogeneity evaluated by AFM-based nanoindentation. Results demonstrated that the narrowed PDL-space was due to invasion of bundle bone (BB) into PDL-space. Protruded BB had a wider range with higher elastic modulus values (2-8 GPa) compared to lamellar bone (0.8-6 GPa), and increased quantities of Ca, P and Zn as revealed by μ-XRF. Interestingly, the hygroscopic 10-30 μm interface between protruded BB and lamellar bone exhibited higher X-ray attenuation similar to cement lines and lamellae within bone. Localization of the small leucine rich proteoglycan biglycan (BGN) responsible for mineralization was observed at the PDL-bone interface and around the osteocyte lacunae. Based on these results, it can be argued that the LB-BB interface was the original site of PDL attachment, and that the genesis of protruded BB identified as protrusions occurred as a result of shift in strain. We emphasize the importance of bony protrusions within the context of organ function and that additional study is warranted. PMID:24063947

  9. Multibody Kinematics Optimization for the Estimation of Upper and Lower Limb Human Joint Kinematics: A Systematized Methodological Review.

    Science.gov (United States)

    Begon, Mickaël; Andersen, Michael Skipper; Dumas, Raphaël

    2018-03-01

    Multibody kinematics optimization (MKO) aims to reduce soft tissue artefact (STA) and is a key step in musculoskeletal modeling. The objective of this review was to identify the numerical methods, their validation and performance for the estimation of the human joint kinematics using MKO. Seventy-four papers were extracted from a systematized search in five databases and cross-referencing. Model-derived kinematics were obtained using either constrained optimization or Kalman filtering to minimize the difference between measured (i.e., by skin markers, electromagnetic or inertial sensors) and model-derived positions and/or orientations. While hinge, universal, and spherical joints prevail, advanced models (e.g., parallel and four-bar mechanisms, elastic joint) have been introduced, mainly for the knee and shoulder joints. Models and methods were evaluated using: (i) simulated data based, however, on oversimplified STA and joint models; (ii) reconstruction residual errors, ranging from 4 mm to 40 mm; (iii) sensitivity analyses which highlighted the effect (up to 36 deg and 12 mm) of model geometrical parameters, joint models, and computational methods; (iv) comparison with other approaches (i.e., single body kinematics optimization and nonoptimized kinematics); (v) repeatability studies that showed low intra- and inter-observer variability; and (vi) validation against ground-truth bone kinematics (with errors between 1 deg and 22 deg for tibiofemoral rotations and between 3 deg and 10 deg for glenohumeral rotations). Moreover, MKO was applied to various movements (e.g., walking, running, arm elevation). Additional validations, especially for the upper limb, should be undertaken and we recommend a more systematic approach for the evaluation of MKO. In addition, further model development, scaling, and personalization methods are required to better estimate the secondary degrees-of-freedom (DoF).

  10. Explanations pertaining to the Hip Joint Flexor Moment During the Stance Phase of Human Walking

    DEFF Research Database (Denmark)

    Simonsen, Erik B; Cappelen, Katrine L; Skorini, Ragnhild

    2012-01-01

    A hip joint flexor moment in the last half of the stance phase during walking has repeatedly been reported. However, the purpose of this moment remains uncertain and it is unknown how it is generated. Nine male subjects were instructed to walk at 4.5 km/h with their upper body in three different...... positions: normal, inclined and reclined. Net joint moments were calculated about the hip, knee and ankle joint. The peak hip joint flexor moment during late stance was significantly lower during inclined walking than in the two other conditions. During normal walking the iliacus muscle showed no or very...... weak activity and first at the transition from stance to swing. When walking reclined, a clear but rather low activity level of the iliacus muscle was seen in the first half of the stance phase, which could contribute to the hip moment. In the inclined condition the iliacus showed much increased...

  11. 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.

  12. 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 ...

  13. 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.

  14. 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.)

  15. The Waterfall Fascia Lata Interposition Arthroplasty “Grika Technique” as Treatment of Posttraumatic Osteoarthritis of the Elbow in a High-Demand Adult Patient: Validity and Reliability

    Directory of Open Access Journals (Sweden)

    Giuseppe Rollo

    2018-01-01

    Full Text Available Introduction. The elbow interposition arthroplasty is a very common procedure performed mainly on active young patients who need great functionality and for whom total joint replacement is contraindicated and arthrodesis is noncompliant. We are going to demonstrate a case of a 34-year-old male suffering from malunion of the distal humerus, elbow stiffness, and manifest signs of arthrosis of the dominant limb, treated with the IA Grika technique at a 5-year follow-up. Patients and Methods. The chosen criteria to evaluate the injured side and the uninjured side during the clinical and radiological follow-up were the objective function and related quality of life, measured by the Mayo Elbow Performance Score (MEPS, and postoperative complications. To assess flexion and supination forces and elbow muscular strength, a hydraulic dynamometer was used. Results. At a 5-year follow-up, the results were excellent as during the first year. Conclusions. The Grika technique is a valid and feasible option in the treatment of elbow injuries.

  16. 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

  17. 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

  18. 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

  19. Exoskeleton-Based Robotic Platform Applied in Biomechanical Modelling of the Human Upper Limb

    Directory of Open Access Journals (Sweden)

    Andres F. Ruiz

    2009-01-01

    Full Text Available One of the approaches to study the human motor system, and specifically the motor strategies implied during postural tasks of the upper limbs, is to manipulate the mechanical conditions of each joint of the upper limbs independently. At the same time, it is essential to pick up biomechanical signals and bio-potentials generated while the human motor system adapts to the new condition. The aim of this paper is two-fold: first, to describe the design, development and validation of an experimental platform designed to modify or perturb the mechanics of human movement, and simultaneously acquire, process, display and quantify bioelectric and biomechanical signals; second, to characterise the dynamics of the elbow joint during postural control. A main goal of the study was to determine the feasibility of estimating human elbow joint dynamics using EMG-data during maintained posture. In particular, the experimental robotic platform provides data to correlate electromyographic (EMG activity, kinetics and kinematics information from the upper limb motion. The platform aims consists of an upper limb powered exoskeleton, an EMG acquisition module, a control unit and a software system. Important concerns of the platform such as dependability and safety were addressed in the development. The platform was evaluated with 4 subjects to identify, using system identification methods, the human joint dynamics, i.e. visco-elasticity. Results obtained in simulations and experimental phase are introduced.

  20. 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

  1. 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.

  2. Arthroscopic Debridement for Primary Degenerative Osteoarthritis of the Elbow Leads to Significant Improvement in Range of Motion and Clinical Outcomes: A Systematic Review.

    Science.gov (United States)

    Sochacki, Kyle R; Jack, Robert A; Hirase, Takashi; McCulloch, Patrick C; Lintner, David M; Liberman, Shari R; Harris, Joshua D

    2017-12-01

    The purpose of this investigation was to determine whether arthroscopic debridement of primary elbow osteoarthritis results in statistically significant and clinically relevant improvement in (1) elbow range of motion and (2) clinical outcomes with (3) low complication and reoperation rates. A systematic review was registered with PROSPERO and performed using PRISMA guidelines. Databases were searched for studies that investigated the outcomes of arthroscopic debridement for the treatment of primary osteoarthritis of the elbow in adult human patients. Study methodological quality was analyzed. Studies that included post-traumatic arthritis were excluded. Elbow motion and all elbow-specific patient-reported outcome scores were eligible for analysis. Comparisons between preoperative and postoperative values from each study were made using 2-sample Z-tests (http://in-silico.net/tools/statistics/ztest) using a P value osteoarthritis results in statistically significant and clinically relevant improvement in elbow range of motion and clinical outcomes with low complication and reoperation rates. Systematic review of level IV studies. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  3. Candida tropicalis arthritis of the elbow in a patient with Ewing’s sarcoma that successfully responded to itraconazole

    Directory of Open Access Journals (Sweden)

    Seung Youn Kim

    2011-09-01

    Full Text Available Fungal infections are rarely responsible for arthritis. Few cases of fungal arthritis have been reported, even in immunocompromised hosts susceptible to low-virulence organisms. Herein, the authors report the first case of Candida tropicalis arthritis in a child with a solid tumor. A 13-year-old boy with Ewing’s sarcoma developed arthritis in his elbow during the neutropenic period after chemotherapy. Despite treatment with broad-spectrum antibiotics, his condition did not improve and serial blood cultures failed to reveal any causative organisms. After surgical drainage, culture of the joint fluid revealed the presence of C. tropicalis . Itraconazole treatment was started and after 3 months of therapy, the patient completely recovered full elbow function.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. Inner Synovial Membrane Footprint of the Anterior Elbow Capsule: An Arthroscopic Boundary

    Directory of Open Access Journals (Sweden)

    Srinath Kamineni

    2015-01-01

    Full Text Available Introduction. The purpose of this study is to describe the inner synovial membrane (SM of the anterior elbow capsule, both qualitatively and quantitatively. Materials and Methods. Twenty-two cadaveric human elbows were dissected and the distal humerus and SM attachments were digitized using a digitizer. The transepicondylar line (TEL was used as the primary descriptor of various landmarks. The distance between the medial epicondyle and medial SM edge, SM apex overlying the coronoid fossa, the central SM nadir, and the apex of the SM insertion overlying the radial fossa and distance from the lateral epicondyle to lateral SM edge along the TEL were measured and further analyzed. Gender and side-to-side statistical comparisons were calculated. Results. The mean age of the subjects was 80.4 years, with six male and five female cadavers. The SM had a distinctive double arched attachment overlying the radial and coronoid fossae. No gender-based or side-to-side quantitative differences were noted. In 18 out of 22 specimens (81.8%, an infolding extension of the SM was observed overlying the medial aspect of the trochlea. The SM did not coincide with the outer fibrous attachment in any specimen. Conclusion. The humeral footprint of the synovial membrane of the anterior elbow capsule is more complex and not as capacious as commonly understood from the current literature. The synovial membrane nadir between the two anterior fossae may help to explain and hence preempt technical difficulties, a reduction in working arthroscopic volume in inflammatory and posttraumatic pathologies. This knowledge should allow the surgeon to approach this aspect of the anterior elbow compartment space with the confidence that detachment of this synovial attachment, to create working space, does not equate to breaching the capsule. Alternatively, stripping the synovial attachment from the anterior humerus does not constitute an anterior capsular release.

  9. Human prosthetic joint infections are associated with myeloid-derived suppressor cells (MDSCs): Implications for infection persistence.

    Science.gov (United States)

    Heim, Cortney E; Vidlak, Debbie; Odvody, Jessica; Hartman, Curtis W; Garvin, Kevin L; Kielian, Tammy

    2017-11-15

    Prosthetic joint infection (PJI) is a devastating complication of joint arthroplasty surgery typified by biofilm formation. Currently, mechanisms whereby biofilms persist and evade immune-mediated clearance in immune competent patients remain largely ill-defined. Therefore, the current study characterized leukocyte infiltrates and inflammatory mediator expression in tissues from patients with PJI compared to aseptic loosening. CD33 + HLA-DR - CD66b + CD14 -/low granulocytic myeloid-derived suppressor cells (G-MDSCs) were the predominant leukocyte population at sites of human PJI compared to aseptic tissues. MDSCs inhibit T cell proliferation, which coincided with reduced T cells in PJIs compared to aseptic tissues. IL-10, IL-6, and CXCL1 were significantly elevated in PJI tissues and have been implicated in MDSC inhibitory activity, expansion, and recruitment, respectively, which may account for their preferential increase in PJIs. This bias towards G-MDSC accumulation during human PJI could account for the chronicity of these infections by preventing the pro-inflammatory, antimicrobial actions of immune effector cells. Animal models of PJI have revealed a critical role for MDSCs and IL-10 in promoting infection persistence; however, whether this population is prevalent during human PJI and across distinct bacterial pathogens remains unknown. This study has identified that granulocytic-MDSC infiltrates are unique to human PJIs caused by distinct bacteria, which are not associated with aseptic loosening of prosthetic joints. Better defining the immune status of human PJIs could lead to novel immune-mediated approaches to facilitate PJI clearance in combination with conventional antibiotics. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  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. Histological Osteoarthritic Changes in the Human Cervical Spine Facet Joints Related to Age and Gender

    DEFF Research Database (Denmark)

    Uhrenholt, Lars; Charles, Annie Vesterby; Gregersen, Markil

    2018-01-01

    STUDY DESIGN: Cross-sectional autopsy study. OBJECTIVE: Quantify histological changes in the lower cervical spine facet joints with regard to age and gender using systematic random sampling of entire joints. SUMMARY OF BACKGROUND DATA: Neck pain is a common debilitating musculoskeletal condition...... and one of the highest ranked causes of years lived with disability. The cause of neck pain is multifactorial and osteoarthritis is one potential cause. The cervical spine facet joints have been implicated in the aetiology of chronic neck pain. Hence, a detailed description of their anatomy and age......- and gender related changes is needed. METHODS: The lower four cervical spine segments (C4-C7 included) were obtained from 72 subjects during autopsy; 29 females (median age 53 years [22-77]) and 43 males (median age 38 years [20-78]). A total of 1132 articular facets were embedded in toto in hard plastic...

  13. Joint bleeds increase the inhibitor response to human factor VIII in a rat model of severe haemophilia A

    DEFF Research Database (Denmark)

    Löfgren, Karin Maria; Søndergaard, H.; Skov, Søren

    2016-01-01

    Introduction The most serious complication in haemophilia A (HA) replacement therapy with coagulation factor VIII (FVIII) is neutralizing antibodies, i.e. inhibitors. It has been hypothesized that danger signals generated during a bleed might have an adjuvant effect on the immune response to FVIII...... in on-demand treatment, increasing the inhibitor risk. Aim To compare the antibody response to treatment with recombinant human FVIII (rhFVIII) in relation to induced knee joint bleeds and treatment without concurrent bleeds in a HA rat model. Method HA rats were divided into two groups: one group (n...... = 10) receiving three needle induced knee joint bleeds 14 days apart and a control group (n = 9) receiving three sham procedures. Three hours after each injury/sham 50 IU kg−1 rhFVIII was administrated intravenously. Subsequently, both groups continued rhFVIII treatment for another 9 weeks. Binding...

  14. A Mechanical Musculo-Skeletal System for a Human-Shaped Robot Arm

    Directory of Open Access Journals (Sweden)

    Koichi Koganezawa

    2014-06-01

    Full Text Available This paper presents a mechanical system with a similar configuration to a human musculo-skeletal system for use in anthropomorphic robots or as artificial limbs for disabled persons. First, a mechanical module called ANLES (Actuator with Non-Linear Elasticity System is introduced. There are two types of ANLES: the linear-type ANLES and rotary-type ANLES. They can be used as a voluntary muscle in a wide-range of musculo-skeletal structures in which at least double actuators work in an antagonistic setup via some elastic elements. Next, an application of the two types of ANLES to a two-degree-of-freedom (DOF manipulator that has a similar configuration to the human elbow joint is shown. The experimental results of the joint stiffness and joint angle control elucidate that the developed mechanism effectively regulates joint stiffness in the same way as a musculo-skeletal system.

  15. 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

  16. Model-based sensorimotor integration for multi-joint control: development of a virtual arm model.

    Science.gov (United States)

    Song, D; Lan, N; Loeb, G E; Gordon, J

    2008-06-01

    An integrated, sensorimotor virtual arm (VA) model has been developed and validated for simulation studies of control of human arm movements. Realistic anatomical features of shoulder, elbow and forearm joints were captured with a graphic modeling environment, SIMM. The model included 15 musculotendon elements acting at the shoulder, elbow and forearm. Muscle actions on joints were evaluated by SIMM generated moment arms that were matched to experimentally measured profiles. The Virtual Muscle (VM) model contained appropriate admixture of slow and fast twitch fibers with realistic physiological properties for force production. A realistic spindle model was embedded in each VM with inputs of fascicle length, gamma static (gamma(stat)) and dynamic (gamma(dyn)) controls and outputs of primary (I(a)) and secondary (II) afferents. A piecewise linear model of Golgi Tendon Organ (GTO) represented the ensemble sampling (I(b)) of the total muscle force at the tendon. All model components were integrated into a Simulink block using a special software tool. The complete VA model was validated with open-loop simulation at discrete hand positions within the full range of alpha and gamma drives to extrafusal and intrafusal muscle fibers. The model behaviors were consistent with a wide variety of physiological phenomena. Spindle afferents were effectively modulated by fusimotor drives and hand positions of the arm. These simulations validated the VA model as a computational tool for studying arm movement control. The VA model is available to researchers at website http://pt.usc.edu/cel .

  17. 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.

  18. 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.

  19. 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.

  20. Passive Muscle-Tendon Unit Gearing is Joint Dependent in Human Medial Gastrocnemius

    Directory of Open Access Journals (Sweden)

    Emma F Hodson-Tole

    2016-03-01

    Full Text Available Skeletal muscles change length and develop force both passively and actively. Gearing allows muscle fibre length changes to be uncoupled from those of the whole muscle-tendon unit. During active contractions this process allows muscles to operate at mechanically favorable conditions for power or economical force production. Here we ask whether gearing is constant in passive muscle; determining the relationship between fascicle and muscle-tendon unit length change in the bi-articular medial gastrocnemius and investigating the influence of whether motion occurs at the knee or ankle joint. Specifically, the same muscle-tendon unit length changes were elicited by rotating either the ankle or knee joint whilst simultaneously measuring fascicle lengths in proximal and distal muscle regions using B-mode ultrasound. In both the proximal and distal muscle region, passive gearing values differed depending on whether ankle or knee motion occurred. Fascicle length changes were greater with ankle motion, likely reflecting anatomical differences in proximal and distal passive tendinous tissues, as well as shape changes of the adjacent mono-articular soleus. This suggests that there is joint-dependent dissociation between the mechanical behaviour of muscle fibres and the muscle-tendon unit during passive joint motions that may be important to consider when developing accurate models of bi-articular muscles.

  1. 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

  2. Hydro-galvanic and rising - temperature bath therapy for chronic elbow epicondylitis: a comparative study

    Directory of Open Access Journals (Sweden)

    C. Mucha

    2004-02-01

    Full Text Available The efficacy of two different regimens of physiotherapy for epicondylitis was compared. A combination treatment with hydrogalvanic four-cell bath and arm bath with rising temperature, which had showed good effects in treatment of tennis elbow in an earlier observational study (Mucha 1987, was compared with the analgesic interference current treatment often recommended in the literature (Sadil and Sadil 1994, Noteboom et al 1994, Becker and Reuter 1982. For this study, 60 patients with epicondylitis that was resistant to conservative treatment were randomized into two groups for comparison. In group 1, interference currents were administered twice a day for six weeks and group 2 received combination treatment with the hydrogalvanic four-cell bath and rising- temperature arm bath once a day for six weeks. Criteria for inclusion, control and appraisal were laid down prospectively. Several parameters were used, recorded and statistically evaluated as outcome measures.  These were active joint range of movement of the elbow, grip strength, pain provocation with muscle contraction, palpation pain and pain with functional activities.  The results showed a significant superiority of combination treatment over therapy with interference current. It is therefore recommended that hydrogalvanic four-cell bath and arm bath with rising temperature should be carried out before considering surgical treatment for chronic epicondylitis.

  3. 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.

  4. 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

  5. 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.

  6. Jointly Optimize Data Augmentation and Network Training: Adversarial Data Augmentation in Human Pose Estimation

    OpenAIRE

    Peng, Xi; Tang, Zhiqiang; Yang, Fei; Feris, Rogerio; Metaxas, Dimitris

    2018-01-01

    Random data augmentation is a critical technique to avoid overfitting in training deep neural network models. However, data augmentation and network training are usually treated as two isolated processes, limiting the effectiveness of network training. Why not jointly optimize the two? We propose adversarial data augmentation to address this limitation. The main idea is to design an augmentation network (generator) that competes against a target network (discriminator) by generating `hard' au...

  7. No evidence hip joint angle modulates intrinsically produced stretch reflex in human hopping.

    Science.gov (United States)

    Gibson, W; Campbell, A; Allison, G

    2013-09-01

    Motor output in activities such as walking and hopping is suggested to be mediated neurally by purported stretch reflex augmentation of muscle output. Reflex EMG activity during these tasks has been frequently investigated in the soleus muscle; with alterations in reflex amplitude being associated with changes in hip joint angle/phase of the gait cycle. Previous work has focussed on reflex activity induced by an artificial perturbation or by induction of H-reflexes. As such, it is currently unknown if stretch reflex activity induced intrinsically (as part of the task) is modulated by changes in hip joint angle. This study investigated whether hip joint angle modulated reflex EMG 'burst' activity during a hopping task performed on a custom-built partially reclined sleigh. Ten subjects participated; EMG and kinematic data (VICON motor capture system) was collected for each hop cycle. Participants completed 5 sets of 30s of self-paced hopping in (1) hip neutral and (2) hip 60° flexion conditions. There was no difference in EMG 'burst' activity or in sagittal plane kinematics (knee/ankle) in the hopping task between the two conditions. The results indicate that during a functional task such as hopping, changes in hip angle do not alter the stretch reflex-like activity associated with landing. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. Supramolecular Organization of Collagen Fibrils in Healthy and Osteoarthritic Human Knee and Hip Joint Cartilage.

    Directory of Open Access Journals (Sweden)

    Riccardo Gottardi

    Full Text Available Cartilage matrix is a composite of discrete, but interacting suprastructures, i.e. cartilage fibers with microfibrillar or network-like aggregates and penetrating extrafibrillar proteoglycan matrix. The biomechanical function of the proteoglycan matrix and the collagen fibers are to absorb compressive and tensional loads, respectively. Here, we are focusing on the suprastructural organization of collagen fibrils and the degradation process of their hierarchical organized fiber architecture studied at high resolution at the authentic location within cartilage. We present electron micrographs of the collagenous cores of such fibers obtained by an improved protocol for scanning electron microscopy (SEM. Articular cartilages are permeated by small prototypic fibrils with a homogeneous diameter of 18 ± 5 nm that can align in their D-periodic pattern and merge into larger fibers by lateral association. Interestingly, these fibers have tissue-specific organizations in cartilage. They are twisted ropes in superficial regions of knee joints or assemble into parallel aligned cable-like structures in deeper regions of knee joint- or throughout hip joints articular cartilage. These novel observations contribute to an improved understanding of collagen fiber biogenesis, function, and homeostasis in hyaline cartilage.

  9. Joint Intentionality

    Directory of Open Access Journals (Sweden)

    Koreň Ladislav

    2016-03-01

    Full Text Available According to the shared intentionality hypothesis proposed by Michael Tomasello, two cognitive upgrades – joint and collective intentionality, respectively – make human thinking unique. Joint intentionality, in particular, is a mindset supposed to account for our early, species-specific capacity to participate in collaborative activities involving two (or a few agents. In order to elucidate such activities and their proximate cognitive-motivational mechanism, Tomasello draws on philosophical accounts of shared intentionality. I argue that his deference to such cognitively demanding accounts of shared intentional activities is problematic if his theoretical ambition is in part to show that and how early (prelinguistic and precultural capacities for joint action contribute to the development of higher cognitive capacities.

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. Analysing the Hydraulic Actuator-based Knee Unit Kinematics and Correlating the Numerical Results and Walking Human Knee Joint Behavior

    Directory of Open Access Journals (Sweden)

    K. A. Trukhanov

    2014-01-01

    Full Text Available State-of-the-art machinery development enables people with lost lower limb to continue their previous life despite a loss. International companies dealing with this area pursue a minimization of human behaviour problems because of amputation. Researches to create an optimal design of the artificial knee joint are under way.The work task was to define analytical relationships of changing kinematic parameters of the human walking on the flat surface such as an angle of the knee joint, knee point (moment, definition of reduced knee actuator (A load, as well as to compare obtained results with experimental data.As an A in created design, the article proposes to use a controlled shock absorber based on the hydraulic cylinder.A knee unit is a kinematic two-tier mechanism. One of the mechanism links performs rotational motion, and the other is rotation-translational to provide a rotation of the first one.When studying the hydraulic actuator device dynamics, as a generalized coordinate a coordinate of the piston x (or ρ position is chosen while in the study of link movements an angle β is preferable.Experimental data are obtained for a human with the body weight of 57.6 kg walking on the flat surface to estimate a value of the knee joint angle, speed, acceleration, torque, and capacity in the knee joint and are taken from the published works of foreign authors.A trigonometric approximation was used for fitting the experimental data. The resulting dependence of the reduced load on the stock of A is necessary to perform the synthesis of A. The criterion for linear mechanisms mentioned in the D.N. Popov’s work is advisable to use as a possible criterion for optimization of A.The results obtained are as follows:1. Kinematics linkage mechanism is described using relationships for dependencies of its geometrical parameters, namely a cylinder piston stroke x (or ρ and a links angle β.2. Obtained polynomials of kinematic relationships allow a synthesis of

  15. An artery accompanying the sciatic nerve (arteria comitans nervi ischiadici) and the position of the hip joint: a comparative histological study using chick, mouse, and human foetal specimens.

    Science.gov (United States)

    Ishizawa, A; Hayashi, S; Nasu, H; Abe, H; Rodríguez-Vázquez, J F; Murakami, G

    2013-02-01

    Birds and reptiles always carry a long and thick artery accompanying the sciatic nerve (i.e., the sciatic artery), whereas mammals do not. We attempted to demonstrate a difference in courses of the nerve and artery in fetuses in relation with the hip joint posture. Eight mid-term human fetuses (15-18 weeks), five mouse fetuses (E18) and five chick embryos (11 days after incubation) were examined histologically. Thin feeding arteries in the sciatic nerve were consistently observed in human fetuses in spite of the long, inferiorly curved course of the nerve around the ischium. The tissue around the human sciatic nerve was not so tight because of the medial and inferior shift of the nerve away from the hip joint. The fetal hip joint position differed among the species, being highly flexed in humans and almost at right angle flexion in mice and chicks. Because of deep adduction of the hip joint in the mouse, the knee was located near the midline of the body. The mouse sciatic nerve ran through the tight tissue along the head of the femur, whereas the chick nerve ran through the loose space even in the gluteal region. In birds, evolution of the pelvis including the hip joint without adduction seemed to make the arterial development possible. In mammals, highly flexed or adducted hip joint seemed to be one of the disturbing factors against development of the long and thick artery. A slight change in posture may cause significant arterial variation.

  16. Comparison of Quaternion and Euler Angle Methods for Joint Angle Animation of Human Figure Models

    National Research Council Canada - National Science Library

    Usta, Umit

    1999-01-01

    .... The model is then manipulated with user inputs by a mouse. As part of this research, the real-time display of human arm tracking with two inertial sensors, human walking, inverse kinematics, and key frame animation...

  17. 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

  18. 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)

  19. 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...

  20. Indian Hedgehog in Synovial Fluid Is a Novel Marker for Early Cartilage Lesions in Human Knee Joint

    Science.gov (United States)

    Zhang, Congming; Wei, Xiaochun; Chen, Chongwei; Cao, Kun; Li, Yongping; Jiao, Qiang; Ding, Juan; Zhou, Jingming; Fleming, Braden C.; Chen, Qian; Shang, Xianwen; Wei, Lei

    2014-01-01

    To determine whether there is a correlation between the concentration of Indian hedgehog (Ihh) in synovial fluid (SF) and the severity of cartilage damage in the human knee joints, the knee cartilages from patients were classified using the Outer-bridge scoring system and graded using the Modified Mankin score. Expression of Ihh in cartilage and SF samples were analyzed with immunohistochemistry (IHC), western blot, and enzyme-linked immunosorbent assay (ELISA). Furthermore, we detected and compared Ihh protein levels in rat and mice cartilages between normal control and surgery-induced osteoarthritis (OA) group by IHC and fluorescence molecular tomography in vivo respectively. Ihh expression was increased 5.2-fold in OA cartilage, 3.1-fold in relative normal OA cartilage, and 1.71-fold in OA SF compared to normal control samples. The concentrations of Ihh in cartilage and SF samples was significantly increased in early-stage OA samples when compared to normal samples (r = 0.556; p Ihh protein was also an early event in the surgery-induced OA models. Increased Ihh is associated with the severity of OA cartilage damage. Elevated Ihh content in human knee joint synovial fluid correlates with early cartilage lesions. PMID:24786088

  1. Indian Hedgehog in Synovial Fluid Is a Novel Marker for Early Cartilage Lesions in Human Knee Joint

    Directory of Open Access Journals (Sweden)

    Congming Zhang

    2014-04-01

    Full Text Available To determine whether there is a correlation between the concentration of Indian hedgehog (Ihh in synovial fluid (SF and the severity of cartilage damage in the human knee joints, the knee cartilages from patients were classified using the Outer-bridge scoring system and graded using the Modified Mankin score. Expression of Ihh in cartilage and SF samples were analyzed with immunohistochemistry (IHC, western blot, and enzyme-linked immunosorbent assay (ELISA. Furthermore, we detected and compared Ihh protein levels in rat and mice cartilages between normal control and surgery-induced osteoarthritis (OA group by IHC and fluorescence molecular tomography in vivo respectively. Ihh expression was increased 5.2-fold in OA cartilage, 3.1-fold in relative normal OA cartilage, and 1.71-fold in OA SF compared to normal control samples. The concentrations of Ihh in cartilage and SF samples was significantly increased in early-stage OA samples when compared to normal samples (r = 0.556; p < 0.001; however, there were no significant differences between normal samples and late-stage OA samples. Up-regulation of Ihh protein was also an early event in the surgery-induced OA models. Increased Ihh is associated with the severity of OA cartilage damage. Elevated Ihh content in human knee joint synovial fluid correlates with early cartilage lesions.

  2. 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.

  3. 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.

  4. Effects of pretension on work and power output of the muscle-tendon complex in dynamic elbow flexion.

    Science.gov (United States)

    Wakayama, Akinobu; Nagano, Akinori; Hay, Dean; Fukashiro, Senshi

    2005-06-01

    The purpose of the present study was to investigate the effects of pretension on work and power output of the muscle-tendon complex during dynamic elbow flexion under several submaximal and maximal conditions. The subjects were 10 healthy female students. Randomized trials from 0% to 100% maximal voluntary contraction (MVC) pretension (PT) at 60 degrees elbow flexion were conducted. After about 3 s of static PT, subjects maximally flexed the elbow joint to 90 degrees using a quick release method. The weight was individually selected for each subject to provide an optimal load for the development of maximal power. A Hill-type model was utilized to analyze the performance of the elbow muscle-tendon complex (MTC). PT 0, 30, 60 and 90% MVC data were used for comparison, and all data were expressed as the mean and standard deviation. Multiple paired comparisons between the value of PT 0% MVC and that of the other PT levels were performed post-hoc using Dunnett's method. The work of the series elastic component (SEC) increased gradually with the PT level because elastic energy was stored in the PT phase. However, the work of the contractile component (CC) decreased gradually with an increase in PT level. Moreover, the work of the MTC also decreased, closely related to the CC work decrement. The phenomenon of CC work decrement was caused by force depression and was not related to either the force-length or force-velocity relationships of the CC. EMG activity (agonist and antagonist) showed no significant differences. Muscle geometry changes or intracellular chemical shifts may have occurred in the PT phase.

  5. Dual-Modality Imaging of the Human Finger Joint Systems by Using Combined Multispectral Photoacoustic Computed Tomography and Ultrasound Computed Tomography

    Directory of Open Access Journals (Sweden)

    Yubin Liu

    2016-01-01

    Full Text Available We developed a homemade dual-modality imaging system that combines multispectral photoacoustic computed tomography and ultrasound computed tomography for reconstructing the structural and functional information of human finger joint systems. The fused multispectral photoacoustic-ultrasound computed tomography (MPAUCT system was examined by the phantom and in vivo experimental tests. The imaging results indicate that the hard tissues such as the bones and the soft tissues including the blood vessels, the tendon, the skins, and the subcutaneous tissues in the finger joints systems can be effectively recovered by using our multimodality MPAUCT system. The developed MPAUCT system is able to provide us with more comprehensive information of the human finger joints, which shows its potential for characterization and diagnosis of bone or joint diseases.

  6. Pain sensation in human osteoarthritic knee joints is strongly enhanced by diabetes mellitus.

    Science.gov (United States)

    Eitner, Annett; Pester, Julia; Vogel, Franziska; Marintschev, Ivan; Lehmann, Thomas; Hofmann, Gunther O; Schaible, Hans-Georg

    2017-09-01

    The major burden of knee joint osteoarthritis (OA) is pain. Since in elder patients diabetes mellitus is an important comorbidity of OA, we explored whether the presence of diabetes mellitus has a significant influence on pain intensity at the end stage of knee OA, and we aimed to identify factors possibly related to changes of pain intensity in diabetic patients. In 23 diabetic and 47 nondiabetic patients with OA undergoing total knee arthroplasty, we assessed the pain intensity before the operation using the "Knee Injury and Osteoarthritis Outcome Score". Furthermore, synovial tissue, synovial fluid (SF), cartilage, and blood were obtained. We determined the synovitis score, the concentrations of prostaglandin E2 and interleukin-6 (IL-6) in the SF and serum, and of C-reactive protein and HbA1c and other metabolic parameters in the serum. We performed multivariate regression analyses to study the association of pain with several parameters. Diabetic patients had on average a higher Knee Injury and Osteoarthritis Outcome Score pain score than nondiabetic patients (P Knee joints from diabetic patients exhibited on average higher synovitis scores (P = 0.024) and higher concentrations of IL-6 in the SF (P = 0.003) than knee joints from nondiabetic patients. Multivariate regression analysis showed that patients with higher synovitis scores had more intense pain independent of all investigated confounders, and that the positive association between pain intensities and IL-6 levels was dependent on diabetes mellitus and/or synovitis. These data suggest that diabetes mellitus significantly increases pain intensity of knee OA, and that in diabetic patients higher pain intensities were determined by stronger synovitis.

  7. Novel joint TOA/RSSI-based WCE location tracking method without prior knowledge of biological human body tissues.

    Science.gov (United States)

    Ito, Takahiro; Anzai, Daisuke; Jianqing Wang

    2014-01-01

    This paper proposes a novel joint time of arrival (TOA)/received signal strength indicator (RSSI)-based wireless capsule endoscope (WCE) location tracking method without prior knowledge of biological human tissues. Generally, TOA-based localization can achieve much higher localization accuracy than other radio frequency-based localization techniques, whereas wireless signals transmitted from a WCE pass through various kinds of human body tissues, as a result, the propagation velocity inside a human body should be different from one in free space. Because the variation of propagation velocity is mainly affected by the relative permittivity of human body tissues, instead of pre-measurement for the relative permittivity in advance, we simultaneously estimate not only the WCE location but also the relative permittivity information. For this purpose, this paper first derives the relative permittivity estimation model with measured RSSI information. Then, we pay attention to a particle filter algorithm with the TOA-based localization and the RSSI-based relative permittivity estimation. Our computer simulation results demonstrates that the proposed tracking methods with the particle filter can accomplish an excellent localization accuracy of around 2 mm without prior information of the relative permittivity of the human body tissues.

  8. 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.

  9. 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

  10. Rubber hand illusion affects joint angle perception.

    Directory of Open Access Journals (Sweden)

    Martin V Butz

    Full Text Available The Rubber Hand Illusion (RHI is a well-established experimental paradigm. It has been shown that the RHI can affect hand location estimates, arm and hand motion towards goals, the subjective visual appearance of the own hand, and the feeling of body ownership. Several studies also indicate that the peri-hand space is partially remapped around the rubber hand. Nonetheless, the question remains if and to what extent the RHI can affect the perception of other body parts. In this study we ask if the RHI can alter the perception of the elbow joint. Participants had to adjust an angular representation on a screen according to their proprioceptive perception of their own elbow joint angle. The results show that the RHI does indeed alter the elbow joint estimation, increasing the agreement with the position and orientation of the artificial hand. Thus, the results show that the brain does not only adjust the perception of the hand in body-relative space, but it also modifies the perception of other body parts. In conclusion, we propose that the brain continuously strives to maintain a consistent internal body image and that this image can be influenced by the available sensory information sources, which are mediated and mapped onto each other by means of a postural, kinematic body model.

  11. The Yucatan Minipig Temporomandibular Joint Disc Structure-Function Relationships Support Its Suitability for Human Comparative Studies.

    Science.gov (United States)

    Vapniarsky, Natalia; Aryaei, Ashkan; Arzi, Boaz; Hatcher, David C; Hu, Jerry C; Athanasiou, Kyriacos A

    2017-11-01

    Frequent involvement of the disc in temporomandibular joint (TMJ) disorders warrants attempts to tissue engineer TMJ disc replacements. Physiologically, a great degree of similarity is seen between humans and farm pigs (FPs), but the pig's rapid growth confers a significant challenge for in vivo experiments. Minipigs have a slower growth rate and are smaller than FPs, but minipig TMJ discs have yet to be fully characterized. The objective of this study was to determine the suitability of the minipig for TMJ studies by extensive structural and functional characterization. The properties of minipig TMJ discs closely reproduced previously reported morphological, biochemical, and biomechanical values of human and FP discs. The width/length dimension ratio of the minipig TMJ disc was 1.95 (1.69 for human and 1.94 for FP). The biochemical evaluation revealed, on average per wet weight, 24.3% collagen (22.8% for human and 24.9% for FP); 0.8% glycosaminoglycan (GAG; 0.5% for human and 0.4% for FP); and 0.03% DNA (0.008% for human and 0.02% for FP). Biomechanical testing revealed, on average, compressive relaxation modulus of 50 kPa (37 kPa for human and 32 kPa for FP), compressive instantaneous modulus of 1121 kPa (1315 kPa for human and 1134 kPa for FP), and coefficient of viscosity of 13 MPa·s (9 MPa·s for human and 3 MPa·s for FP) at 20% strain. These properties also varied topographically in accordance to those of human and FP TMJ discs. Anisotropy, quantified by bidirectional tensile testing and histology, again was analogous among minipig, human, and FP TMJ discs. The minipig TMJ's ginglymoarthrodial nature was verified through cone beam computer tomography. Collectively, the similarities between minipig and human TMJ discs support the use of minipig as a relevant model for TMJ research; considering the practical advantages conferred by its growth rate and size, the minipig may be a preferred model over FP.

  12. Expression of lumican related to CD34 and VEGF in the articular disc of the human temporomandibular joint.

    Directory of Open Access Journals (Sweden)

    N. Kiga

    2010-07-01

    Full Text Available Lumican belongs to the small leucine-rich repeat proteoglycan (SLRP gene family and has been reported to exist in the cornea, intervertebral disc and tendon. Lumican plays a significant role in the assembly and regulation of collagen fibres. The human temporomandibular joint (TMJ disc is made up of fibrocartilage with an extracellular matrix (ECM composed of collagen and proteoglycans. The existence and behaviour of lumican have not been studied in the human TMJ disc. Therefore, we used immunohistochemical methods to detect lumican, CD34 and vascular endothelial growth factor (VEGF and histochemical staining with toluidine blue in 13 human TMJ specimens (10 surgically removed and 3 obtained from autopsy. In both normal and deformed discs we observed staining with toluidine blue. We found that the area of metachromasia inside the deformed disc was uneven and expression of lumican was strong in the areas negative for metachromasia. Staining of VEGF and CD34 inside the deformed disc was seen. We confirmed the expression of lumican in the human TMJ disc and showed that a large number of fibroblastlike cells existed in the area of strong lumican expression. These new findings about the behaviour of lumican suggest that it may play a key role in the generation of a new collagen network by fibroblast-like cells.

  13. 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.

  14. 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

  15. 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.)

  16. A joint model of persistent human papillomavirus infection and cervical cancer risk: Implications for cervical cancer screening.

    Science.gov (United States)

    Katki, Hormuzd A; Cheung, Li C; Fetterman, Barbara; Castle, Philip E; Sundaram, Rajeshwari

    2015-10-01

    New cervical cancer screening guidelines in the US and many European countries recommend that women get tested for human papillomavirus (HPV). To inform decisions about screening intervals, we calculate the increase in precancer/cancer risk per year of continued HPV infection. However, both time to onset of precancer/cancer and time to HPV clearance are interval-censored, and onset of precancer/cancer strongly informatively censors HPV clearance. We analyze this bivariate informatively interval-censored data by developing a novel joint model for time to clearance of HPV and time to precancer/cancer using shared random-effects, where the estimated mean duration of each woman's HPV infection is a covariate in the submodel for time to precancer/cancer. The model was fit to data on 9,553 HPV-positive/Pap-negative women undergoing cervical cancer screening at Kaiser Permanente Northern California, data that were pivotal to the development of US screening guidelines. We compare the implications for screening intervals of this joint model to those from population-average marginal models of precancer/cancer risk. In particular, after 2 years the marginal population-average precancer/cancer risk was 5%, suggesting a 2-year interval to control population-average risk at 5%. In contrast, the joint model reveals that almost all women exceeding 5% individual risk in 2 years also exceeded 5% in 1 year, suggesting that a 1-year interval is better to control individual risk at 5%. The example suggests that sophisticated risk models capable of predicting individual risk may have different implications than population-average risk models that are currently used for informing medical guideline development.

  17. Histochemistry for studying structure and function of the articular disc of the human temporomandibular joint

    Directory of Open Access Journals (Sweden)

    N. Kiga

    2012-02-01

    Full Text Available The articular disc of the temporomandibular joint (TMJ is composed of fibrocartilage, and the extracellular matrix of this disc is composed mainly of collagen, glycosaminoglycan and proteoglycans. Research on the changes that occur in the composition of the articular disc of the TMJ is necessary for understanding the basis of the pathological process of internal derangement (ID, and a number of reports have been published in recent years on the application of refined histochemical techniques to investigate the structure and function of the TMJ. The direction of future TMJ disc studies should be towards obtaining more evidence to support previous results, and should hopefully be of practical use in terms of prevention and cure of ID.

  18. Modular one-to-many clutchable actuator for a soft elbow exosuit.

    Science.gov (United States)

    Canesi, M; Xiloyannis, M; Ajoudani, A; Biechi, A; Masia, L

    2017-07-01

    Exoskeletons have been developed for a wide range of applications, from the military to the medical field, with the aim of augmenting human performance or compensating for neuromuscular deficiencies. However, to empower the high number of degrees of freedom of the human body, they often employ a high number of motors, increasing the size, weight and power consumption of the system. We hereby present an actuation strategy to empower our elbow exosuit that adopts a single motor to drive multiple, independently actuated, degrees of freedom. This paradigm, known as One-to-many, is achieved using a modular design where each module comprises a clutchable mechanism that allows to convert a single directional motion from the prime mover to a selectable bidirectional output. Moreover, the mechanism has a locking feature that enables the wearer of the exoskeleton to hold a static load with a minimal power consumption. We present a simple controller for the clutchable unit based on a finite-state machine model, and evaluate its performance for varying input velocities. The system is shown to have a bandwidth of 1.5 Hz, sufficient for daily elbow movements, whilst retaining a compact design.

  19. Evaluation of taper joints with combined fatigue and crevice corrosion testing: Comparison to human explanted modular prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Reclaru, L., E-mail: lucien.reclaru@pxgroup.com [PX Group S.A., Dep R and D Corrosion and Biocompatibility Group, Bd. des Eplatures 42, CH-2304 La Chaux-de-Fonds (Switzerland); Brooks, R.A. [Orthopaedic Research, Addenbrooke' s Hospital, University of Cambridge, Box 180 Hills Road, CB2 0QQ Cambridge (United Kingdom); Zuberbühler, M. [Smith and Nephew Orthopaedics AG, Schachenalle 29, 5001 Aarau (Switzerland); Eschler, P.-Y.; Constantin, F. [PX Group S.A., Dep R and D Corrosion and Biocompatibility Group, Bd. des Eplatures 42, CH-2304 La Chaux-de-Fonds (Switzerland); Tomoaia, G. [University of Medicine and Pharmacy Iuliu Hateganu of Cluj-Napoca, Dept. of Orthopaedics and Traumatology, Cluj-Napoca (Romania)

    2014-01-01

    The requirement for revision surgery of total joint replacements is increasing and modular joint replacement implants have been developed to provide adjustable prosthetic revision systems with improved intra-operative flexibility. An electrochemical study of the corrosion resistance of the interface between the distal and proximal modules of a modular prosthesis was performed in combination with a cyclic fatigue test. The complexity resides in the existence of interfaces between the distal part, the proximal part, and the dynamometric screw. A new technique for evaluating the resistance to cyclic dynamic corrosion with crevice stimulation was used and the method is presented. In addition, two components of the proximal module of explanted Ti6Al4V and Ti6Al7Nb prostheses were investigated by optical and electron microscopy. Our results reveal that: The electrolyte penetrates into the interface between the distal and proximal modules during cyclic dynamic fatigue tests, the distal module undergoes cracking and corrosion was generated at the interface between the two models; The comparison of the explanted proximal parts with the similar prostheses evaluated following cyclic dynamic crevice corrosion testing showed that there were significant similarities indicating that this method is suitable for evaluating materials used in the fabrication of modular prostheses. - Highlights: • Electrochemical crevice corrosion testing combined with fatigue test conducted on Ti6Al7Nb and Ti6Al4V modular prostheses • Cations released from integral prostheses • Comparison of human explanted modular prostheses with the similar prostheses evaluated in cyclic dynamic crevice corrosion.

  20. 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.

  1. 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

  2. The Joint Role of Industry and Education in Human Resource Development.

    Science.gov (United States)

    Striner, Herbert E.

    1981-01-01

    Until the United States adopts an investment approach to its labor force and provides adequate funds for continuous upgrading of human resources, the unemployment rate will remain above acceptable levels. (SK)

  3. Synovial Osteochondromatosis at the Carpometacarpal Joint of the Thumb

    Directory of Open Access Journals (Sweden)

    Satoru Yonekura

    2017-01-01

    Full Text Available Synovial osteochondromatosis (SOC is a benign tumor characterized by synovial connective tissue metaplasia. SOC commonly affects major joints including the knee followed by the hip, elbow, and wrist. SOC cases in the hand are not reported as often as SOC of major joints. Particularly SOC of the carpometacarpal joint of the thumb is rare. We report on a 57-year-old female with primary SOC of the carpometacarpal joint of her left thumb. Surgical excision was performed and the patient had no symptoms with full range of motion of her left thumb. At 3 years of follow-up, there was no recurrence.

  4. The postnatal development of the temporal part of the human temporomandibular joint. A quantitative study on skulls.

    Science.gov (United States)

    Dibbets, J M; Dijkman, G E

    1997-12-01

    The morphology of the temporal part of the human temporomandibular joint (TMJ) changes drastically during postnatal development. The glenoid fossa will acquire its characteristic S shape and a tubercle will develop. The combined results of the literature and of this study allow a reconstruction of the actual growth processes. The roof of the glenoid fossa appears to enlarge forward by remodeling while sagittal and vertical growth is mainly achieved by deposition at the top of the tubercle. These latter changes result in a steeper slope of the eminence and take place in 3 phases, parallelling the eruption of the first incisors, the permanent first molars and the permanent second molars. While the zygomatic arch thickens by deposition at all surfaces, it also remodels downward relative to the external meatus. As a result, the neonate anulus occupies a lower position relative to this arch than does the adult meatus.

  5. 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

  6. The influence of ligament modelling strategies on the predictive capability of finite element models of the human knee joint.

    Science.gov (United States)

    Naghibi Beidokhti, Hamid; Janssen, Dennis; van de Groes, Sebastiaan; Hazrati, Javad; Van den Boogaard, Ton; Verdonschot, Nico

    2017-12-08

    In finite element (FE) models knee ligaments can represented either by a group of one-dimensional springs, or by three-dimensional continuum elements based on segmentations. Continuum models closer approximate the anatomy, and facilitate ligament wrapping, while spring models are computationally less expensive. The mechanical properties of ligaments can be based on literature, or adjusted specifically for the subject. In the current study we investigated the effect of ligament modelling strategy on the predictive capability of FE models of the human knee joint. The effect of literature-based versus specimen-specific optimized material parameters was evaluated. Experiments were performed on three human cadaver knees, which were modelled in FE models with ligaments represented either using springs, or using continuum representations. In spring representation collateral ligaments were each modelled with three and cruciate ligaments with two single-element bundles. Stiffness parameters and pre-strains were optimized based on laxity tests for both approaches. Validation experiments were conducted to evaluate the outcomes of the FE models. Models (both spring and continuum) with subject-specific properties improved the predicted kinematics and contact outcome parameters. Models incorporating literature-based parameters, and particularly the spring models (with the representations implemented in this study), led to relatively high errors in kinematics and contact pressures. Using a continuum modelling approach resulted in more accurate contact outcome variables than the spring representation with two (cruciate ligaments) and three (collateral ligaments) single-element-bundle representations. However, when the prediction of joint kinematics is of main interest, spring ligament models provide a faster option with acceptable outcome. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. 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.)

  8. Evaluation of validity and reliability of a methodology for measuring human postural attitude and its relation to temporomandibular joint disorders

    Science.gov (United States)

    Fernández, Ramón Fuentes; Carter, Pablo; Muñoz, Sergio; Silva, Héctor; Venegas, Gonzalo Hernán Oporto; Cantin, Mario; Ottone, Nicolás Ernesto

    2016-01-01

    INTRODUCTION Temporomandibular joint disorders (TMJDs) are caused by several factors such as anatomical, neuromuscular and psychological alterations. A relationship has been established between TMJDs and postural alterations, a type of anatomical alteration. An anterior position of the head requires hyperactivity of the posterior neck region and shoulder muscles to prevent the head from falling forward. This compensatory muscular function may cause fatigue, discomfort and trigger point activation. To our knowledge, a method for assessing human postural attitude in more than one plane has not been reported. Thus, the aim of this study was to design a methodology to measure the external human postural attitude in frontal and sagittal planes, with proper validity and reliability analyses. METHODS The variable postures of 78 subjects (36 men, 42 women; age 18–24 years) were evaluated. The postural attitudes of the subjects were measured in the frontal and sagittal planes, using an acromiopelvimeter, grid panel and Fox plane. RESULTS The method we designed for measuring postural attitudes had adequate reliability and validity, both qualitatively and quantitatively, based on Cohen’s Kappa coefficient (> 0.87) and Pearson’s correlation coefficient (r = 0.824, > 80%). CONCLUSION This method exhibits adequate metrical properties and can therefore be used in further research on the association of human body posture with skeletal types and TMJDs. PMID:26768173

  9. Effect of hammer mass on upper extremity joint moments.

    Science.gov (United States)

    Balendra, Nilanthy; Langenderfer, Joseph E

    2017-04-01

    This study used an OpenSim inverse-dynamics musculoskeletal model scaled to subject-specific anthropometrics to calculate three-dimensional intersegmental moments at the shoulder, elbow and wrist while 10 subjects used 1 and 2 lb hammers to drive nails. Motion data were collected via an optoelectronic system and the interaction of the hammer with nails was recorded with a force plate. The larger hammer caused substantial increases (50-150%) in moments, although increases differed by joint, anatomical component, and significance of the effect. Moment increases were greater in cocking and strike/follow-through phases as opposed to swinging and may indicate greater potential for injury. Compared to shoulder, absolute increases in peak moments were smaller for elbow and wrist, but there was a trend toward larger relative increases for distal joints. Shoulder rotation, elbow varus-valgus and pronation-supination, and wrist radial-ulnar deviation and rotation demonstrated large relative moment increases. Trial and phase durations were greater for the larger hammer. Changes in moments and timing indicate greater loads on musculoskeletal tissues for an extended period with the larger hammer. Additionally, greater variability in timing with the larger hammer, particularly for cocking phase, suggests differences in control of the motion. Increased relative moments for distal joints may be particularly important for understanding disorders of the elbow and wrist associated with hammer use. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. 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.

  11. Joint Estimation of Contamination, Error and Demography for Nuclear DNA from Ancient Humans

    Science.gov (United States)

    Slatkin, Montgomery

    2016-01-01

    When sequencing an ancient DNA sample from a hominin fossil, DNA from present-day humans involved in excavation and extraction will be sequenced along with the endogenous material. This type of contamination is problematic for downstream analyses as it will introduce a bias towards the population of the contaminating individual(s). Quantifying the extent of contamination is a crucial step as it allows researchers to account for possible biases that may arise in downstream genetic analyses. Here, we present an MCMC algorithm to co-estimate the contamination rate, sequencing error rate and demographic parameters—including drift times and admixture rates—for an ancient nuclear genome obtained from human remains, when the putative contaminating DNA comes from present-day humans. We assume we have a large panel representing the putative contaminant population (e.g. European, East Asian or African). The method is implemented in a C++ program called ‘Demographic Inference with Contamination and Error’ (DICE). We applied it to simulations and genome data from ancient Neanderthals and modern humans. With reasonable levels of genome sequence coverage (>3X), we find we can recover accurate estimates of all these parameters, even when the contamination rate is as high as 50%. PMID:27049965

  12. 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.

  13. 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

  14. [124I]FIAU: Human dosimetry and infection imaging in patients with suspected prosthetic joint infection

    International Nuclear Information System (INIS)

    Zhang, Xiaoyan M.; Zhang, Halle H.; McLeroth, Patrick; Berkowitz, Richard D.; Mont, Michael A.; Stabin, Michael G.; Siegel, Barry A.; Alavi, Abass; Barnett, T. Marc; Gelb, Jeffrey; Petit, Chantal; Spaltro, John; Cho, Steve Y.; Pomper, Martin G.; Conklin, James J.; Bettegowda, Chetan; Saha, Saurabh

    2016-01-01

    Introduction: Fialuridine (FIAU) is a nucleoside analog that is a substrate for bacterial thymidine kinase (TK). Once phosphorylated by TK, [ 124 I]FIAU becomes trapped within bacteria and can be detected with positron emission tomography/computed tomography (PET/CT). [ 124 I]FIAU PET/CT has been shown to detect bacteria in patients with musculoskeletal bacterial infections. Accurate diagnosis of prosthetic joint infections (PJIs) has proven challenging because of the lack of a well-validated reference. In the current study, we assessed biodistribution and dosimetry of [ 124 I]FIAU, and investigated whether [ 124 I]FIAU PET/CT can diagnose PJIs with acceptable accuracy. Methods: To assess biodistribution and dosimetry, six subjects with suspected hip or knee PJI and six healthy subjects underwent serial PET/CT after being dosed with 74 MBq (2 mCi) [ 124 I]FIAU intravenously (IV). Estimated radiation doses were calculated with the OLINDA/EXM software. To determine accuracy of [ 124 I]FIAU, 22 subjects with suspected hip or knee PJI were scanned at 2–6 and 24–30 h post IV injection of 185 MBq (5 mCi) [ 124 I]FIAU. Images were interpreted by a single reader blinded to clinical information. Representative cases were reviewed by 3 additional readers. The utility of [ 124 I]FIAU to detect PJIs was assessed based on the correlation of the patient's infection status with imaging results as determined by an independent adjudication board (IAB). Results: The kidney, liver, spleen, and urinary bladder received the highest radiation doses of [ 124 I]FIAU. The effective dose was 0.16 to 0.20 mSv/MBq and doses to most organs ranged from 0.11 to 0.76 mGy/MBq. PET image quality obtained from PJI patients was confounded by metal artifacts from the prostheses and pronounced FIAU uptake in muscle. Consequently, a correlation with infection status and imaging results could not be established. Conclusions: [ 124 I]FIAU was well-tolerated in healthy volunteers and subjects with

  15. [(124)I]FIAU: Human dosimetry and infection imaging in patients with suspected prosthetic joint infection.

    Science.gov (United States)

    Zhang, Xiaoyan M; Zhang, Halle H; McLeroth, Patrick; Berkowitz, Richard D; Mont, Michael A; Stabin, Michael G; Siegel, Barry A; Alavi, Abass; Barnett, T Marc; Gelb, Jeffrey; Petit, Chantal; Spaltro, John; Cho, Steve Y; Pomper, Martin G; Conklin, James J; Bettegowda, Chetan; Saha, Saurabh

    2016-05-01

    Fialuridine (FIAU) is a nucleoside analog that is a substrate for bacterial thymidine kinase (TK). Once phosphorylated by TK, [(124)I]FIAU becomes trapped within bacteria and can be detected with positron emission tomography/computed tomography (PET/CT). [(124)I]FIAU PET/CT has been shown to detect bacteria in patients with musculoskeletal bacterial infections. Accurate diagnosis of prosthetic joint infections (PJIs) has proven challenging because of the lack of a well-validated reference. In the current study, we assessed biodistribution and dosimetry of [(124)I]FIAU, and investigated whether [(124)I]FIAU PET/CT can diagnose PJIs with acceptable accuracy. To assess biodistribution and dosimetry, six subjects with suspected hip or knee PJI and six healthy subjects underwent serial PET/CT after being dosed with 74MBq (2mCi) [(124)I]FIAU intravenously (IV). Estimated radiation doses were calculated with the OLINDA/EXM software. To determine accuracy of [(124)I]FIAU, 22 subjects with suspected hip or knee PJI were scanned at 2-6 and 24-30h post IV injection of 185MBq (5mCi) [(124)I]FIAU. Images were interpreted by a single reader blinded to clinical information. Representative cases were reviewed by 3 additional readers. The utility of [(124)I]FIAU to detect PJIs was assessed based on the correlation of the patient's infection status with imaging results as determined by an independent adjudication board (IAB). The kidney, liver, spleen, and urinary bladder received the highest radiation doses of [(124)I]FIAU. The effective dose was 0.16 to 0.20mSv/MBq and doses to most organs ranged from 0.11 to 0.76mGy/MBq. PET image quality obtained from PJI patients was confounded by metal artifacts from the prostheses and pronounced FIAU uptake in muscle. Consequently, a correlation with infection status and imaging results could not be established. [(124)I]FIAU was well-tolerated in healthy volunteers and subjects with suspected PJI, and had acceptable dosimetry. However, the

  16. Aging and cytomegalovirus (CMV) infection differentially and jointly affect distinct circulating T cell subsets in humans1

    Science.gov (United States)

    Wertheimer, Anne M.; Bennett, Michael S.; Park, Byung; Uhrlaub, Jennifer L.; Martinez, Carmine; Pulko, Vesna; Currier, Noreen L.; Nikolich-Zugich, Dragana; Kaye, Jeffrey; Nikolich-Zugich, Janko

    2014-01-01

    The impact of intrinsic aging upon human peripheral blood T-cell subsets remains incompletely quantified and understood. This impact must be distinguished from the influence of latent persistent microorganisms, particularly cytomegalovirus (CMV), which has been associated with age-related changes in the T cell pool. In a cross-sectional cohort of 152 CMV-negative individuals, aged 21–101 years, we found that aging correlated strictly to an absolute loss of naïve CD8, but not CD4, T cells, but, contrary to many reports, did not lead to an increase in memory T cell numbers. The loss of naïve CD8 T cells was not altered by CMV in 239 subjects (range 21–96 years) but the decline in CD4+ naïve cells showed significance in CMV+ individuals. These individuals also exhibited an absolute increase in the effector/effector memory CD4+ and CD8+ cells with age. That increase was seen mainly, if not exclusively, in older subjects with elevated anti-CMV Ab titers, suggesting that efficacy of viral control over time may determine the magnitude of CMV impact upon T cell memory, and perhaps upon immune defense. These findings provide important new insights into the age-related changes in the peripheral blood pool of older adults, demonstrating that aging and CMV exert both distinct and joint influence upon blood T cell homeostasis in humans. PMID:24501199

  17. Squeeze-film Lubrication of the Human Ankle Joint with Synovial Fluid Filtrated by Articular Cartilage with the Superficial Zone Worn out

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2000-01-01

    Roč. 33, č. 11 (2000), s. 1415-1422 ISSN 0021-9290 R&D Projects: GA ČR GA103/00/0008 Keywords : human ankle joint * squeeze-film lubrication * synovial fluid filtration * worn-out cartilage superficial zone Subject RIV: BK - Fluid Dynamics Impact factor: 1.474, year: 2000

  18. Synovial Fluid Filtration by Articular Cartilage with a Worn-out Surface Zone in the Human Ankle Joint during Walking- II. Numerical Results for Steady Pure Sliding

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2000-01-01

    Roč. 45, č. 4 (2000), s. 375-396 ISSN 0001-7043 R&D Projects: GA ČR GA103/00/0008 Keywords : biphasic articular cartilage * biphasic synovial fluid * boundary lubrication * human ankle joint Subject RIV: BK - Fluid Dynamics

  19. Synovial Fluid Filtration by Articular Cartilage with a Worn-out Surface Zone in the Human Ankle Joint during Walking- I.A Mathematical Mixture Model

    Czech Academy of Sciences Publication Activity Database

    Hlaváček, Miroslav

    2000-01-01

    Roč. 45, č. 3 (2000), s. 295-321 ISSN 0001-7043 R&D Projects: GA ČR GA103/00/0008 Keywords : asymptotic solution * biphasic articular cartilage * biphasic synovial fluid * human ankle joint Subject RIV: BK - Fluid Dynamics

  20. 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.)

  1. 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.

  2. 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.

  3. 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

  4. 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)

  5. 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.)

  6. 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.

  7. [Research of joint-robotics-based design of biomechanics testing device on human spine].

    Science.gov (United States)

    Deng, Guoyong; Tian, Lianfang; Mao, Zongyuan

    2009-12-01

    This paper introduces the hardware and software of a biomechanical robot-based testing device. The bottom control orders, posture and torque data transmission, and the control algorithms are integrated in a unified visual control platform by Visual C+ +, with easy control and management. By using hybrid force-displacement control method to load the human spine, we can test the organizational structure and the force state of the FSU (Functional spinal unit) well, which overcomes the shortcomings due to the separation of the force and displacement measurement, thus greatly improves the measurement accuracy. Also it is esay to identify the spinal degeneration and the load-bearing impact on the organizational structure of the FSU after various types of surgery.

  8. Regionally variant collagen alignment correlates with viscoelastic properties of the disc of the human temporomandibular joint.

    Science.gov (United States)

    Gutman, Shawn; Kim, Daniel; Tarafder, Solaiman; Velez, Sergio; Jeong, Julia; Lee, Chang H

    2018-02-01

    To determine the regionally variant quality of collagen alignment in human TMJ discs and its statistical correlation with viscoelastic properties. For quantitative analysis of the quality of collagen alignment, horizontal sections of human TMJ discs with Pricrosirius Red staining were imaged under circularly polarized microscopy. Mean angle and angular deviation of collagen fibers in each region were analyzed using a well-established automated image-processing for angular gradient. Instantaneous and relaxation moduli of each disc region were measured under stress-relaxation test both in tensile and compression. Then Spearman correlation analysis was performed between the angular deviation and the moduli. To understand the effect of glycosaminoglycans on the correlation, TMJ disc samples were treated by chondroitinase ABC (C-ABC). Our imaging processing analysis showed the region-variant direction of collagen alignment, consistently with previous findings. Interestingly, the quality of collagen alignment, not only the directions, was significantly different in between the regions. The angular deviation of fiber alignment in the anterior and intermediate regions were significantly smaller than the posterior region. Medial and lateral regions showed significantly bigger angular deviation than all the other regions. The regionally variant angular deviation values showed statistically significant correlation with the tensile instantaneous modulus and the relaxation modulus, partially dependent on C-ABC treatment. Our findings suggest the region-variant degree of collagen fiber alignment is likely attributed to the heterogeneous viscoelastic properties of TMJ disc that may have significant implications in development of regenerative therapy for TMJ disc. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. 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.

  10. 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

  11. Joint hypermobility: incidence and some clinical symptoms

    Directory of Open Access Journals (Sweden)

    M P Isaev

    2003-01-01

    Full Text Available Objective. To study joint mobility range among urban population aged 18 to 30 years and to assess association of joint and other connective tissue structures disorders clinical signs with hypermobility. Material and methods. 769 randomly selected individuals aged 18 to 30 (mean - 25,56 years (419 female and 350 male were examined. Hypermobility was assessed with 9-point Beighton scale. Examination included skin stretchability evaluation at elbow back surface, determination of flat feet, high palate, joint pain and deformities of knee joints, joint luxation and subluxation, hand and feet vasospastic disturbances, cardiac pain, oculist examination. Methods of variational statistics were used (x2, Student's test, Spirmen's correlation. Results. Hypermobility incidence and joint mobility in population aged 18 to 30 years in Orenburg largely comply with data received in Moscow. Joint mobility up to 5 points in women and up to 4 points in men is usual for persons of this age and in absence of additional clinical symptoms cannot be considered as pathological. Knee joint deformities, presence of high palate, cardiac pain accompanied by signs of vegetative dysfunction, hand and feet vasospastic disturbances are significantly connected with degree of joint mobility and in some cases can help in hypermobility syndrome diagnosis.

  12. 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.

  13. 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.

  14. Human bones obtained from routine joint replacement surgery as a tool for studies of plutonium, americium and {sup 90}Sr body-burden in general public

    Energy Technology Data Exchange (ETDEWEB)

    Mietelski, Jerzy W., E-mail: jerzy.mietelski@ifj.edu.pl [Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Cracow (Poland); Golec, Edward B. [Traumatology and Orthopaedic Clinic, 5th Military Clinical Hospital and Polyclinic, Independent Public Healthcare Facility, Wroclawska 1-3, 30-901 Cracow (Poland); Orthopaedic Rehabilitation Department, Chair of Clinical Rehabilitation, Faculty of Motor of the Bronislaw Czech' s Academy of Physical Education, Cracow (Poland); Department of Physical Therapy Basics, Faculty of Physical Therapy, Administration College, Bielsko-Biala (Poland); Tomankiewicz, Ewa [Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Cracow (Poland); Golec, Joanna [Orthopaedic Rehabilitation Department, Chair of Clinical Rehabilitation, Faculty of Motor of the Bronislaw Czech' s Academy of Physical Education, Cracow (Poland); Physical Therapy Department, Institute of Physical Therapy, Faculty of Heath Science, Jagiellonian University, Medical College, Cracow (Poland); Nowak, Sebastian [Traumatology and Orthopaedic Clinic, 5th Military Clinical Hospital and Polyclinic, Independent Public Healthcare Facility, Wroclawska 1-3, 30-901 Cracow (Poland); Orthopaedic Rehabilitation Department, Chair of Clinical Rehabilitation, Faculty of Motor of the Bronislaw Czech' s Academy of Physical Education, Cracow (Poland); Szczygiel, Elzbieta [Physical Therapy Department, Institute of Physical Therapy, Faculty of Heath Science, Jagiellonian University, Medical College, Cracow (Poland); Brudecki, Kamil [Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Cracow (Poland)

    2011-06-15

    The paper presents a new sampling method for studying in-body radioactive contamination by bone-seeking radionuclides such as {sup 90}Sr, {sup 239+240}Pu, {sup 238}Pu, {sup 241}Am and selected gamma-emitters, in human bones. The presented results were obtained for samples retrieved from routine surgeries, namely knee or hip joints replacements with implants, performed on individuals from Southern Poland. This allowed to collect representative sets of general public samples. The applied analytical radiochemical procedure for bone matrix is described in details. Due to low concentrations of {sup 238}Pu the ratio of Pu isotopes which might be used for Pu source identification is obtained only as upper limits other then global fallout (for example Chernobyl) origin of Pu. Calculated concentrations of radioisotopes are comparable to the existing data from post-mortem studies on human bones retrieved from autopsy or exhumations. Human bones removed during knee or hip joint surgery provide a simple and ethical way for obtaining samples for plutonium, americium and {sup 90}Sr in-body contamination studies in general public. - Highlights: > Surgery for joint replacement as novel sampling method for studying in-body radioactive contamination. > Proposed way of sampling is not causing ethic doubts. > It is a convenient way of collecting human bone samples from global population. > The applied analytical radiochemical procedure for bone matrix is described in details. > The opposite patient age correlations trends were found for 90Sr (negative) and Pu, Am (positive).

  15. Outcome of primary soft tissue sarcoma of the knee and elbow

    International Nuclear Information System (INIS)

    Alektiar, Kaled M.; McKee, Andrea B.; Jacobs, Jordan M.; McKee, Brady J.; Healey, John H.; Brennan, Murray F.

    2002-01-01

    Purpose: Concern is frequently raised regarding the tolerance of irradiation over a joint space. The purpose of this study was to determine the outcome in terms of relapse and potential complications in patients with knee and elbow soft tissue sarcoma treated with limb-sparing surgery with or without adjuvant radiotherapy (RT). Methods and Materials: A review of our prospective database between June 1982 and December 1999 identified 86 adult patients with primary soft tissue sarcoma arising from the knee (n=65; 76%) or elbow (n=21; 24%) treated with limb-sparing surgery. Tumors had high-grade histologic features in 72% and were >5 cm in 48% of patients. Adjuvant RT was given to 46 (54%) of 86 patients. The type of RT was postoperative external beam RT in 63% and brachytherapy in 37%. Of the 46 patients who received RT, 85% (n=39) had deep, 78% (n=36) high-grade, and 54% (n=25) >5-cm tumors. Complications were assessed in terms of wound complications requiring repeated surgery, bone fracture, nerve damage, and joint stiffness. Results: With a median follow-up of 48 months (range 4-175), the 5-year actuarial rate of local control, distant control, and overall survival was 75% (95% confidence interval [CI] 64-85%), 82% (95% CI 73-91%), and 81% (95% CI 71-91%), respectively. The 5-year local control rate for patients who received RT was 80% vs. 71% for those who did not (p=0.3). The type of RT did not significantly influence the local control rate. Patients treated with external beam RT had a 5-year local control rate of 84% compared with 73% for those treated with brachytherapy (p=0.4). On multivariate analysis, tumor size >5 cm retained its significance as an independent predictor of poor local control (p=0.04; relative risk 3; 95% CI 1-6). In addition, high-grade histologic features emerged as an independent predictor of local recurrence (p=0.02; relative risk 4; 95% CI 1-20). No statistically significant difference was found between the RT and no-RT group in terms

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. Effects of hip joint position and intra-capsular volume on hip joint intra-capsular pressure: a human cadaveric model

    Directory of Open Access Journals (Sweden)

    Tse Paul

    2009-04-01

    Full Text Available Abstract Background Increase in hip intra-capsular pressure has been implicated in various hip pathologies, such as avascular necrosis complicating undisplaced femoral neck fracture. Our study aimed at documenting the relationship between intra-capsular volume and pressure in various hip positions. Methods Fifty-two cadaveric hips were studied. An electronic pressure-monitoring catheter recorded the intra-capsular hip pressure after each instillation of 2 ml of normal saline and in six hip positions. Results In neutral hip position, the control position for investigation, intra-capsular pressure remained unchanged when its content was below 10 ml. Thereafter, it increased exponentially. When the intra-capsular volume was 12 ml, full abduction produced a 2.1-fold increase (p = 0.028 of the intra-capsular hip joint pressure; full external rotation and full internal rotation increased the pressure by at least 4-fold (p Conclusion Intra-capsular pressure increases with its volume, but with a wide variation with different positions. It would be appropriate to recommend that hips with haemarthrosis or effusion should be positioned in 45-degree flexion.

  2. 'Soft' human resource management in small international joint ventures:Cases from the Danish-Vietnamese context

    OpenAIRE

    Dao, Li

    2012-01-01

    This paper examines the value creation aspects of HRM in international joint ventures of a relatively small size and their implications for strategic management. We assume that HRM in this context is rather a process than a function, and a ‘soft’ – humanistic rather than a ‘hard’, instrumentalist managerial approach. Using cases from a modest sample of Danish – Vietnamese joint ventures, we propose that HRM is significantly associated with creating a healthy and adaptive environment for mutua...

  3. Method of calculation for three-dimensional joint torque in human movement in a linked rigid body system

    OpenAIRE

    宮西, 智久; Tomohisa, Miyanishi; 仙台大学; Sendai College

    1998-01-01

    In sports biomechanics, joint torque analysis play a very important role. For this reason, if we understand the joint torque during sports activity, it will be useful for the diagnosis and/or evaluation of sports technique, the specific method for muscle training and the mechanisms of sports movement. In the past decade, many studies which dealt with the motion analysis for sports activity using a three-dimensional cinematography, have been done. However, most of these studies has been focuse...

  4. 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

  5. MR anatomy study of the elbow, with emphasis in ligaments and tendons structure - methodology

    International Nuclear Information System (INIS)

    Vilela, Sonia de Aguiar; Fernandes, Artur da Rocha Correa; Barbieri, Antonio; Turrini, Elisabete; Juliano, Yara

    1999-01-01

    Seventeen MR exams of the elbow joints of fifteen healthy volunteers were obtained on T1 spin-echo sequences in the transversal, coronal and sagital planes. Eight anatomic structures were selected and evaluated by three independent blind readers. The aim of this study was to establish the frequency of visibility as well to determine the best plane to characterize these anatomic structures and also to analyze the interobserver variability. The readers analyzed the exams using the same criteria: degree 0 (structure not visible); degree 1 (structure visible and partially delineated); degree 2 (structure well visible and well delineated). The structure visibility showed variability close related to the degree (1 or 2) chosen by the readers to define the structure visualization and mainly in the transverse plane. The coronal plane was showed to be the ideal to evaluate the collateral ligaments, the common extensor tendon and the com,mon flexor tendon, otherwise the sagital plane was useful to define triceps and braquial tendons. The biceps tendon and annular ligament were well defined in the transverse plane. The usefulness of this study is to establish the ideal planes to evaluate these anatomic structures, and develop faster protocols. (author)

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 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:

  11. 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)

  12. 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

  13. 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

  14. 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

  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. 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.

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. Rehabilitation of the elbow extension with motor imagery in a patient with quadriplegia after tendon transfer.

    Science.gov (United States)

    Grangeon, Murielle; Guillot, Aymeric; Sancho, Pierre-Olivier; Picot, Marion; Revol, Patrice; Rode, Gilles; Collet, Christian

    2010-07-01

    To test the effect of a postsurgical motor imagery program in the rehabilitation of a patient with quadriplegia. Crossover design with kinematic analysis. Rehabilitation Hospital of Lyon. Study approved by the local Human Research Ethics Committee. C6-level injured patient (American Spinal Injury Association Impairment Scale grade A) with no voluntary elbow extension (triceps brachialis score 1). The surgical procedure was to transfer the distal insertion of the biceps brachii onto the triceps tendon of both arms. The postsurgical intervention on the left arm included 10 sessions of physical rehabilitation followed by 10 motor imagery sessions of 30 minutes each. The patient underwent 5 sessions a week during 2 consecutive weeks. The motor imagery content included mental representations based on elbow extension involved in goal-directed movements. The rehabilitation period of the right arm was reversed, with motor imagery performed first, followed by physical therapy. The kinematics of upper-limb movements was recorded (movement time and variability) before and after each type of rehabilitation period. A long-term retention test was performed 1 month later. Motor imagery training enhanced motor recovery by reducing hand trajectory variability-that is, improving smoothness. Motor performance then remained stable over 1 month. Motor imagery improved motor recovery when associated with physical therapy, with motor performance remaining stable over the 1-month period. We concluded that motor imagery should be successfully associated with classic rehabilitation procedure after tendon transfer. Physical sessions may thus be shortened if too stressful or painful. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Synovial osteochondromatosis of the temporomandibular joint; Osteocondromatosis sinovial en la articulacion temporomandibular

    Energy Technology Data Exchange (ETDEWEB)

    Nemnon, Jorge; Nemnon, Marcelo; Staffieri, Roberto; Villavicencio, C; Marconi, G; Masjoan, Diego [Fundacion Villavicencio, Rosario (Argentina). Diagnostico Medico

    2004-07-01

    Synovial osteochondromatosis (SO) is a meta plastic process by which synovial mesenchymal cells transform into chondroblasts and chondrocytes. This disease affects most frequently the knee, the hip, the elbow, and uncommonly the temporomandibular joint (TMJ). The authors present 2 cases of synovial osteochondromatosis of the TMJ. (author)

  5. 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.

  6. 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.

  7. 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.

  8. 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.)

  9. 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....

  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. Pneumatic Muscle Actuated Rehabilitation Equipment of the Upper Limb Joints

    Science.gov (United States)

    Deaconescu dr. eng. habil., Andrea, Prof.

    2017-06-01

    Rehabilitation equipment of the upper limb joints holds a key role in passive physical therapy. Within this framework, the paper presents two such pieces of equipment developed for the rehabilitation of elbow and of wrist and knuckles, respectively. The presented and discussed equipment is actuated by pneumatic muscles, its benefits being a low cost, simple and robust construction, as well as short response time to commands.

  12. Hyperextension trauma to the elbow joint induced through the distal ulna or the distal radius

    DEFF Research Database (Denmark)

    Tyrdal, Stein; Olsen, Bo Sanderhoff

    1998-01-01

    , 2) L-formed rupture of the origin of the pronator muscle with elongation of the anterior bundle of the medial collateral ligament, 3) partial rupture of the lateral collateral ligament and 4) small cartilage damage to the posterior or anteromedial edge of the ulna. In conclusion, hyperextension...

  13. 21 CFR 888.3150 - Elbow joint metal/polymer constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... (viii) ISO 14630:1997 “Non-active Surgical Implants—General Requirements,” (3) American Society for... Biomaterials (Nonporous) for Surgical Implant with Respect to Effect of Material on Muscle and Bone,” (v) F...

  14. Joint ventures

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret......Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret...

  15. 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

  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

    2016-07-01

    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).

  17. Corrosion resistance of a laser spot-welded joint of NiTi wire in simulated human body fluids.

    Science.gov (United States)

    Yan, Xiao-Jun; Yang, Da-Zhi

    2006-04-01

    The purpose of this study was to investigate corrosion resistance of a laser spot-welded joint of NiTi alloy wires using potentiodynamic tests in Hank's solution at different PH values and the PH 7.4 NaCl solution for different Cl- concentrations. Scanning electron microscope observations were carried out before and after potentiodynamic tests. The composition of a laser spot-welded joint and base metal were characterized by using an electron probe microanalyzer. The results of potentiodynamic tests showed that corrosion resistance of a laser spot-welded joint of NiTi alloy wire was better than that of base metal, which exhibited a little higher breakdown potential and passive range, and a little lower passive current density. Corrosion resistances of a laser spot-welded joint and base metal decreased with increasing of the Cl- concentration and PH value. The improvement of corrosion resistance of the laser spot-welded joint was due to the decrease of the surface defects and the increase of the Ti/Ni ratio. (c) 2005 Wiley Periodicals, Inc.

  18. Coracoclavicular joint

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kun Sang; Park, Chan Il; Ahn, Jae Doo; Lim, Chong Won [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1970-10-15

    The coracoclvicular joint, a rear abnormality which may be the cause of pain in the shoulder and limitation of motion of the shoulder joint, is discussed. A case of coracoclvicular joint with shoulder pain was observed in 65 yrs old Korean male.

  19. Population coding of forelimb joint kinematics by peripheral afferents in monkeys.

    Directory of Open Access Journals (Sweden)

    Tatsuya Umeda

    Full Text Available Various peripheral receptors provide information concerning position and movement to the central nervous system to achieve complex and dexterous movements of forelimbs in primates. The response properties of single afferent receptors to movements at a single joint have been examined in detail, but the population coding of peripheral afferents remains poorly defined. In this study, we obtained multichannel recordings from dorsal root ganglion (DRG neurons in cervical segments of monkeys. We applied the sparse linear regression (SLiR algorithm to the recordings, which selects useful input signals to reconstruct movement kinematics. Multichannel recordings of peripheral afferents were performed by inserting multi-electrode arrays into the DRGs of lower cervical segments in two anesthetized monkeys. A total of 112 and 92 units were responsive to the passive joint movements or the skin stimulation with a painting brush in Monkey 1 and Monkey 2, respectively. Using the SLiR algorithm, we reconstructed the temporal changes of joint angle, angular velocity, and acceleration at the elbow, wrist, and finger joints from temporal firing patterns of the DRG neurons. By automatically selecting a subset of recorded units, the SLiR achieved superior generalization performance compared with a regularized linear regression algorithm. The SLiR selected not only putative muscle units that were responsive to only the passive movements, but also a number of putative cutaneous units responsive to the skin stimulation. These results suggested that an ensemble of peripheral primary afferents that contains both putative muscle and cutaneous units encode forelimb joint kinematics of non-human primates.

  20. Relationship between Joint Position Sense, Force Sense, and Muscle Strength and the Impact of Gymnastic Training on Proprioception

    Directory of Open Access Journals (Sweden)

    Bartłomiej Niespodziński

    2018-01-01

    Full Text Available The aims of this study were (1 to assess the relationship between joint position (JPS and force sense (FS and muscle strength (MS and (2 to evaluate the impact of long-term gymnastic training on particular proprioception aspects and their correlations. 17 elite adult gymnasts and 24 untrained, matched controls performed an active reproduction (AR and passive reproduction (PR task and a force reproduction (FR task at the elbow joint. Intergroup differences and the relationship between JPS, FS, and MS were evaluated. While there was no difference in AR or PR between groups, absolute error in the control group was higher during the PR task (7.15 ± 2.72° than during the AR task (3.1 ± 1.93°. Mean relative error in the control group was 61% higher in the elbow extensors than in the elbow flexors during 50% FR, while the gymnast group had similar results in both reciprocal muscles. There was no linear correlation between JPS and FS in either group; however, FR was negatively correlated with antagonist MS. In conclusion, this study found no evidence for a relationship between the accuracy of FS and JPS at the elbow joint. Long-term gymnastic training improves the JPS and FS of the elbow extensors.