WorldWideScience

Sample records for left 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. 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...

  3. Prosthetic elbow joint

    Science.gov (United States)

    Weddendorf, Bruce C. (Inventor)

    1994-01-01

    An artificial, manually positionable elbow joint for use in an upper extremity, above-elbow, prosthetic is described. The prosthesis provides a locking feature that is easily controlled by the wearer. The instant elbow joint is very strong and durable enough to withstand the repeated heavy loadings encountered by a wearer who works in an industrial, construction, farming, or similar environment. The elbow joint of the present invention comprises a turntable, a frame, a forearm, and a locking assembly. The frame generally includes a housing for the locking assembly and two protruding ears. The forearm includes an elongated beam having a cup-shaped cylindrical member at one end and a locking wheel having a plurality of holes along a circular arc on its other end with a central bore for pivotal attachment to the protruding ears of the frame. The locking assembly includes a collar having a central opening with a plurality of internal grooves, a plurality of internal cam members each having a chamfered surface at one end and a V-shaped slot at its other end; an elongated locking pin having a crown wheel with cam surfaces and locking lugs secured thereto; two coiled compression springs; and a flexible filament attached to one end of the elongated locking pin and extending from the locking assembly for extending and retracting the locking pin into the holes in the locking wheel to permit selective adjustment of the forearm relative to the frame. In use, the turntable is affixed to the upper arm part of the prosthetic in the conventional manner, and the cup-shaped cylindrical member on one end of the forearm is affixed to the forearm piece of the prosthetic in the conventional manner. The elbow joint is easily adjusted and locked between maximum flex and extended positions.

  4. Elbow joint biomechanics for preclinical evaluation of total elbow prostheses.

    Science.gov (United States)

    Kincaid, Brian L; An, Kai-Nan

    2013-09-27

    Total elbow arthroplasty is a clinically successful procedure, yet long-term implant survival rates have historically lagged behind those reported for total hips and knees. Clinical complications associated with implant wear, osteolysis, stem loosening and device fracture have been implicated as reasons for limited long-term survivorship. Unfortunately, there is little published information on the biomechanics and method(s) for preclinical evaluation of total elbow prostheses that could provide insight into the mechanisms of failure. Additionally, there are no consensus testing standards or summaries of loading profiles of the humero-ulnar joint associated with a range of activities of daily living. Such data would facilitate the standardized preclinical assessment of total elbow devices such is commonplace for other large joints. The objective of the work here is therefore to provide a comprehensive review of elbow joint biomechanics as it relates to preclinical evaluation of total elbow implants. This summary includes a review of elbow joint forces, kinematics, the types and frequency of humero-ulnar joint motions associated with activities of daily living and clinical outcomes, as well as proposing a methodology for deriving humero-ulnar joint reaction force magnitudes and vector orientations as a function of a known mass/force at the hand. From these data, a scalable, bi-axial loading profile is proposed as a foundation for the development of clinically relevant, laboratory simulations for assessment of total elbow prostheses performance. © 2013 Elsevier Ltd. All rights reserved.

  5. 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... (hemi-elbow) polymer prosthesis. (a) Identification. An elbow joint radial (hemi-elbow) polymer prosthesis is a device intended to be implanted made of medical grade silicone elastomer used to replace the...

  6. 21 CFR 888.3180 - Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented prosthesis. 888.3180 Section 888.3180 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Elbow joint humeral (hemi-elbow) metallic uncemented prosthesis. (a) Identification. An elbow joint humeral (hemi-elbow) metallic uncemented prosthesis is a device intended to be implanted made of alloys...

  7. Hyperextension of the elbow joint

    DEFF Research Database (Denmark)

    Tyrdal, Stein; Olsen, Bo Sanderhoff

    1998-01-01

    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."...

  8. Arthroscopical treatment of elbow joint disease

    Directory of Open Access Journals (Sweden)

    C.M.F. Rezende

    2012-02-01

    Full Text Available Elbow arthroscopy was performed in 30 dogs of different breeds. The procedure was performed bilaterally in 20 of these dogs, yielding a total of 50 joints. Different lesions were found, varying from cartilage fissures (8 to fragmentation (42 of medial coronoid process (FCP of the ulna. Osteochondritis dissecans (OCD of the humerus medial condyle was associated in four of them. All of these cases displayed varying degrees of synovitis. Osteoarthrosis (OA in varying intensity was observed in 44 joints. The majority of cases were treated two to four months after the manifestation of clinical signs. Good clinical recovery occurred in dogs with minimal joint lesions, where these were diagnosed and treated within four weeks of the onset of clinical symptoms. Early diagnosis and arthroscopic treatment prevent osteoarthrosis and preserve locomotor function.

  9. 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...

  10. Elbow kinematics : Studies of the elbow joint under normal conditions and after joint replacement

    OpenAIRE

    Ericson, Anne

    2010-01-01

    Background: Total elbow arthroplasty (TEA) is used for treatment of patients with severe pain and disability due to reumatoid arthritis. Long term results are not as good as for hip and knee replacements. Further development of the implant designs and surgical technique based on proper knowledge of the in vivo biomechanical joint properties are required to improve results. Aim: To analyse the variation and the position of the instantaneous flexion axes in vivo in the nor...

  11. The Effects of Elbow Bracing on Medial Elbow Joint Space Gapping Associated With Repetitive Throwing in High School Baseball Players.

    Science.gov (United States)

    Hattori, Hiroshi; Akasaka, Kiyokazu; Otsudo, Takahiro; Takei, Keiichi; Yamamoto, Mitsuru

    2017-04-01

    Throwing athletes risk medial elbow injury from extreme valgus stress generated across the medial elbow during throwing. Braces have been developed to protect the elbow joint; however, no previous study has investigated the effects of elbow bracing on medial elbow joint space gapping associated with repetitive throwing. The purpose of this study was to investigate the effects of elbow bracing on medial elbow joint space gapping during repetitive throwing. Our hypothesis was that an elbow brace may reduce mechanical stress on the elbow by reducing medial elbow joint space gapping. Controlled laboratory study. Twenty-five high school baseball players participated in this study. Each subject pitched 100 times under 2 conditions: control (without elbow brace) and elbow brace. The ulnohumeral joint space was measured ultrasonically before pitching and after every block of 20 pitches. Measurement of the ulnohumeral joint space was carried out using ultrasound with the forearm hanging by the side. Two-way repeated-measures analysis of variance and post hoc tests were used to compare ulnohumeral joint space with repeated pitching and between the elbow brace and control conditions. In the control condition, ulnohumeral joint space after 60 pitches was significantly greater than that before pitching ( P space was not significantly different after repeated pitching. When comparing these 2 conditions, ulnohumeral joint space in the control condition was significantly greater than that in the elbow brace condition after 60 pitches ( P space gapping with repeated throwing when determined ultrasonically by measuring the ulnohumeral joint space under gravity load. An elbow brace worn during baseball pitching practice may help reduce mechanical stress on the elbow by reducing medial elbow joint space gapping.

  12. 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...

  13. Elbow joint kinematics after excision of the radial head

    DEFF Research Database (Denmark)

    Jensen, Steen Lund; Olsen, Bo Sanderhoff; Søjbjerg, Jens Ole

    1999-01-01

    The contribution of the radial head to elbow joint kinematics was studied in 7 osteoligamentous elbow preparations. During unloaded flexion and extension, radial head excision induced a maximum varus displacement of 1.6 degrees with 20 degrees of joint flexion and a maximum external rotation of 3.......2 degrees at 110 degrees of flexion. With application of a 0.75-Nm load, radial head excision induced a maximum laxity of 3.3 degrees at 20 degrees of flexion in forced varus and a maximum laxity of 8.9 degrees at 10 degrees of flexion in forced external rotation. No laxity was observed in forced valgus...... or internal rotation. The results were independent of the rotation of the forearm. This study indicates that the radial head acts as stabilizer to the elbow joint in forced varus and in forced external rotation. The results suggest that fractures of the radial head cannot be treated by simple excision without...

  14. 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

    Thirty osteoligamentous elbow joint specimens were included in a study of the lateral collateral ligament complex (LCLC). The morphologic characteristics of the LCLC were examined, and then three-dimensional kinematic measurements were undertaken after selective ligament dissections were performed....... Isolated sectioning of the annular ligament (AL) or the lateral ulnar collateral ligament (LUCL) induced only minor laxity to the elbow joint with a maximum of 2.2 degrees and 4.4 degrees during forced varus and external rotation (supination), respectively. Transsection of the lateral collateral ligament...

  15. 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....

  16. 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...

  17. 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

  18. The effects of elbow joint angle change on the elbow flexor muscle activation in pulley with weight exercise.

    Science.gov (United States)

    Kang, Taewook; Seo, Youngjoon; Park, Jaehoon; Dong, Eunseok; Seo, Byungdo; Han, Dongwook

    2013-09-01

    [Purpose] This research investigated the effect of angular variation of flexion of the elbow joint on the muscle activation of elbow flexor muscles. [Subjects] The research subjects were 24 male college students with a dominant right hand who had no surgical or neurological disorders and gave their prior written consent to participation with full knowledge of the method and purpose of this study. [Methods] The subjects' shoulder joints stayed in the resting position, and the elbow joint was positioned at angles of 55°, 70°, and 90°. The angle between the pulley with weights and forearm stayed at 90°. Surface electromyography was used to measure muscle activities. Three measurements were made at each elbow angle, and every time the angle changed, two minutes rest was given. [Result] The muscle activities of the elbow flexors showed significant changes with change in the elbow joint angle, except for the biceps brachii activities between the angles of 55° and 70° of elbow flexion. The muscle activities of the biceps brachii and brachioradialis showed angle-related changes in the order of 55°, which showed the biggest value, followed by 70° and 90°. [Conclusion] In order to improve muscle strength of the elbow flexor using a pulley system, it seems more effective to have a 90° angle between the pulley with weights and the forearm when the muscle is stretched to a length 20% greater than its resting position.

  19. 21 CFR 888.3160 - Elbow joint metal/polymer semi-constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... cemented prosthesis. 888.3160 Section 888.3160 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Elbow joint metal/polymer semi-constrained cemented prosthesis. (a) Identification. An elbow joint metal/polymer semi-constrained cemented prosthesis is a device intended to be implanted to replace an elbow...

  20. 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.

  1. 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....

  2. 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)

  3. 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

  4. 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....

  5. 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 ...

  6. 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

  7. 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

  8. Elbow joint stability in relation to forced external rotation

    DEFF Research Database (Denmark)

    Deutch, Søren R; Jensen, Steen L; Olsen, Bo S

    2003-01-01

    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...

  9. Elbow prosthesis (image)

    Science.gov (United States)

    Elbow replacement involves surgically replacing bones that make up the elbow joint with artificial elbow joint parts (prosthetic components). The artificial joint consists of two stems made of high-quality metal. They are joined together ...

  10. 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.

  11. Evaluations of stress concentration at girth butt weld joint between straight pipe and elbow

    International Nuclear Information System (INIS)

    Mizuno, S.

    1983-01-01

    The design of class 1 piping for nuclear plants is performed in accordance with the ASME B and PV Code Sec. Ill by rising stress index which have been defined at the center portion of elbow, since it has been generally believed that the highest stress will occur at this point. Consequently the stress evaluations at girth weld joint is riot recognized contrary to tire high stress concentration due to the weld irregularities. However, for LMFBR piping, especially under high temperature conditions the stress evaluations based on the index at the center portion of the elbow will not always provide conservative results from the piping design point of view, especially for fatigue, because it requires to evaluate the stress or strain range by multiplying the square of the stress or strain concentration factor. For thin wall and large diameter LMFBR piping the following four items provide significant effects on the stress and strain at the girth weld joint between straight pipe and elbow: stresses in weld joint due to ovalization of elbow, represented by 'carry over factor'; stress concentration due to weld Irregularities between straight pipe and elbow; gross structural discontinuity due to radial deflection caused by weld shrinkage at joint; increase of nominal stress due to decrease of nominal pipe wall thickness caused by counter bore machining. This report presents proposed design factors of above four items with the aim to use them in Monju FBR PHTS main piping and verify the structural integrity

  12. 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.

  13. Shape of articular surface of crocodilian (Archosauria) elbow joints and its relevance to sauropsids.

    Science.gov (United States)

    Fujiwara, Shin-ichi; Taru, Hajime; Suzuki, Daisuke

    2010-07-01

    The determination of area and shape of articular surfaces on the limb bones of extinct archosaurs is difficult because of postmortem decomposition of the fibrous tissue and articular cartilages that provide the complex three-dimensional joint surfaces in vivo. This study aims at describing the shape of the articular cartilages in the elbow joints of six crocodilian specimens; comparing its structure with that of four birds, three testudines, and five squamates; and comparing the shapes of the surfaces of the calcified and the articular cartilages in the elbow joints of an Alligator specimen. The shapes of the articular cartilages of crocodilian elbow joint are shown to resemble those of birds. The humerus possesses an olecranon fossa positioned approximately at the midportion of the distal epiphysis and bordering the margin of the extensor side of the articular surface. The ulna possesses a prominent intercotylar process at approximately the middle of its articular surface, and splits the surface into the radial and ulnar cotylae. This divides the articular cartilage into an articular surface on the flexor portion, and the olecranon on the extensor portion. The intercotylar process fits into the olecranon fossa to restrict elbow joint extension. Dinosaurs and pterosaurs, phylogenetically bracketed by Crocodylia and Aves (birds), may have possessed a similar olecranon fossa and intercotylar process on their articular cartilages. Although these shapes are rarely recognizable on the bones, their impressions on the surfaces of the calcified cartilages provide an important indication of the extensor margin of the articular surfaces. This, in turn, helps to determine the maximum angle of extension of the elbow joint in archosaurs.

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

    Science.gov (United States)

    White, Rebekah C; Aimola Davies, Anne M

    2011-01-01

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

  15. 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.

  16. 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...

  17. 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...

  18. [Endoprosthesis for the fractured elbow: uni- and bicompartmental alloarthroplasty of the humero-ulnar joint].

    Science.gov (United States)

    Weber, O; Burger, C; Stein, G; Gravius, S; Wirtz, D C; Pennekamp, P H; Kraft, C N; Müller, M

    2010-12-01

    Posttraumatic arthrosis or rheumatoid arthritis located at the elbow, in particular at the humero-ulnar joint will probably not occur in increasing numbers in the future due to new antirheumatic medications and modern implants. However, the demographic development with an increase of the geriatric population and the typical physical changes is evident. Due to osteoporosis with a resulting poor bone quality severe fracture patterns may occur at the site of the distal humerus after a simple collapse. The usual surgical aim consisting of an exact anatomic reduction may be impossible to achieve by applying the standard operative treatment. Several studies have proven that a prosthetic replacement of such a severely damaged elbow is a viable solution for elderly people. A mobile, pain-free and stable elbow joint promotes a fast recovery of the patient with a quick return to former activities. Nevertheless, elbow prostheses cannot withstand great strains and the surgeon has to identify those fractures which require a prosthetic replacement. The surgical implantation procedure requires an adequate knowledge of both elbow anatomy and prosthetic options.

  19. Posterior Elbow Dislocation

    Directory of Open Access Journals (Sweden)

    Victoria Oppenheim

    2016-09-01

    Full Text Available History of present illness: A 15-year old female presented with left elbow pain. While competing in a high school wrestling match, she extended her left arm to brace a fall and had immediate onset of sharp pain. She denied weakness or numbness of her left arm. She had no past medical history. Significant findings: Elbow dislocations are classified by the position of the radio-ulnar joint relative to the humerus.1 Images 1, 2, and 3 show a left posterior elbow dislocation; the radius and ulna are displaced posteriorly with respect to the distal humerus. The lateral view of the elbow most clearly shows this: trochlear notch of the ulna is empty and displaced posteriorly relative to the trochlea. There is no associated fracture. Images 4 and 5 show the elbow status-post reduction, demonstrating proper alignment of the distal humerus with the radius and ulna. Discussion: Traumatic dislocations of the elbow are relatively uncommon in pediatric patients, with a peak incidence at 13 to 14 years.1 Dislocations are usually posterior and occur after forced abduction and extension of the elbow.1 It is important to evaluate for an associated fracture or avulsion, which occurs in over 50% of pediatric elbow dislocations. Fractures most commonly involve the medial epicondyle, radial head and neck, or coronoid process.1 One should also consider a neurovascular injury to the ulnar or median nerve or to the brachial artery or its branches.1 Posterior elbow dislocations should be reduced as soon as possible.1 Patients should receive adequate sedation and/or analgesia. One method of reduction is the “puller” technique, during which a practitioner stabilizes the humerus, while a second practitioner applies force against the anterior forearm, with gentle traction distally.1 Post-reduction neurovascular reassessment is important. After successful reduction, patients can be immobilized in a posterior long arm splint.

  20. 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.

  1. 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.

  2. An Investigation Into Time Domain Features of Surface Electromyography to Estimate the Elbow Joint Angle

    Directory of Open Access Journals (Sweden)

    Triwiyanto Triwiyanto

    2017-01-01

    Full Text Available In literature, it is well established that feature extraction and pattern classification algorithms play essential roles in accurate estimation of the elbow joint angle. The problem with these algorithms, however, is that they require a learning stage to recognize the pattern as well as capture the variability associated with every subject when estimating the elbow joint angle. As EMG signals can be used to represent motion, we developed a non-pattern recognition method to estimate the elbow joint angle based on twelve time-domain features extracted from EMG signals recorded from bicep muscles alone. The extracted features were smoothed using a second order Butterworth low pass filter to produce the estimation. The accuracy of the estimated angles was evaluated by using the Pearson’s Correlation Coefficient (PCC and Root Mean Square Error (RMSE.The regression parameters (Euclidean distance, R^2 and slope were calculated to observe the response of the features to the elbow-joint angle. From the investigation, we found, in the period of motion 10s, MYOP features have the best accuracy: 0.97±0.02 (Mean±SD and 11.37±3.04˚ (Mean±SD for correlation coefficient and RMSE respectively. MYOP features also showed the highest R^2 and slope value 0.986±0.0083 (Mean±SD and 0.746±0.17 (Mean±SD respectively for flexion and extension motion and all periods of motion.

  3. 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

  4. 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

    2016-06-01

    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. The study was designed to compare the smartphone inclinometer-based app and UG in evaluation of ROM of elbow. 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. 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). Smartphones due to ease of access and usage for the physician and the patient, may be good alternatives for UG.

  5. 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

  6. 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.

  7. Anatomic relation between the medial collateral ligament of the elbow and the humero-ulnar joint axis.

    Science.gov (United States)

    Ochi, N; Ogura, T; Hashizume, H; Shigeyama, Y; Senda, M; Inoue, H

    1999-01-01

    The anatomic relation between the proximal attachment of the medial collateral ligament of the elbow joint and the humero-ulnar joint axis has not been clearly shown in a published study. We examined cadaveric specimens to find the exact relation between them. The medial collateral ligament was microscopically dissected to isolate specific fiber bundles. The length of each bundle was measured with a charge-coupled device camera system that faced the medial side of the elbow joint. The measurements indicated that the projected length of the deep middle bundle of the anterior oblique ligament, which is the strong cord-like part of the medial collateral ligament, is isometric during elbow flexion. The proximal end of the deep middle bundle was thus considered to be located almost on the humero-ulnar joint axis.

  8. Consequences of impact on arm (elbow and shoulder joints) caused by ball hitting, theoretical analysis

    Science.gov (United States)

    Negrea, Adina; Busuioceanu, Ioana Iuliana

    2018-02-01

    Present paper estimates the mechanics of the impact of a ball and a hand-arm, during the sports training using a classical model for the hand-arm system, avoiding the contribution of the coefficient of restitution. The results of this investigation are focused on the equations needed to find out theimpact reactions in elbow and shoulder joints, for different anthropometric data. Also, the computing of the position of mass centers and the moments of inertia for each constitutive part of hand-arm system is made.

  9. 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

  10. Fracture-dislocations of the elbow joint--strategy for treatment and results.

    Science.gov (United States)

    Lill, H; Korner, J; Rose, T; Hepp, P; Verheyden, P; Josten, C

    2001-01-01

    Between January 1993 and December 1996, 41 patients with fracture dislocation of the elbow joint were treated in our department. In 28 patients (median age 46 years, range 15-77 years; 16 male, 12 female), a clinical and radiological follow-up was obtained after median 34 months (range 12-59 months). In addition to the humero-ulnar dislocation, isolated fractures were present in 13 patients and combined fractures in 15 (all with involvement of the radial head). Primary neurological deficits were found in 7 and open fractures in 3 patients. In 7 patients, primary definitive surgical therapy was carried out by open reduction and internal fixation. A two-step surgical management (initial closed reduction and immobilization, 5 patients with external fixator, 7 with plaster; secondary open surgical procedure) was performed in 12 and conservative treatment in 9 patients. According to the Leipzig Elbow Score, taking subjective, clinical and radiological criteria into consideration, 4 patients achieved 'excellent' and 5 patients a 'good' result. Ten patients were scored 'moderate' and 9 'poor'. The rate of secondary complications necessitating revision was 36%. Poor results were primarily caused by extensive initial soft-tissue damage, delayed definitive surgical therapy, and ectopic heterotopic ossification. In contrast, fracture localization and degree of arthrosis were not of significant importance for the final outcome. In fracture dislocations, the goal is a primary definitive surgical treatment aiming for early postoperative physiotherapy.

  11. 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...... repair, and (5) radial head replacement combined with LCL repair. Isolated radial head excision increased varus (mean, 4.8 degrees) and external rotatory laxity (mean, 7.1 degrees), as did isolated LCL division (mean, 14.1 degrees for varus; mean, 14.7 degrees for external rotation). After removal...... of both constraints, varus and external rotatory laxities were increased by 19.0 degrees and 20.1 degrees, respectively, compared with the intact specimens. Isolated radial head replacement reduced mean varus laxity to 14.6 degrees and mean external rotatory laxity to 14.8 degrees. Isolated LCL repair...

  12. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Koca, Go Khan; Ozsoy, Ha Kan; Atilgan, Hasan Ikbal; Demirel, Koray; Dincel, Veysel Ercan; Korkmaz, Meliha [Ankara Training and Research Hospital, Ankara (Turkmenistan)

    2012-09-15

    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.

  14. 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.

  15. 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.

  16. 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.

  17. Peak velocity of elbow joint during touching contra lateral shoulder activity for normal subject

    Science.gov (United States)

    Nan, Hasyatun Che; Rambely, Azmin Sham

    2017-04-01

    A better understanding of upper limb movements requires analysis of motion. Measurements of movement analysis through biomechanical studies are necessary to describe upper limb activities. Therefore this study intend to investigate peak velocity of elbow joint for different age groups during the "touching contra lateral shoulder" activity. Twenty healthy subjects age range 20 - 59 years old (n = 60) performed a complete cycle of hand lifting, resting and returning the hand to its initial position. This activity was analyzed using Vicon motion-analysis system, which consists of three infra-red and high speed cameras. Phase definitions were defined and descriptive kinematic variables were obtained from this activity. Movement times is found to increase in 50's age group. The difference of movement times is < 0.3s. Peak velocity for subject age 50s' also higher between all subjects. The difference of peak velocity is < 0.03m/s for all different phases. It was found that there were a significant difference in total movement time and no significance different between each age group for peak velocity parameter.

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

    NARCIS (Netherlands)

    Eygendaal, Denise; Rahussen, F. T. G.; 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 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

  19. 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.

  20. 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.

  1. The Measurement of Rigidity in Elbow Joint: An Objective Method for the Evaluation of Parkinson's disease

    Directory of Open Access Journals (Sweden)

    B. Sepehri

    2007-06-01

    Full Text Available Introduction: One of the most common syndromes in Parkinson's disease (PD is rigidity. Currently, an index is used to evaluate the level of PD by the clinical measurement of rigidity in the upper extremity. The index uses a subjective method called Unified Parkinson's Disease Rating System (UPDRS. The subjective nature of this method makes the influence of physician in the measurement of rigidity possible. Hence, the development of a new standard method based on objective indices is needed. Materials and Methods: In this research, a new device was fabricated and used to measure the viscous and elastic indices and the range of motion during passive movement of elbow joint. The relation between each index and the level of illness was analyzed. The parameters were measured on 41 patients and 11 controls. The indices were extracted using Matlab-R14 software and the statistical analysis was performed using Spss-13. Results: Although there were significant differences in both the viscous and elastic indices between the pair groups and also among the UPDRS groups, but better correlations of the viscous ones and UPDRS were found.  The range of motion by itself has no good correlation with the level of the disease. Discussion and Conclusion: Based on the obtained results, it can be inferred that using viscous indices of rigidity may have an advantage over the elastic ones for the evaluation of Parkinson’s disease. Upon conducting more trials and also considering the sub indices in different parts of the range of motion, the method used here may become a standard objective method for the evaluation of Parkinson's disease.

  2. Radiosynovectomy of the elbow joint synovitis in rheumatoid arthritis treated with Lutetium - 177 labeled hydroxylapatite (Lu-177 HA) particulates; first case report and image of Lu -177 HA in the elbow joint

    International Nuclear Information System (INIS)

    Kamaleshwaran, Koramadai Karuppusamy; Rajamani, Venkataraman; Thirumalaisamy, Subbiah Gounder; Chakraborty, Sudipta; Kalarikal, Radhakrishnan; Mohanan, Vyshakh; Shinto, Ajit Sugunan

    2014-01-01

    Rheumatoid arthritis is a chronic disease that is mainly characterized by asymmetric erosive synovitis, particularly affecting the peripheral joints. Radiation synovectomy or radiosynovectomy, also known as radiosynoviorthesis was first described in 1950's as a adjuvant treatment for rheumatoid arthritis. Radiosynovectomy is based on the irradiation of the joint synovium by the intra-articular administration of various β-emitting radiopharmaceuticals. Lu-177 has presence of gamma photons of imagable energy with low abundance which provides the additional benefit of carrying out simultaneous scintigraphy. We describe the first case report of use of Lu-177 hydroxylapatite particulates in a 35-year-old female patient who was presented with elbow joint synovitis due to rheumatoid arthritis

  3. 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

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

    African Journals Online (AJOL)

    Aim: This study was conducted to evaluate the elbow carrying angle in normal adolescents of South India and also analyze the data statistically to find out any significant difference in the angle between the different groups of subjects within the study population. Methods: 60 adolescents with ages varying from 17 to 20 years ...

  5. Changes in head and neck position have a greater effect on elbow joint position sense in people with whiplash-associated disorders.

    Science.gov (United States)

    Knox, Joanna Joy; Beilstein, Darren Jay; Charles, Scott Darren; Aarseth, Geir Arne; Rayar, Shivanthi; Treleaven, Julia; Hodges, Paul William

    2006-01-01

    It has been shown that perception of elbow joint position is affected by changes in head and neck position. Further, people with whiplash-associated disorders (WAD) present with deficits in upper limb coordination and movement. This study is aimed to determine whether the effect of changes in head position on elbow joint position error (JPE) is more pronounced in people with WAD, and to determine whether this is related to the participant's pain and anxiety levels. Nine people with chronic and disabling WAD and 11 healthy people participated in this experiment. The ability to reproduce a position at the elbow joint was assessed after changes in the position of the head and neck to 30 degrees , and with the head in the midline. Pain was monitored in WAD participants. Absolute elbow JPE with the head in neutral was not different between WAD and control participants (P=0.5). Changes in the head and neck position increased absolute elbow JPE in the WAD group (P<0.05), but did not affect elbow JPE in the control group (P=0.4). There was a connection between pain during testing and the effect of changes in head position on elbow JPE (P<0.05). Elbow JPE is affected by movement of the head and neck, with smaller angles of neck rotation in people with WAD than in healthy individuals. This observation may explain deficits in upper limb coordination in people with WAD, which may be due to the presence of pain or reduced range of motion in this population.

  6. In vitro validation of a technique for assessment of canine and feline elbow joint collateral ligament integrity and description of a new method for collateral ligament prosthetic replacement.

    Science.gov (United States)

    Farrell, Michael; Draffan, Davinia; Gemmill, Toby; Mellor, Dominic; Carmichael, Stuart

    2007-08-01

    To assess the ability of an operator to differentiate intact from transected canine and feline elbow joint collateral ligaments (CL) using a reported manipulative test (Campbell's test) and to determine the potential for elbow joint luxation in canine and feline elbows with intact, transected, and surgically stabilized CL. In vitro biomechanical study. Canine (n=6) and feline cadavers (n=3). Thoracic limb specimens were mounted on a custom-built jig with the elbows and carpi fixed in 90 degrees of flexion. Angles of pronation and supination were recorded after applying rotational forces to the manus. Attempts were made to manually luxate each elbow with intact CL. Constructs were re-evaluated after sequential sectioning of the medial (MCL) and lateral (LCL) collateral ligaments and after insertion of a new CL prosthesis. Mean (+/-SD) angles of rotation in dogs increased from 27.3+/-8 degrees (range, 16.7-41.3 degrees ) in pronation to 58.9+/-9.2 degrees (range, 38-88.3 degrees ) after sectioning the MCL and from 45.5+/-10.8 degrees (range, 30.7-67.3 degrees ) in supination to 68.9+/-17.2 degrees (range, 45-94 degrees ) after sectioning the LCL. Angles of pronation and supination were subject to significant interanimal variability, with a strong correlation between increasing animal weight and smaller angles of rotation. Elbow luxation in dogs was not possible unless at least the LCL was transected. In cats, mean angles of rotation increased from 49.8+/-14.9 degrees (range, 30.7-70 degrees ) in pronation to 99.1+/-17.6 degrees (range, 79-111.7 degrees ) after sectioning the MCL and from 128.7+/-18.8 degrees (range, 108.3-151.7 degrees ) in supination to 166.7+/-13.1 degrees (range, 157.3-181.7 degrees ) after sectioning the LCL. Luxation in cats was not possible unless both CL were cut. Use of the ligament prosthesis without primary CL repair reliably prevented reluxation in all canine and feline elbows. Campbell's test allowed reliable differentiation of intact

  7. Conversion of a surgical elbow arthrodesis to total elbow arthroplasty.

    Science.gov (United States)

    Rog, Dominik; Zuckerman, Lee M; Riedel, Barth

    2015-01-01

    Arthrodesis of the elbow joint addresses pain due to intra-articular pathology, but with significant functional limitations. Loss of motion at the elbow is not completely compensated by the wrist and shoulder joints and elbow fusion is thus purely a salvage procedure. Advances in joint arthroplasty have allowed surgeons to address the functional limitations of arthrodesis, but despite these advances the elbow is still one of the joint replacements with higher complication rate. Conversion of a joint fusion to arthroplasty has been reported for the hip, knee, shoulder, and ankle. The takedown of a surgically fused elbow was reported in German literature in 2013. We present the first such case report in the English literature with a 49-year-old male whose status is elbow fusion performed for trauma 31 years prior.

  8. Conversion of a Surgical Elbow Arthrodesis to Total Elbow Arthroplasty

    Directory of Open Access Journals (Sweden)

    Dominik Rog

    2015-01-01

    Full Text Available Arthrodesis of the elbow joint addresses pain due to intra-articular pathology, but with significant functional limitations. Loss of motion at the elbow is not completely compensated by the wrist and shoulder joints and elbow fusion is thus purely a salvage procedure. Advances in joint arthroplasty have allowed surgeons to address the functional limitations of arthrodesis, but despite these advances the elbow is still one of the joint replacements with higher complication rate. Conversion of a joint fusion to arthroplasty has been reported for the hip, knee, shoulder, and ankle. The takedown of a surgically fused elbow was reported in German literature in 2013. We present the first such case report in the English literature with a 49-year-old male whose status is elbow fusion performed for trauma 31 years prior.

  9. 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

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

    Science.gov (United States)

    Chiovetto, Enrico; Berret, Bastien; Delis, Ioannis; Panzeri, Stefano; Pozzo, Thierry

    2013-01-01

    A long standing hypothesis in the neuroscience community is that the central nervous system (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

  11. 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

    ) during forced valgus, external and internal rotation, respectively, but not during forced varus. The hyperextension trauma produced three lesions: (1) anterior capsule rupture, (2) avulsion of the proximal insertion of both the medial and the lateral collateral ligaments, and (3) occasional single...... rupture of the lateral collateral ligament. The lesions indicate that combined hyperextension and supination represent a possible mechanism leading to 'handball goalie's elbow'....

  12. Reconstructing four joint angles on the shoulder and elbow from noninvasive electroencephalographic signals through electromyography

    Directory of Open Access Journals (Sweden)

    Kyuwan eChoi

    2013-10-01

    Full Text Available In this study, first the cortical activities over 2240 vertexes on the brain were estimated from 64 channels electroencephalography (EEG signals using the Hierarchical Bayesian estimation while 5 subjects did continuous arm reaching movements. From the estimated cortical activities, a sparse linear regression method selected only useful features in reconstructing the electromyography (EMG signals and estimated the EMG signals of 9 arm muscles. Then, a modular artificial neural network was used to estimate four joint angles from the estimated EMG signals of 9 muscles: one for movement control and the other for posture control. The estimated joint angles using this method have the correlation coefficient of 0.807 (±0.10 and the normalized root-mean-square error (nRMSE of 0.176 (±0.29 with the actual joint angles.

  13. [Malpractice in the treatment of fractures and dislocations of the elbow joint in children--experience of the arbitration office of the North German Medical Boards].

    Science.gov (United States)

    Vinz, H; Festge, O-A; Neu, J

    2012-02-01

    Statistics of the arbitration office of the North German Medical Boards show that 30% of all panel proceedings confirm medical malpractices. In panel proceedings concerning the treatment of fractures in children, the percentage rose to 60% with significant differences in the individual fracture localisations. Between the years 2000 and 2010, the arbitration office dealt with 257 panel proceedings regarding the fracture treatment of children. This study evaluates the decisions of 53 proceedings concerning the treatment of fractures and dislocations of the elbow joint. All cases except one concerned the following surgical specialities: 1. orthopaedics/traumatology, n = 14; 2. general surgery, n = 13; 3. paediatric surgery, n = 5. On 7 occasions 2 treatment facilities were involved in the same proceeding. The following types of fractures/dislocations were present (each with the number of proceedings [p] and the confirmed malpractices [m]): fracture of the radial humeral condyle and transcondylar Y-fractures, p = 12, m = 11; fracture of the ulnar epicondyle, p = 2, m = 2; sole dislocation of the radial head as well as in combination with Monteggia lesion, p = 19, m = 17; displaced fracture of the radial head and radial neck, respectively, p = 8, m = 4; fractures of the olecranon, p = 3, m = 2; fracture of the coronoid processus, p = 1, m = 1; dislocations and dislocation fractures of the elbow joint without Monteggia lesion, p = 8, m = 5. 42 of these cases (79 %) confirmed malpractice of which 27 (64%) resulted in permanent restriction of the elbow joint mobility. Due to the diversity of injuries, the types of treatment errors were also very variable. In most cases the treatment errors were initiated through the false interpretation of X-ray findings which resulted in false and inadequate therapy measures, for example, the overlooked and not reduced dislocation of the radial head. Three transcondylar

  14. Active Elbow Orthosis

    Directory of Open Access Journals (Sweden)

    Tomas Ripel

    2014-09-01

    Full Text Available This paper presents a novel approach to the design of a motorized rehabilitation device – active elbow orthosis (AEO – inspired by the principles of robotic exoskeletons. The device is currently designed for the elbow joint, but can be easily modified for other joints as well. AEO determines the motion activity of the patient using a strain gauge and utilizes this measurement to control the actuator that drives the forearm part of the orthosis. Patient activity level is related to a free arm measurement obtained via a calibration procedure prior to the exercise. A high-level control module offers several types of exercises mimicking the physiotherapist. The device was successfully verified by tests on a number of patients, resulting in extended range of elbow-joint motion.

  15. Primary total elbow arthroplasty

    Directory of Open Access Journals (Sweden)

    Suresh Kumar

    2013-01-01

    Full Text Available Background: Primary total elbow arthroplasty (TEA is a challenging procedure for orthopedic surgeons. It is not performed as frequently as compared to hip or knee arthroplasty. The elbow is a nonweight-bearing joint; however, static loading can create forces up to three times the body weight and dynamic loading up to six times. For elderly patients with deformity and ankylosis of the elbow due to posttraumatic arthritis or rheumatoid arthritis or comminuted fracture distal humerus, arthroplasty is one of the option. The aim of this study is to analyze the role of primary total elbow arthroplasty in cases of crippling deformity of elbow. Materials and Methods: We analyzed 11 cases of TEA, between December 2002 and September 2012. There were 8 females and 3 males. The average age was 40 years (range 30-69 years. The indications for TEA were rheumatoid arthritis, comminuted fracture distal humerus with intraarticular extension, and posttraumatic bony ankylosis of elbow joint. The Baksi sloppy (semi constrained hinge elbow prosthesis was used. Clinico-radiological followup was done at 1 month, 3 months, 6 months, 1 year, and then yearly basis. Results: In the present study, average supination was 70° (range 60-80° and average pronation was 70° (range 60-80°. Average flexion was 135° (range 130-135°. However, in 5 cases, there was loss of 15 to 35° (average 25° of extension (45° out of 11 cases. The mean Mayo elbow performance score was 95.4 points (range 70-100. Arm length discrepancy was only in four patients which was 36% out of 11 cases. Clinico-radiologically all the elbows were stable except in one case and no immediate postoperative complication was noted. Radiolucency or loosening of ulnar stem was seen in 2 cases (18% out of 11 cases, in 1 case it was noted after 5 years and in another after 10 years. In second case, revision arthroplasty was done, in which only ulnar hinge section, hinge screw and lock screw with hexagonal head

  16. 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)

  17. Tennis elbow

    Science.gov (United States)

    Epitrochlear bursitis; Lateral epicondylitis; Epicondylitis - lateral; Tendonitis - elbow ... Philadelphia, PA: Elsevier; 2017:chap 25. Biundo JJ. Bursitis, tendinitis, and other periarticular disorders and sports medicine. ...

  18. Concomitant Total Wrist and Total Elbow Arthroplasty in a Rheumatoid Patient.

    Science.gov (United States)

    Kane, Patrick M; Stull, Justin D; Culp, Randall W

    2016-05-01

    Background Concomitant arthroplasty has been described to have several benefits over multistage procedures. Ipsilateral total elbow and total shoulder arthroplasty has been reported with good outcomes in upper extremity concomitant arthroplasty. Case Description A 65-year-old woman presented with ipsilateral left-sided wrist and elbow joint degeneration as a result of longstanding rheumatoid arthritis. Concomitant total wrist and total elbow arthroplasty was performed with satisfactory results at both joints. She tolerated the procedure well and had an uneventful clinical course postoperatively. Literature Review Currently, no literature exists that describes one-stage total wrist and total elbow arthroplasty. Individually, total wrist and total elbow arthroplasty have both been reported to result in good outcomes and patient satisfaction. Previous studies have reported the utility of concomitant ipsilateral upper extremity procedures with a one-stage total elbow and total shoulder arthroplasty having been identified as a cost-saving procedure with expedited return to functionality versus a two-stage procedure. Clinical Relevance Patients with ipsilateral degenerative changes in the wrist and elbow should be considered on an individual case basis for concomitant total wrist and total elbow arthroplasty.

  19. Concomitant Total Wrist and Total Elbow Arthroplasty in a Rheumatoid Patient

    Science.gov (United States)

    Kane, Patrick M.; Stull, Justin D.; Culp, Randall W.

    2015-01-01

    Background Concomitant arthroplasty has been described to have several benefits over multistage procedures. Ipsilateral total elbow and total shoulder arthroplasty has been reported with good outcomes in upper extremity concomitant arthroplasty. Case Description A 65-year-old woman presented with ipsilateral left-sided wrist and elbow joint degeneration as a result of longstanding rheumatoid arthritis. Concomitant total wrist and total elbow arthroplasty was performed with satisfactory results at both joints. She tolerated the procedure well and had an uneventful clinical course postoperatively. Literature Review Currently, no literature exists that describes one-stage total wrist and total elbow arthroplasty. Individually, total wrist and total elbow arthroplasty have both been reported to result in good outcomes and patient satisfaction. Previous studies have reported the utility of concomitant ipsilateral upper extremity procedures with a one-stage total elbow and total shoulder arthroplasty having been identified as a cost-saving procedure with expedited return to functionality versus a two-stage procedure. Clinical Relevance Patients with ipsilateral degenerative changes in the wrist and elbow should be considered on an individual case basis for concomitant total wrist and total elbow arthroplasty. PMID:27104080

  20. 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...

  1. Elbow Pain

    Science.gov (United States)

    ... pain is often caused by overuse. Many sports, hobbies and jobs require repetitive hand, wrist or arm ... Accessed Jan. 16, 2016. Jan. 11, 2018 Original article: http://www.mayoclinic.org/symptoms/elbow-pain/basics/ ...

  2. Golfer's Elbow

    Science.gov (United States)

    ... in baseball or softball can be another culprit. Football, archery and javelin throwing also can cause golfer's ... your wrist rigid and stable to reduce the force to your elbow. Know when to rest. Try ...

  3. 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......Background: The next fifty years will see a drastic increase in the older population. Among other effects, ageing causes a decrease in strength. It is necessary to provide safe and comfortable environments for the elderly. To achieve this, digital human modelling has proved to be a useful...... 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...

  4. A comparison of the effects of concentric versus eccentric exercise on force and position sense at the human elbow joint.

    Science.gov (United States)

    Brockett, C; Warren, N; Gregory, J E; Morgan, D L; Proske, U

    1997-10-17

    It is generally accepted that our sense of limb position and movement is provided, in part, by signals from muscle spindles, while the sense of muscle force derives from signals in tendon organs. Experiments are described here, using human subjects, in which the effects of eccentric and concentric exercise of elbow flexor muscles are compared on the sense of forearm position and the sense of tension in elbow flexors. Subjects were required to compress a preloaded spring with one arm, carrying out a concentric contraction in elbow flexors, then flexors of the other arm released the spring from compression and thereby carried out an eccentric contraction. The force of the spring was adjusted to be 20% maximum voluntary contraction (MVC), and each subject carried out a minimum of 120 contractions. Position sense was measured in blindfolded subjects by placing one forearm at a set angle and asking subjects to match it by positioning the other arm. Over 4 days postexercise, subjects placed the eccentrically exercised arms in a more extended position than the concentrically exercised arm suggesting that they thought the muscle was shorter than it actually was. In a force-matching task, subjects systematically undershot the target 10% MVC with their eccentrically exercised arm. Since it is known that eccentric exercise is associated with damage to muscle fibres, it is postulated that this leads to a disturbance of muscle receptors, the muscle spindles and tendon organs.

  5. Otitis interna, media, and externa with destruction of the left tympanic bulla and subluxation and septic arthritis of the left temporomandibular joint in an alpaca (Vicugna pacos)

    Science.gov (United States)

    Galvan, Noe; Middleton, John R.; Cook, Cristi; Britt, Lisa G.; Kuroki, Keiichi

    2013-01-01

    A 1.5-year-old, 37.7 kg, female alpaca was evaluated for a 2-week history of weight loss, left ear droop, and deviation of the rostral mandible to the right. Antemortem radiography and postmortem examination revealed otitis interna, media, and externa, destruction of the left tympanic bulla, and subluxation and septic arthritis of the left temporomandibular joint. PMID:23997267

  6. Elbow fracture-dislocation combined with Galeazzi fracture in adult: A case report and literature review.

    Science.gov (United States)

    Asadollahi, Saeed; Shepherd, David; Hau, Raphael C

    2013-01-01

    Galeazzi fracture associated with ipsilateral posterior elbow dislocation and radial head fracture is a rare pattern of injury. Few reports exist that describes this injury pattern and its treatment. We describe a case report of simultaneous occurrence of Galeazzi fracture and ipsilateral dislocation of elbow. A 58 year-old female presented with Galeazzi fracture and posterior elbow dislocation associated with radial head fracture of left upper extremity. This was managed with closed reduction of the elbow, open reduction and internal fixation of the radial shaft fracture and K-wire stabilisation of the unstable distal radioulnar joint. Prophylactic fasciotomy was performed. At 10 months follow-up, the outcome was favourable with the American shoulder and elbow surgeon score of 92 and the disabilities of the arm, shoulder and hand score of 18. The presumed mechanism of the injury was a forceful axial loading of a hyperpronated forearm and extended elbow. Our literature review shows that this pattern of injury occurs as a result of high energy trauma in young individuals, and successful outcome can be achieved by addressing each component of this complex injury individually. Simultaneous occurrence of elbow dislocation and Galeazzi fracture seems to be the result of extreme axial force and unique position of upper extremity at the time of impact. Individualised approach to each component of this injury can result in favourable outcome. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  7. 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;

  8. 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;

  9. Correlation of Resting Elbow Angle with Spasticity in Chronic Stroke Survivors.

    Science.gov (United States)

    Bhadane, Minal Y; Gao, Fan; Francisco, Gerard E; Zhou, Ping; Li, Sheng

    2015-01-01

    To evaluate whether resting joint angle is indicative of severity of spasticity of the elbow flexors in chronic stroke survivors. Seventeen hemiparetic stroke subjects (male: n = 13; female: n = 4; age: 37-89 years; 11 right and 6 left hemiplegia; averaged 54.8 months after stroke, ranging 12-107 months) participated in the study. The number of subjects with modified Ashworth scale score (MAS) = 0, 1, 1+, 2, and 3 was 3, 3, 5, 3, and 3, respectively. In a single experimental session, resting elbow joint angle, MAS, and Tardieu scale score (Tardieu R1) were measured. A customized motorized stretching device was used to stretch elbow flexors at 5, 50, and 100°/s, respectively. Biomechanical responses (peak reflex torque and reflex stiffness) of elbow flexors were quantified. Correlation analyses between clinical and biomechanical assessments were performed. Resting elbow joint angle showed a strong positive correlation with Tardieu R1 (r = 0.77, p spasticity in chronic stroke. Resting angle observation for spasticity assessment can and will be an easy, yet a valid way of spasticity estimation in clinical settings, particularly for small muscles or muscles which are not easily measurable by common clinical methods.

  10. [Automated Assessment for Bone Age of Left Wrist Joint in Uyghur Teenagers by Deep Learning].

    Science.gov (United States)

    Hu, T H; Huo, Z; Liu, T A; Wang, F; Wan, L; Wang, M W; Chen, T; Wang, Y H

    2018-02-01

    To realize the automated bone age assessment by applying deep learning to digital radiography (DR) image recognition of left wrist joint in Uyghur teenagers, and explore its practical application value in forensic medicine bone age assessment. The X-ray films of left wrist joint after pretreatment, which were taken from 245 male and 227 female Uyghur nationality teenagers in Uygur Autonomous Region aged from 13.0 to 19.0 years old, were chosen as subjects. And AlexNet was as a regression model of image recognition. From the total samples above, 60% of male and female DR images of left wrist joint were selected as net train set, and 10% of samples were selected as validation set. As test set, the rest 30% were used to obtain the image recognition accuracy with an error range in ±1.0 and ±0.7 age respectively, compared to the real age. The modelling results of deep learning algorithm showed that when the error range was in ±1.0 and ±0.7 age respectively, the accuracy of the net train set was 81.4% and 75.6% in male, and 80.5% and 74.8% in female, respectively. When the error range was in ±1.0 and ±0.7 age respectively, the accuracy of the test set was 79.5% and 71.2% in male, and 79.4% and 66.2% in female, respectively. The combination of bone age research on teenagers' left wrist joint and deep learning, which has high accuracy and good feasibility, can be the research basis of bone age automatic assessment system for the rest joints of body. Copyright© by the Editorial Department of Journal of Forensic Medicine.

  11. Elbow replacement - discharge

    Science.gov (United States)

    Total elbow arthroplasty - discharge; Endoprosthetic elbow replacement - discharge ... Pain is normal after elbow replacement surgery. It should get better over time. Your doctor will give you a prescription for pain medicine. Get it filled when ...

  12. Elbow replacement

    Science.gov (United States)

    ... of the arm bones. The ends of the artificial joint are usually glued in place into each bone. They can be connected with a hinge. The ... this procedure include: Blood vessel damage during surgery Bone break during surgery Dislocation of the artificial joint Loosening of the artificial joint over time ...

  13. Correlation of resting elbow angle with spasticity in chronic stroke survivors

    Directory of Open Access Journals (Sweden)

    Minal Y Bhadane

    2015-08-01

    Full Text Available Objective: To evaluate whether resting joint angle is indicative of severity of spasticity of the elbow flexors in chronic stroke survivors. Methods: Seventeen hemiparetic stroke subjects (male: n=13; female: n=4; age: 37-89 years; 11 right and 6 left hemiplegia; averaged 54.8 months after stroke, ranging 12-107 months participated in the study. The number of subjects with modified Ashworth scale score (MAS = 0, 1, 1+, 2, 3 was 3, 3, 5, 3, 3, respectively. In a single experimental session, resting elbow joint angle, MAS, and Tardieu scale score (Tardieu R1 were measured. A customized motorized stretching device was used to stretch elbow flexors at 5°/s, 50°/s, and 100°/s, respectively. Biomechanical responses (peak reflex torque and reflex stiffness of elbow flexors were quantified. Correlation analyses between clinical and biomechanical assessments were performed. Results: Resting elbow joint angle showed a strong positive correlation with Tardieu R1 (r = 0.77, p<0.01 and a very strong negative correlation with MAS (r = −0.89, p<0.01. The resting angle also had strong correlations with biomechanical measures (r= −0.63 to −0.76, p<0.01. Conclusion: Our study provides experimental evidence for anecdotal observation that the resting elbow joint angle correlates with severity of spasticity in chronic stroke. Resting angle observation for spasticity assessment can and will be an easy, yet a valid way of spasticity estimation in clinical settings, particularly for small muscles or muscles which are not easily measurable by common clinical methods.

  14. Long-term results with the Kudo type 3 total elbow arthroplasty

    DEFF Research Database (Denmark)

    Thillemann, Theis Muncholm; Olsen, Bo Sanderhoff; Johannsen, Hans Viggo

    2012-01-01

    From 1992 to 1993, 17 elbows were replaced with the unlinked Kudo type 3 total elbow arthroplasty in 16 patients with arthritic joint destruction. Of these elbows, 8 were available for clinical examination after a mean of 9.5 years. Of the 17 elbow implants, 5 were revised: 2 because of loosening...

  15. Open Galeazzi fracture with ipsilateral elbow dislocation.

    Science.gov (United States)

    Adanır, Oktay; Yüksel, Serdar; Beytemur, Ozan; Güleç, M Akif

    2016-08-01

    Combination of the Galeazzi fracture and dislocation of the elbow joint in same extremity is very rare. In this article, we report a 26-year-old male patient with a posterolateral dislocation of the elbow and ipsilateral volar type Galeazzi fracture. We performed closed reduction for the elbow dislocation during admission to the emergency department. Patient was taken to the operating room in the sixth hour of his application to emergency department and open wound on the ulnovolar region of the wrist was closed primarily after irrigation and debridement. We performed open reduction and internal fixation of the radial fracture with a dynamic compression plate. After fixation, we evaluated the stability of the elbow joint and distal radioulnar joint. Distal radioulnar joint was unstable under fluoroscopic examination and fixed with one 1.8 mm Kirschner wire in a pronated position. Then, elbow joint was stable. One year after surgery, patient had no pain or sings of instability. At the last follow-up, range of motion of the elbow was 10°-135° and forearm pronation and supination were 70°.

  16. 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.

  17. 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.

  18. 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...

  19. Managing a Female Patient with Left Low Back Pain and Sacroiliac Joint Pain with Therapeutic Exercise: A Case Report

    OpenAIRE

    Boyle, Kyndall L.

    2011-01-01

    Purpose: The purpose of this case study is to describe the management of a female patient with chronic left low back pain and sacroiliac joint pain (LBP/SIJP) using unique unilateral exercises developed by the Postural Restoration Institute (PRI) to address pelvic asymmetry and left hip capsule restriction, which is consistent with a Right Handed and Left Anterior Interior Chain pattern of postural asymmetry.

  20. STRESS ANALYSIS OF THE RADIAL HEAD REPLACEMENTS IN AN ELBOW ARTICULATION

    Czech Academy of Sciences Publication Activity Database

    Hlavoň, Pavel; Fuis, Vladimír; Florian, Z.

    2008-01-01

    Roč. 15, č. 5 (2008), s. 319-327 ISSN 1802-1484 Institutional research plan: CEZ:AV0Z20760514 Keywords : elbow joint * elbow articulation * radial head replacement * computational modelling Subject RIV: BO - Biophysics

  1. High temperature lined conduits, elbows and tees

    Science.gov (United States)

    De Feo, Angelo; Drewniany, Edward

    1982-01-01

    A high temperature lined conduit comprising, a liner, a flexible insulating refractory blanket around and in contact with the liner, a pipe member around the blanket and spaced therefrom, and castable rigid refractory material between the pipe member and the blanket. Anchors are connected to the inside diameter of the pipe and extend into the castable material. The liner includes male and female slip joint ends for permitting thermal expansion of the liner with respect to the castable material and the pipe member. Elbows and tees of the lined conduit comprise an elbow liner wrapped with insulating refractory blanket material around which is disposed a spaced elbow pipe member with castable refractory material between the blanket material and the elbow pipe member. A reinforcing band is connected to the elbow liner at an intermediate location thereon from which extend a plurality of hollow tubes or pins which extend into the castable material to anchor the lined elbow and permit thermal expansion. A method of fabricating the high temperature lined conduit, elbows and tees is also disclosed which utilizes a polyethylene layer over the refractory blanket after it has been compressed to maintain the refractory blanket in a compressed condition until the castable material is in place. Hot gases are then directed through the interior of the liner for evaporating the polyethylene and setting the castable material which permits the compressed blanket to come into close contact with the castable material.

  2. 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

    in the negative (p=3D0.02). At joints 1, 2, 3, 5 and 6 of the left arm, and at joints 1, 4, 5 and 6 of the right arm, the mean score for each joint was significantly higher in the positive group than in the negative. Among 78 arms in which radiographs revealed epitrochlear lymphadenopathy, the score was zero for all joints in nine cases (11.6%). In patients with rheumatoid arthritis, evidence of epitrochlear lymphadenopathy, as seen on radiographs of the elbow, appears to be related to the distribution and severity of the disease and to CRP levels. (author)

  3. Magnetic resonance imaging of the elbow

    International Nuclear Information System (INIS)

    Maeurer, J.; Vogl, T.J.; Siewert, C.; Schedel, H.; Felix, R.

    1993-01-01

    The diagnostic performance of Magnetic resonance imaging (MRI) was retrospectively assesed in 24 patients with injured or painful joint of the elbow. The normal anatomy of the elbow joint could be illustrated in T1-weighted axial and sagittal planes. The results were analysed and compared with clinical and surgical findings (n=7). MRI proved to detect avulsion of the biceps tendon and soft tissue injuries. This technique could describe synovial effusion, cartilagine contusion and hyperplastic synovium. Fracture fragments were detected and marrow fat replacement demonstrated. Two synovial cysts were identified by an increased signal intensity and histologically verified. These results suggest that MRI is useful in the evaluation of the elbow. (orig.) [de

  4. 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

  5. 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.

  6. Managing a female patient with left low back pain and sacroiliac joint pain with therapeutic exercise: a case report.

    Science.gov (United States)

    Boyle, Kyndall L

    2011-01-01

    The purpose of this case study is to describe the management of a female patient with chronic left low back pain and sacroiliac joint pain (LBP/SIJP) using unique unilateral exercises developed by the Postural Restoration Institute (PRI) to address pelvic asymmetry and left hip capsule restriction, which is consistent with a Right Handed and Left Anterior Interior Chain pattern of postural asymmetry.Client Description: The client was 65-year-old woman with a 10-month history of constant left LBP/SIJP and leg pain. The patient was seen six times to correct pelvic position/posture and left hip posterior capsule restriction via (1) muscle activation (left hamstrings, adductor magnus, and anterior gluteus medius) and (2) left hip adduction to lengthen the left posterior capsule/ischiofemoral ligament. Stabilization exercises included bilateral hamstrings, gluteus maximus, adductors, and abdominals to maintain pelvic position/posture.Measures and Outcome: Left Ober's test (initially positive) was negative at discharge. Pain as measured on the Numeric Pain Rating Scale (initially 1/10 at best and 8/10 at worst) was 0/10-0/10 at discharge. Oswestry Disability Index score (initially 20%) was 0% at discharge. The patient no longer had numbness in her left leg, and sexual intercourse had become pain free. INTERVENTIONs to restore and maintain the optimal position of pelvis and hip (femoral head in the acetabulum) may be beneficial for treating patients with chronic LBP/SIJP. The patient's pain was eliminated 13 days after she first performed three exercises to reposition the pelvis and restore left posterior hip capsule extensibility and internal rotation.

  7. 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.

  8. Body mass index and elbow range of motion in a healthy pediatric population: a possible mechanism of overweight in children.

    Science.gov (United States)

    Golden, Daniel W; Wojcicki, Janet M; Jhee, Jeffrey T; Gilpin, Susan L; Sawyer, Jeffrey R; Heyman, Melvin B

    2008-02-01

    Childhood overweight has become a serious health problem among children and adolescents in the United States. No previous study, to our knowledge, has analyzed the effect of body mass index (BMI) on range of motion and carrying angle of the elbow joint in a healthy pediatric population. The primary objective of this study was to determine the effect of BMI on orthopedic parameters of the elbow joint, including range of motion, flexion, extension, and carrying angle. Healthy children age 2 to 18 years (mean 12.0 +/- 3.9 years) were recruited at an urban pediatric orthopedic clinic as pediatric orthopedic patients or as the siblings or friends of patients. Measures of range of motion (flexion and extension) and carrying angle of 226 elbows and of BMI from 113 study participants were analyzed. BMI was negatively correlated with right and left elbow range of motion (r = -0.54, P consequences of impaired range of motion associated with overweight on activity levels and energy expenditure in growing children and adolescents.

  9. Correlation of resting elbow angle with spasticity in chronic stroke survivors

    OpenAIRE

    Minal Y Bhadane; Minal Y Bhadane; Fan eGao; Gerard E Francisco; Gerard E Francisco; Ping eZhou; Ping eZhou; Ping eZhou; Sheng eLi; Sheng eLi

    2015-01-01

    Objective: To evaluate whether resting joint angle is indicative of severity of spasticity of the elbow flexors in chronic stroke survivors. Methods: Seventeen hemiparetic stroke subjects (male: n=13; female: n=4; age: 37-89 years; 11 right and 6 left hemiplegia; averaged 54.8 months after stroke, ranging 12-107 months) participated in the study. The number of subjects with modified Ashworth scale score (MAS) = 0, 1, 1+, 2, 3 was 3, 3, 5, 3, 3, respectively. In a single experimental session, ...

  10. Correlation of Resting Elbow Angle with Spasticity in Chronic Stroke Survivors

    OpenAIRE

    Bhadane, Minal Y.; Gao, Fan; Francisco, Gerard E.; Zhou, Ping; Li, Sheng

    2015-01-01

    Objective To evaluate whether resting joint angle is indicative of severity of spasticity of the elbow flexors in chronic stroke survivors. Methods Seventeen hemiparetic stroke subjects (male: n = 13; female: n = 4; age: 37–89 years; 11 right and 6 left hemiplegia; averaged 54.8 months after stroke, ranging 12–107 months) participated in the study. The number of subjects with modified Ashworth scale score (MAS) = 0, 1, 1+, 2, and 3 was 3, 3, 5, 3, and 3, respectively. In a single e...

  11. 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

  12. Tennis elbow surgery - discharge

    Science.gov (United States)

    Lateral epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... Soon after surgery, severe pain will decrease, but you may have mild soreness for 3 to 6 months.

  13. 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.

  14. 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.)

  15. Radiographic arthrosis after elbow trauma: interobserver reliability.

    Science.gov (United States)

    Lindenhovius, Anneluuk; Karanicolas, Paul Jack; Bhandari, Mohit; Ring, David

    2012-04-01

    This study measured observer variation in radiographic rating of elbow arthrosis. 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; grade 1, slight joint-space narrowing with minimum osteophyte formation; grade 2, moderate joint-space narrowing with moderate osteophyte formation; and grade 3, severe degenerative change with gross destruction of the joint). The kappa multirater measure (κ) was used to estimate reliability between observers, with 0 indicating no agreement above chance, and 1 indicating perfect agreement. There was fair agreement in arthrosis ratings between surgeons. Surgeons with more than 10 years of experience had greater agreement than did surgeons with less experience, and surgeons who treated more than 10 elbow fractures per year had better agreement than did those treating fewer fractures. In post hoc analyses, 2 simplified binary rating systems (eg, "none or mild" vs "moderate or severe" arthrosis) resulted in moderate agreement among observers. The 4 grades of the Broberg and Morrey classification system have only fair interobserver reliability that is influenced by subspecialty and experience. Binary rating systems might be more reliable. Diagnostic III. Copyright © 2012 American Society for Surgery of the Hand. All rights reserved.

  16. [Total Elbow Replacement - Implantation of the Latitude Prosthesis (Tornier)].

    Science.gov (United States)

    Hackl, M; Wegmann, K; Leschinger, T; Ries, C; Burkhart, K J; Müller, L

    2015-10-01

    Due to technical progress, the indication for total elbow arthroplasty could be expanded in recent years. As a result, the demand regarding functionality and mobility of the replaced joint has risen as well. Elbow arthroplasty has to be considered as technically demanding. Only with detailed knowledge of this surgical procedure and its possible intraoperative pitfalls can one provide the best possible results. In this instructional video we explain the implantation of the Latitude elbow prosthesis (Tornier) putting emphasis on the correct approach as well as implantation of the prosthesis and subsequent wound closure. Georg Thieme Verlag KG Stuttgart · New York.

  17. Detection of intraarticular bodies of the elbow with saline arthrosonography

    International Nuclear Information System (INIS)

    Miller, John H.; Beggs, Ian

    2001-01-01

    AIM: To assess whether ultrasound with intraarticular injection of saline increases the detection of intraarticular bodies of the elbow. SUBJECTS AND METHODS: Twelve patients (age range 21-42 years, mean 29 years; 8 male, 4 female) referred over a 2-year period with an equivocal history of elbow locking and plain radiographs had a joint injection of at least 12 ml of sterile saline during ultrasound examination. No patient had a joint effusion before injection. Surgical correlation was available in six patients. RESULTS: Ten patients had intraarticular bodies but these were demonstrated only after joint injection in six patients. Arthroscopy performed in six patients confirmed intraarticular bodies in five. Radiographs were falsely positive in one and falsely negative in seven patients. CONCLUSION: Joint injection improves the sonographic evaluation and conspicuity of small and radiographically occult intraarticular loose bodies in the clinically equivocal elbow. The procedure is simple, quick, well tolerated and reproducible. Miller, J. and Beggs, I. (2001)

  18. 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

  19. Three-Dimensional Evaluation of Similarity of Right and Left Knee Joints.

    Science.gov (United States)

    Jang, Ki-Mo; Park, Jong-Hoon; Chang, Minho; Kim, Youngjun; Lee, Deukhee; Park, Sehyung; Wang, Joon Ho

    2017-12-01

    The purpose of this study was to evaluate the anatomical similarity of three-dimensional (3D) morphometric parameters between right and left knees. Ten fresh-frozen paired cadaveric knees were tested. Following dissection, footprint areas of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) were measured. Surface scanning was performed using a 3D scanner. Scanned data were reproduced and morphometric parameters were measured on specialized software. After making mirror models, we compared footprint center positions of the ACL and PCL of both sides and calculated the average deviation of 3D alignment between the right- and left-side models. No significant side-to-side differences were found in any morphometric parameters. Bony shapes displayed a side-to-side difference of 〈1 mm. Distal femoral and proximal tibial volumes did not present side-to-side differences, either; the average 3D deviations of alignment between the right and left sides were 0.8±0.4/1.1±0.6 mm (distal femur/proximal tibia). Center-to-center distances between the right and left ACL footprints were 2.6/2.7 mm (femur/tibia) for the anteromedial bundle and 2.4/2.8 mm for the posterolateral bundle. They were 1.9/1.5 mm for the anterolateral bundle and 2.2/1.8 mm for the posteromedial bundle of the PCL. There was a remarkable 3D morphometric similarity between right and left knees. Our results might support the concept of obtaining morphologic reference data from the uninvolved contralateral knee.

  20. 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

  1. Quantitative evaluation of toothbrush and arm-joint motion during tooth brushing.

    Science.gov (United States)

    Inada, Emi; Saitoh, Issei; Yu, Yong; Tomiyama, Daisuke; Murakami, Daisuke; Takemoto, Yoshihiko; Morizono, Ken; Iwasaki, Tomonori; Iwase, Yoko; Yamasaki, Youichi

    2015-07-01

    It is very difficult for dental professionals to objectively assess tooth brushing skill of patients, because an obvious index to assess the brushing motion of patients has not been established. The purpose of this study was to quantitatively evaluate toothbrush and arm-joint motion during tooth brushing. Tooth brushing motion, performed by dental hygienists for 15 s, was captured using a motion-capture system that continuously calculates the three-dimensional coordinates of object's motion relative to the floor. The dental hygienists performed the tooth brushing on the buccal and palatal sides of their right and left upper molars. The frequencies and power spectra of toothbrush motion and joint angles of the shoulder, elbow, and wrist were calculated and analyzed statistically. The frequency of toothbrush motion was higher on the left side (both buccal and palatal areas) than on the right side. There were no significant differences among joint angle frequencies within each brushing area. The inter- and intra-individual variations of the power spectrum of the elbow flexion angle when brushing were smaller than for any of the other angles. This study quantitatively confirmed that dental hygienists have individual distinctive rhythms during tooth brushing. All arm joints moved synchronously during brushing, and tooth brushing motion was controlled by coordinated movement of the joints. The elbow generated an individual's frequency through a stabilizing movement. The shoulder and wrist control the hand motion, and the elbow generates the cyclic rhythm during tooth brushing.

  2. Mensuração do ângulo articular do cotovelo no teste de tensão neural em indivíduos com hanseníase Mensuration of elbow joint angle in the application of the neural tension test in individuals with leprosy

    Directory of Open Access Journals (Sweden)

    Débora Scheibe

    2012-06-01

    Full Text Available A hanseníase é uma patologia crônica e granulomatosa, que atinge a pele e o sistema nervoso periférico pela invasão no sistema imune do Mycobacterium leprae. O objetivo deste estudo foi mensurar o ângulo articular do cotovelo com a aplicação do teste de tensão neural do nervo ulnar em pacientes com hanseníase. Na aplicação do teste de tensão neural, foram utilizadas a goniometria e a fotometria para a mensuração do ângulo articular do cotovelo, sendo que para a realização da fotometria foi utilizada uma câmera Samsung de 12.1 Mega pixels, e os dados foram analisados pelo software Corel Draw X5 (Microsoft®. Foram selecionados 44 indivíduos da Fundação Pró-Hansen, com média de idade de 48,13±12,55 anos, divididos em três grupos: G1, G2 e G3. O G1 compreende voluntários com hanseníase e sensibilidade preservada; o G2, aqueles com hanseníase e com perda de sensibilidade; e o G3, o controle. Na goniometria, foi encontrada diferença significativa (pLeprosy is a chronic and granulomatous disease, which affects skin and peripheral nervous system by invasion of Mycobacterium leprae in the immune system. The objective of this study was to evaluate the ulnar neural tension test in leprosy patients. In applying the test of neural tension, it was done goniometry and photometry to measure the angle of the elbow joint, and to perform the photometry we used a Samsung camera, 12.1 Mega pixels, and the data were analyzed using Corel Draw Software X5 (Microsoft®. We selected 44 individuals of Pro-Hansen Foundation, with an average age of 48.13±12.55 years, divided in three groups: G1, G2 and G3. G1 consisted of leprosy volunteers with preserved sensibility; the G2, the ones with leprosy and with no sensibility; and G3 was control group. In goniometry, it was found significant difference (p<0.05 when comparing the G1 and G2 with control of both the right and left limb, but no difference was found when comparing the two leprosy

  3. 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...

  4. 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.)

  5. 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.

  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. Posttraumatic immobilization in flexion of a congenital valgus elbow and cubital tunnel syndrome-case report.

    Science.gov (United States)

    Di Rocco, Federico; Doglietto, Francesco; Tufo, Tommaso; Ciampini, Alessandro; Lauretti, Liverana; Fernandez, Eduardo

    2009-06-01

    Elbow trauma, cubitus valgus deformity, and prolonged flexion of the elbow are recognized risk factors for ulnar nerve entrapment. The 3 conditions coincided in the present case. In fact, a 36-year-old woman had a bilateral severe congenital cubitus valgus. A trauma of the right elbow caused luxation and supracondylar humeral fracture for which the joint was fixed in flexion at 90 degrees for 1 month. The patient developed a severe ulnar nerve entrapment syndrome that did not respond to several months of physiotherapy and active mobilization of the elbow. The symptoms recovered after surgical decompression and anterior subcutaneous transposition of the nerve. The present case illustrates how the development of a cubital tunnel syndrome should be considered as the expected outcome of a long immobilization in flexion of an elbow with a severe cubitus valgus. A simple subcutaneous anterior transposition of the ulnar nerve might be recommended before a long immobilization of a cubitus valgus elbow is performed.

  8. 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.

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

    African Journals Online (AJOL)

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

  10. Concerns on Little League Elbow.

    Science.gov (United States)

    Wells, Michael J.; Bell, Gerald W.

    1995-01-01

    Little league elbow is a common overuse injury resulting from repetitive valgus stress on the elbow during overhead throwing. Prevention and treatment should emphasize education of athletes, parents, and coaches about its etiology. The paper examines bone development, noting that the condition is highly treatable if diagnosed in early development.…

  11. Improved orthopedic arm joint

    Science.gov (United States)

    Dane, D. H.

    1971-01-01

    Joint permits smooth and easy movement of disabled arm and is smaller, lighter and less expensive than previous models. Device is interchangeable and may be used on either arm at the shoulder or at the elbow.

  12. Epidemiology of Elbow Dislocations in High School Athletes.

    Science.gov (United States)

    Dizdarevic, Ismar; Low, Sara; Currie, Dustin W; Comstock, R Dawn; Hammoud, Sommer; Atanda, Alfred

    2016-01-01

    The elbow is the second most commonly dislocated major joint in the general population. Previous studies that focused on emergency department populations indicate that such injuries occur most frequently among adolescent athletes. To describe the epidemiological rates and patterns of sports-related elbow dislocations in high school athletes. Descriptive epidemiology study. Sports-related injury data for the 2005-2006 through 2013-2014 academic years from a national convenience sample of high schools participating in the National High School Sports-Related Injury Surveillance Study (High School Reporting Information Online [RIO]) were analyzed. Certified athletic trainers participating in High School RIO reported 115 of 1246 (9.2%) elbow injuries as elbow dislocations. A total of 30,415,179 athlete exposures (AEs) were reported during the study period, resulting in a dislocation rate of 0.38 per 100,000 AEs. The majority of the dislocations resulted from boys' wrestling (46.1%) and football (37.4%). Elbow dislocation rates were higher in competition than in practice. Also, 91.3% of dislocations occurred in boys' sports. Among both boys (60.4%) and girls (88.9%), the majority of injuries occurred during varsity sports activities. Contact with another person was the most common injury mechanism (46.9%), followed by contact with the playing surface (46.0%). Dislocations more commonly resulted in removal from play for more than 3 weeks (23.4% vs 6.9%, respectively) or medical disqualification (36.9% vs 7.0%, respectively) compared with other elbow injuries. Dislocations were also more likely to result in surgical treatment than other elbow injuries (13.6% vs 4.7%, respectively). In high school athletes, elbow dislocations result in longer removal from play and are more likely to require surgical treatment than nondislocation-associated elbow injuries. Rates and patterns of elbow dislocations vary by sport. In high-risk sports, focused sport-specific prevention

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

    Science.gov (United States)

    Merad, Manelle; de Montalivet, Étienne; Touillet, Amélie; Martinet, Noël; Roby-Brami, Agnès; Jarrassé, Nathanaël

    2018-01-01

    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' coordination models can

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

    Directory of Open Access Journals (Sweden)

    Manelle Merad

    2018-02-01

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

  15. 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.

  16. 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.......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...

  17. The GSB III elbow prosthesis in rheumatoid arthritis: a 2- to 9-year follow-up

    DEFF Research Database (Denmark)

    Jensen, Claus Hjorth; Jacobsen, Steffen; Ratchke, Martin

    2006-01-01

    and radiographic study. All patients had endstage rheumatoid arthritis (RA) of the elbow joint. RESULTS: In 2 patients, humeral components were revised due to malorientation. 1 arthroplasty was revised due to aseptic loosening of the humeral component. There were 4 cases of intraoperative fracture which healed......BACKGROUND: The optimal design of an elbow prosthesis for badly damaged elbows is unkown. We evaluated 23 GSB III semi-constrained (sloppy-hinged) total elbow arthroplasties in 16 consecutive patients with rheumatoid arthritis. PATIENTS AND METHODS: After a mean follow-up period of 5 (2-9) years......, we assessed quality of the cementing technique, signs of aseptic loosening, patient satisfaction, range of movement, and determined the Hospital for Special Surgery (HSS) elbow score. 3 patients had died before follow-up; thus, 20 replacements in 16 patients were available for clinical...

  18. Posterolateral elbow dislocation with entrapment of the medial epicondyle in children: a case report

    Science.gov (United States)

    Mazzini, Juan Pretell

    2009-01-01

    Introduction Elbow dislocations in children are uncommon injuries. Dislocations with associated fractures or so-called complex dislocations of the elbow can be challenging to diagnose and treat. Case presentation A 14-year-old male had a posterolateral elbow dislocation after a fall. Closed reduction with traction was performed. Radiographs after initial reduction showed a fragment entrapped into the humero-cubital joint. Computerized tomography scan showed the fragment belonging to the medial epicondyle. Open reduction and internal fixation with a 3.0 millimeter cannulated screw was performed, with restoring of the normal function of the elbow at final follow up. Conclusion Elbow dislocations in children can be associated with bone lesions. These injuries must be suspected to avoid misleading diagnosis and achieve good results. PMID:19829829

  19. Open antero-lateral dislocation of the elbow. A case report

    Directory of Open Access Journals (Sweden)

    Roy Bibas R

    2002-01-01

    Full Text Available Abstract Background Open dislocations are infrequent, often associated with damage to the neuro vascular structures. We present an unusual case of an open antero-lateral dislocation of the elbow, which was not associated with any vascular or neural injury. Case presentation A 34 year female dance instructor sustained an open dislocation of her elbow. Surgical exploration was undertaken. No major neurovascular injury was present. There was almost complete disruption of all the muscular and ligamentous attachments to the distal humerus and the proximal radius and ulna, which were not formally repaired during surgery. The elbow was found to be very unstable, and was placed in a back slab. The functional recovery was complete in about six months, the patient regaining full range of elbow movement. Elbow dislocations without associate fractures are adequately treated by manipulation and reduction, in spite of the almost complete disruption of the soft tissues around the joint.

  20. Subacute dislocation of the elbow following Galeazzi fracture-dislocation of the radius: A case report.

    Science.gov (United States)

    Rajeev, Aysha; Senevirathna, Shanaka; Harrison, John

    2011-12-20

    The Galeazzi fracture-dislocation was originally described by Sir Astley Cooper in 1822 but was named after Italian surgeon Ricardo Galeazzi in 1934. It is an injury classified as a radial shaft fracture with associated dislocation of the distal radioulnar joint and disruption of the forearm axis joint. The associated distal radioulnar joint injury may be purely ligamentous in nature, tearing the triangular fibrocartilaginous complex, or involve bony tissue (that is, ulnar styloid avulsions) or both. We report this case because of the rare association of posterior dislocation of the elbow along with Galeazzi fracture-dislocation. To the best of our knowledge, this has not been previously reported in the English literature. A 26-year-old Caucasian man presented to our department after a fall from a motorbike. He sustained a closed, isolated Galeazzi fracture-dislocation of the right forearm and no associated elbow injuries, and this necessitated open reduction and internal fixation of the radius. Post-operative radiographs films were satisfactory. However, clinical and radiological evidence of ipsilateral elbow dislocation was noted at a five-week follow-up, subsequently requiring open reduction of the joint and collateral ligament repair. Our patient was noted to have full elbow and forearm function at three months. Although the Galeazzi fracture-dislocation has been classically described as involving only the distal radioulnar joint, traumatic forces can be transmitted to the elbow via the interosseous membrane of the forearm. This can lead to instability of the elbow joint. Therefore, we recommend that, in every case of forearm fracture, both elbow and wrist joints be assessed clinically as well as radiologically for subluxation or dislocation.

  1. Beyond Hemispheric Dominance: Brain Regions Underlying the Joint Lateralization of Language and Arithmetic to the Left Hemisphere

    Science.gov (United States)

    Pinel, Philippe; Dehaene, Stanislas

    2010-01-01

    Language and arithmetic are both lateralized to the left hemisphere in the majority of right-handed adults. Yet, does this similar lateralization reflect a single overall constraint of brain organization, such an overall "dominance" of the left hemisphere for all linguistic and symbolic operations? Is it related to the lateralization of specific…

  2. 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.)

  3. Transverse divergent dislocation of elbow in a child: a case report and review of current literature.

    Science.gov (United States)

    George, Harvey L; Unnikrishnan, Puthanveetil Nithin; Bass, Alfie; Waseem, Mohammed; Brownson, Peter

    2011-05-01

    We present a case report on transverse divergent dislocation of the elbow, highlighting the spatial relation among the proximal radius, ulna, and distal humerus in this rare pediatric elbow injury and reasons leading to misinterpretation of radiographs. Elbow dislocation is a rare injury in children. It comprises only 6% of pediatric elbow injuries. Most pure dislocations are posterior, but they can occur in any direction. Divergent dislocation of the elbow is a subgroup of posterior dislocation, which is extremely rare. It is important that the pediatric emergency physician is aware, able to identify, and manage this injury. It is defined as a specific elbow dislocation in which the distal humerus is forced between the proximal radius and ulna, resulting in the divergence of the proximal forearm bones. Joint laxity is said to be a predisposing cause in pediatric age group. Atraumatic divergent dislocation of the elbow has been reported in the adults with rheumatoid arthritis. Imaging is challenging because there is no defined specific radiological views, therefore making the diagnosis difficult. This often leads to misdiagnosis or inappropriate treatment. A thorough understanding of mechanism of injury and basis for atypical radiological findings will help in identifying the injury early, and the simple Thompson technique to relocate the elbow will give an excellent functional outcome.

  4. 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.

  5. 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.

  6. Acute effects of one session dry needling on a chronic golfer's elbow disability.

    Science.gov (United States)

    Shariat, Ardalan; Noormohammadpour, Pardis; Memari, Amir Hossein; Ansari, Noureddin Nakhostin; Cleland, Joshua A; Kordi, Ramin

    2018-02-01

    A 40-year-old retired male elite athlete with more than 20 years' experience in wrestling and bodybuilding with mild elbow pain and disability of 2 years presented to our clinic reporting an acute pain in medial aspect of the elbow. Physical examination revealed symptoms of left Golfer's elbow during target-directed movements. The results of sonography in left elbow showed low level of hypo echo irregularity and increased blood flow in color Doppler mode in the common flexor origin. The pain amplitude was moderate at rest and extremely high during kinetic and intentional movements. During last 2 years, the patient tried different types of therapy including manual therapy, Transcutaneous electrical nerve stimulation and also received a variety of injections none of which were effective for reducing pain and disability. This is the first study showed that one sessions of dry needling improved both pain and disability and helped to return to a normal life and exercise training.

  7. Arthroscopic Treatment of Septic Arthritis of the Elbow in a 4-Year-Old Girl

    Directory of Open Access Journals (Sweden)

    Masashi Koide

    2015-01-01

    Full Text Available Pediatric septic arthritis is uncommon and has been traditionally treated by joint aspiration or open arthrotomy. There are some reports about arthroscopic surgery in pediatric septic arthritis of the knee, hip, and shoulder. However, there is no report for the case of elbow. We report a case of pediatric septic arthritis of elbow treated with arthroscopically with good clinical condition at 3-year follow-up. This paper is based on a report first published in Japanese (Tojo (2012.

  8. [Free functional gracilis muscle transplantation for reconstruction of active elbow flexion in posttraumatic brachial plexus lesions].

    Science.gov (United States)

    Berger, Alfred; Hierner, Robert

    2009-06-01

    Reconstruction of powerful active elbow flexion. Reconstruction of missing muscle unit by neurovascular pedicled functional muscle transplantation. Treatment of last choice for --secondary reconstruction of active elbow flexion in case of complete lesion of the brachial plexus or musculocutaneous nerve (M0 muscle function = replacement indication), partial but incomplete lesion of the brachial plexus or musculocutaneous nerve (M1-(3) muscle function = augmentation indication); --replacement of the elbow flexor muscles in case of primary muscle loss (tumor, trauma). Concomitant lesions of the axillary artery. No adequate donor nerve. Relative: no sensibility at all at the forearm and hand. Free functional biarticular myocutaneous transplantation of gracilis muscle. A myocutaneous gracilis flap is raised at the thigh. At the upper arm the flap is fixed proximally to the coracoid process or the lateral clavicle. The distal insertion is sutured to the distal biceps tendon. Vascular anastomoses are carried out in end-to-side fashion with the brachial artery and vein. Nerval coaptation is done in end-to-end technique using the muculocutaneous nerve. Complete immobilization for 6 weeks. Dorsal upper arm splint until sufficient muscle power (M(4)). Progressive increase of active range of motion for another 6 weeks. Continuation of physiotherapy for 12-18 months. Postoperative standardized compression therapy, combined with scar therapy (silicone sheet). Functionally useful results can be expected in 60-75% of patients, especially if there is some residual function (M1 or M2) left ("augmentation indication"). Early free functional muscle transplantation shows best results in patients with direct muscle defect, because all vascular and neuronal structures are still available, and no secondary changes such as fibrosis or joint stiffness are present yet. There are inconsistent results for patients with neurologic insufficiency (i.e., total brachial plexus palsy) or mixed

  9. Novel insights in elbow trauma

    NARCIS (Netherlands)

    Claessen, F.M.A.P.

    2016-01-01

    Musculoskeletal trauma is among the ten most common causes for loss of healthy life years (disability adjusted life years) in Western Countries. Nine percent of all musculoskeletal trauma is related to the elbow; in athletes the prevalence is 11 percent. Approximately 80 percent of patients that had

  10. 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.

  11. 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...

  12. [Does coexistant fractures impair the results of treatment of elbow dislocations in children?].

    Science.gov (United States)

    Lejman, Tadeusz; Kowalczyk, Bartłomiej; Feluś, Jarosław

    2006-01-01

    We present 33 children with 34 elbow dislocations. In 22 cases concomittant fractures around the elbowe were noted: 13 displaced medial epicondyle fractures, 5 radial neck fractures, 2 radial head fractures, 2 coronoid process fractures, 1 olecranon fracture, 1 lateral condyle fracture, 1 medial condyle fracture. In 5 children more than one concomittant fracture were noted. The mean age during dislocation was 11 years (from 4 to 15), the mean follow up period was 3.5 years (from 2 to 5). On follow up a clinical examination of the elbow was performed including axis assesment and elbow ROM. X-ray were taken in all children in AP and lateral view. All children had a satisfying function of the extremity and no pain was noted. No difference in ROM was noted in children with isolated elbow dislocation or with concomittant medial epicondyle fractures however in 3 of those children a persistent flexion contracture was observed. Among children with other fractures poorer results occured in 3 patients, specially after displaced radial neck fractures. In one of them there was slight supination and pronation restriction, in second a complete ankylosis of proximal radioulnar joint occured in neutral forearm position. In one child after elbow dislocation and medial condyle fracture a late radial dislocation occured. We think that concomitant medial epicondyle fracture does not impare good results of elbow dislocation treatment if well recognised and treated. Other fractures, specially radial neck fractures, increase the risk of complications.

  13. Elbow septic arthritis associated with pediatric acute leukemia: a case report and literature review.

    Science.gov (United States)

    Uemura, Takuya; Yagi, Hirohisa; Okada, Mitsuhiro; Yokoi, Takuya; Shintani, Kosuke; Nakamura, Hiroaki

    2015-01-01

    Acute leukemia in children presents with various clinical manifestations that mimic orthopaedic conditions. The association of septic arthritis of the elbow with acute leukemia is very rare, and the correct diagnosis of acute leukemia is often established only after treatment of the septic arthritis. In this article, we present a three-year-old child patient with elbow septic arthritis related to acute leukemia, diagnosed promptly by bone marrow aspiration on the same day as emergency surgical debridement of the septic elbow joint due to the maintenance of a high index of suspicion, and treated with chemotherapy as soon as possible. The emergency physician and orthopaedist must recognize unusual patterns of presentation like this. Since delay in initiating treatment of septic arthritis may result in growth disturbance, elbow septic arthritis associated with pediatric acute leukemia must be treated promptly and appropriately. Early diagnosis is a good prognostic feature of childhood acute leukemia.

  14. A rare paediatric trauma: Lateral condyle humerus fracture with concomitant postero-medial elbow dislocation.

    Directory of Open Access Journals (Sweden)

    Monappa Naik

    2015-12-01

    Full Text Available The association of elbow dislocation with fracture of the lateral condyle in paediatrics is considered very rare and only a few isolated cases have been reported in the literature. Due to its rarity, some of the authors have classified this injury as a complex elbow injury and have deemed them technically demanding to repair. A ten-year-old boy presented to us with a lateral condyle humerus fracture [Milch type 2] with concomitant postero-medial elbow dislocation following a fall on his outstretched hand. At 34 months of follow-up, the child regained a full range of motions around the elbow joint without any deformities.This combination injury, although rare, is not technically different or difficult to treat. [Hand Microsurg 2015; 4(3.000: 75-78

  15. Sideswipe injuries around the elbow: Management and functional evaluation.

    Science.gov (United States)

    Kharbanda, Yatinder; Sharma, Mrinal; Singh, Kuldeep; Kumar, Lokesh

    2013-07-01

    Sideswipe injuries constitute a subgroup of complex elbow trauma. Almost all of these are high energy open injuries. There is no fixed protocol that is followed in the earlier studies. The injury pattern is grotesque and ill managed with poor functional outcome. We report the functional outcome in our series of patients who sustained sideswipe injuries. Thirty four patients presenting with sideswipe injuries around the elbow were managed and functional results evaluated. The patients were followed for 15-94 months (mean 74 months). 32 of these were males and two were females. The injuries were sustained between 8 years and 48 years age group (mean 30 years). The right side was affected in 20 and left side was injured in 14 patients. Road traffic accident was the cause in all patients. Principles of management followed were (1) debridement and stabilization of fractures, (2) vascular repair, (3) redebridement, (4) nerve repair and (5) soft tissue cover. An external fixator was used for fracture stabilization in 20 patients with open fractures. Internal fixation was used as a stabilization modality in 12 patients. Primary nerve repair was carried out in 4 cases. In case of segmental loss, tendon transfers or nerve grafting was carried out at a later date once softtissue healing was complete. Soft tissue coverage was provided within 24-48 h of injury. Results were evaluated using the Mayo elbow performance score. The average Mayo elbow performance score was 70. Excellent results (score > 90) in accordance with Mayo elbow score were seen in 30% of the patients. Good results (score 75-89) were seen in 33% of the patients. Sideswipe injuries should be managed timely, aggressively and an algorithmic protocol should be followed to achieve best results. The injury pattern is distinct for which a multispecialty approach is needed and an orthopedic, vascular and plastic surgeon must be involved. Limb salvage is possible in most cases.

  16. 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

  17. Osteochondritis dissecans of the elbow.

    Science.gov (United States)

    Nissen, Carl W

    2014-04-01

    Osteochondritis dissecans affects the elbow of many young, skeletally immature athletes. The incidence of OCD in the elbow is second to its occurrence in the knee and similar to the incidence in the ankle. Young, athletically active individuals are at increased risk for developing this problem. There is a predilection for those involved in overhead-dominant sports and sports that require the arm to be a weight-bearing limb. The diagnosis is occurring earlier because of an increased awareness of the entity and the increased use of advanced imaging techniques, primarily magnetic resonance imaging. This earlier diagnosis has led to an increase in treatment ideas and modalities and ultimately improved care and outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. 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.

  19. Pre- and Postseason Dynamic Ultrasound Evaluation of the Pitching Elbow.

    Science.gov (United States)

    Keller, Robert A; Marshall, Nathan E; Bey, Michael J; Ahmed, Hafeez; Scher, Courtney E; van Holsbeeck, Marnix; Moutzouros, Vasilios

    2015-09-01

    To use ultrasound imaging to document changes over time (i.e., preseason v postseason) in the pitching elbow of high school baseball pitchers. Twenty-two high school pitchers were prospectively followed. Pitchers were evaluated after a 2-month period of relative arm rest via preseason physical exams, dynamic ultrasound imaging of their throwing elbow, and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) assessment. Players were reevaluated within 1 week of their last game. Dynamic ultrasound images were then randomized, blinded to testing time point, and evaluated by 2 fellowship-trained musculoskeletal radiologists. Average pitcher age was 16.9 years. Average pitches thrown was 456.5, maximum velocity 77.7 mph, games pitched 7.3, and days off between starts 6.6. From preseason to postseason, there were significant increases in ulnar collateral ligament (UCL) thickness (P = .02), ulnar nerve cross-sectional area (P = .001), UCL substance heterogeneity (P = .001), and QuickDASH scores (P = .03). In addition, there was a nonsignificant increase in loaded ulnohumeral joint space (P = .10). No pitchers had loose bodies on preseason exam, while 3 demonstrated loose bodies postseason. The increase in UCL thickness was significantly associated with the number of bullpen sessions per week (P = .01). The increase in ulnar nerve cross-sectional area was significantly associated with the number of pitches (P = .04), innings pitched (P = .01), and games pitched (P = .04). The stresses placed on the elbow during only one season of pitching create adaptive changes to multiple structures about the elbow including UCL heterogeneity and thickening, increased ulnohumeral joint space laxity, and enlarged ulnar nerve cross-sectional area. Level II prospective observational study. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  20. Radiosynovectomy for the treatment of rheumatoid arthritis of the elbow

    International Nuclear Information System (INIS)

    Rozeboom, S.; Doerr, U.; Bihl, H.

    2001-01-01

    The aim of this retrospective study was to evaluate the efficiacy of radiosynovectomy (RSO) in patients with rheumatoid elbow arthritis. Patients and Methods: 40 joints of 31 patients were evaluated. At the time of therapy, patients had been suffering from elbow arthritis for 17.5 months (2-72 months). 95% of the joints (n = 38) had severe daily pain or continuous pain, 97.5% (n = 39) had moderate to severe limitation of the mobility and 10% (n = 4) had severe swelling. RSO was performed by intraarticulaer injection of 74 MBq colloidal rhenium-186 and 15 mg triamcinolonehexacetonide. Before and six to 26 months after therapy (median follow-up 14.7 months) severity of the patients pain, mobility and swelling (transferred to a scoring system) were determined with a standardised questionaire. A clinical re-evaluation, along with an arthrosonographical follow-up was performed in 28 joints. Results: A ''good to very good'' overall long-term response was achieved in 80% (n = 32) of the treated joints and a temporary response in 10% (n = 4). Only 10% (n = 4) had a non-satisfactory response due to advanced articular destruction. The range of motion for flexion-extension increased from 103.8 ± 20.0 degrees to 144.0 ± 12.8 degrees (p [de

  1. 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.

  2. 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.

  3. 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.

  4. Effect of elbow flexion angles on stress distribution of the proximal ulnar and radius bones under a vertical load: measurement using resistance strain gauges.

    Science.gov (United States)

    Rao, Zhi-Tao; Yuan, Feng; Li, Bing; Ma, Ning

    2014-07-31

    This study aimed to explore the surface stress at the proximal ends of the ulna and radius at different elbow flexion angles using the resistance strain method. Eight fresh adult cadaveric elbows were tested. The forearms were fixed in a neutral position. Axial load increment experiments were conducted at four different elbow flexion angles (0°, 15°, 30°, and 45°). Surface stain was measured at six sites (tip, middle, and base of the coronoid process; back ulnar notch; olecranon; and anterolateral margin of the radial head). With the exception of the ulnar olecranon, the load-stress curves at each measurement site showed an approximately linear relationship under the four working conditions studied. At a vertical load of 500 N, the greatest stress occurred at the middle of the coronoid process when the elbow flexion angles were 0° and 15°. When the flexion angles were 30° and 45°, the greatest stress occurred at the base of the coronoid process. The stress on the radial head was higher than those at the measurement sites of the proximal end of the ulna. The resistance strain method for measuring elbow joint surface stress benefits biomechanics research on the elbow joint. Elbow joint surface stress distributions vary according to different elbow flexion angles.

  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. 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.

  7. 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

  8. 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

  9. Wave path calculation for phased array imaging to evaluate weld zone of elbow pipes (Conference Presentation)

    Science.gov (United States)

    Park, Choon-Su; Park, Jin Kyu; Choi, Wonjae; Cho, Seunghyun; Kim, Dong-Yeol; Han, Ki Hyung

    2017-04-01

    It has long been non-destructively evaluated on weld joints of various pipes which are indispensable to most of industrial structures. Ultrasound evaluation has been used to detect flaws in welding joints, but some technical deficiencies still remain. Especially, ultrasound imaging on weld of elbow pipes has many challenging issues due to varying surface along circumferential direction. Conventional ultrasound imaging has particularly focused on ultrasonic wave propagation based on ray theory. This confines the incident angle and the position of an array transducer as well. Total focusing method (TFM), however, can provide not only high resolution images but also flexibility that enables to use ultrasonic waves to every direction that they can reach. This leads us to develop a method to get images of weld zone from an elbow part that curves. It is inevitable of each ultrasonic wave from the array transducer to transmit through different media and to be reflected from the boundary with angles along the curved surface. To form a correct PA image, careful calculation is made to ensure that time delay of receive-after-transmit is correctly shifted and summed even under non-planar boundary condition. Here, a method to calculate wave paths for the zone of interest at weld joint of an elbow pipe is presented. Numerical simulations of wave propagation on an elbow pipe are made to verify the proposed method. It is also experimentally demonstrated that the proposed method is well applied to various actual pipes that contains artificial flaws with a flexible wedge.

  10. Elbow Injuries and Disorders - Multiple Languages

    Science.gov (United States)

    ... Translations Spanish (español) Expand Section Elbow Injuries and Disorders: MedlinePlus Health Topic - English ... Health Information Translations Characters not displaying correctly on this page? See language display issues . Return to the MedlinePlus Health Information ...

  11. 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

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

    Science.gov (United States)

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

    2017-02-01

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

  13. A Quantified Description of the Coupling between the Reaching Direction and Elbow Axis Direction

    Directory of Open Access Journals (Sweden)

    M. M. Stanišić

    2007-01-01

    Full Text Available The human body continues to be an inspiration for the work of a myriad of different fields, both scientific and mathematic. In particular, robotics draws upon the motions and relationships of different human systems in order to reproduce similar mobility while performing different tasks. The human shoulder–arm–elbow complex has been one of the most difficult to exactly replicate. This paper examines the relationship between the motion of the shoulder while positioning the center of the wrist during voluntary arm movements and the resulting orientation of the arm, in particular the direction of the axis passing through the elbow joint. Experimental data is presented that was used to quantify this coupling between the reaching direction of the arm and the elbow axis direction. The results from this paper are two surface-fit equations that can be used to determine the elbow axis direction when given the location of the wrist center. These results are useful when considering the design and control of shoulder–arm–elbow complex models.

  14. 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

  15. Monitoring total-body inflammation and damage in joints and entheses

    DEFF Research Database (Denmark)

    Axelsen, M. B.; Eshed, I.; Østergaard, M.

    2017-01-01

    and axial joints was 82–100%, being less for elbows and small joints of the feet. For entheses, 72–100% were readable, except for entheses at the anterior chest wall, elbow, knee, and plantar fascia. The intrareader agreement was high for bone marrow oedema (BMO), bone erosion (80–100%), and enthesitis (77...

  16. Anterior Elbow Subluxation After Radial Head Arthroplasty for Fracture Dislocation of the Elbow

    Directory of Open Access Journals (Sweden)

    Chan Wai-Kit

    2010-12-01

    Full Text Available We describe a case of elbow dislocation with Hotchkiss type III radial head fracture and Regan-Morrey type II coronoid process fracture, which was treated with radial head replacement. It was complicated with oversizing of prosthesis, resulting in elbow subluxation. It was treated with radial shaft shortening osteotomy. The clinical result was satisfactory.

  17. 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.

  18. 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.)

  19. CT assessment of the influence of dynamic loading on physiological incongruency of the canine elbow.

    Science.gov (United States)

    Burton, N J; Warren-Smith, C M R; Roper, D P; Parsons, K J

    2013-06-01

    To present a novel technique for loading of the canine elbow joint and to quantify changes in congruency with increasing load using computed tomography. Five pairs of thoracic limbs were mounted at a mid stance angle in a custom made jig. Elbow joints were loaded to 0, 33, 66 and 100% of total individual cadaver bodyweight. At each load computed tomography of the elbow was performed. Joint space measurement was performed on sagittal plane central, lateral and medial compartment images at humero-radial (R1 , R2 , R3 ), humero-ulnar (U1 , U2 ) and radio-ulnar loci. The effect of loading on joint spaces was assessed (Phumero-radio-ulnar congruency occurred suggesting pronation of the radius with respect to the ulna was induced during loading. This movement may influence the load experienced by the medial coronoid process and could play a role in the aetiopathogenesis of medial coronoid process disease. © 2013 British Small Animal Veterinary Association.

  20. Acute effects of one session dry needling on a chronic golfer’s elbow disability

    Science.gov (United States)

    Shariat, Ardalan; Noormohammadpour, Pardis; Memari, Amir Hossein; Ansari, Noureddin Nakhostin; Cleland, Joshua A.; Kordi, Ramin

    2018-01-01

    A 40-year-old retired male elite athlete with more than 20 years’ experience in wrestling and bodybuilding with mild elbow pain and disability of 2 years presented to our clinic reporting an acute pain in medial aspect of the elbow. Physical examination revealed symptoms of left Golfer’s elbow during target-directed movements. The results of sonography in left elbow showed low level of hypo echo irregularity and increased blood flow in color Doppler mode in the common flexor origin. The pain amplitude was moderate at rest and extremely high during kinetic and intentional movements. During last 2 years, the patient tried different types of therapy including manual therapy, Transcutaneous electrical nerve stimulation and also received a variety of injections none of which were effective for reducing pain and disability. This is the first study showed that one sessions of dry needling improved both pain and disability and helped to return to a normal life and exercise training. PMID:29511665

  1. 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.

  2. The Effect of Dopaminergic Medication on Joint Kinematics during Haptic Movements in Individuals with Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Kuan-yi Li

    2017-01-01

    Full Text Available This study examined whether altered joint angular motion during haptic exploration could account for a decline in haptic sensitivity in individuals with PD by analyzing joint position data during haptic exploration of a curved contour. Each participant’s hand was passively moved by a robotic arm along the edges of a virtual box (5 cm × 15 cm with a curved left wall. After each trial, participants indicated whether the contour was curved or straight. Visual, auditory, and tactile cues were occluded, and an electrogoniometer recorded shoulder and elbow joint angles during each trial. The PD group in the OFF state had a higher mean detection threshold (4.67 m−1 than the control group (3.06 m−1. Individuals with PD in the OFF state also had a significantly greater magnitude of shoulder abduction than those in the ON state (p=0.003 and a smaller magnitude of elbow flexion than those in the ON state or compared to the control group (both p<0.001. These findings suggest that individuals with PD employ joint configurations that may contribute to haptic insensitivity. Dopamine replacement therapy improved joint configurations during haptic exploration in patients with PD, suggesting a role for dopaminergic dysfunction in PD-related haptic insensitivity.

  3. Magnetic Resonance Imaging in Pediatric Elbow Fractures

    International Nuclear Information System (INIS)

    Pudas, T.; Hurme, T.; Mattila, K.; Svedstroem, E.

    2005-01-01

    Purpose: Magnetic resonance imaging (MRI) evaluation of pediatric elbow trauma with or without a visible fracture on radiography. Material and Methods: MRI was performed in the acute phase in 25 children with an elbow injury. Nine patients with an elbow effusion only on radiographs and 16 with a fracture or luxation seen on radiographs underwent subsequent MRI. No sedation was used. Results: MRI revealed eight occult fractures (89%) in seven out of nine patients who had only an effusion on radiographs. Based on MRI findings, septic arthritis was suspected in one patient. Two patients out of five with a supracondylar fracture on the radiograph had a cartilage lesion in the humerus. MRI depicted a 3-mm gap on the articular surface in two patients with a lateral condyle fracture, a more accurate fracture location in two patients than the radiographs, and an additional occult fracture in two patients. MRI showed a fracture not seen on radiographs in two of three patients with prior luxation. Conclusion: MRI is a sensitive and accurate method in the diagnosis of pediatric elbow injuries, especially when only an effusion is present on radiographs. Occult fractures are more common in pediatric patients with elbow injury than reported earlier

  4. ANALYSIS OF THE PATTERN AND MECHANISM OF ELBOW INJURIES RELATED TO ARMBAR-TYPE ARMLOCKS IN JIU-JITSU FIGHTERS.

    Science.gov (United States)

    Almeida, Thiago Bernardo Carvalho DE; Dobashi, Eiffel Tsuyoshi; Nishimi, Alexandre Yukio; Almeida, Eduardo Bernardo DE; Pascarelli, Luciano; Rodrigues, Luciano Miller Reis

    2017-01-01

    The objective of this study was to analyze elbow injuries and their probable mechanism in Jiu-Jitsu fighters resulting from the armbar-type armlock. We evaluated 5 high-performance Jiu-Jitsu fighters from the Gracie Elite gym who were injured during a tournament. All were healthy males with a mean age of 28.8 years. The right arm was involved in three patients (60%). The athletes were followed for approximately 4.6 months, and pain was present in all cases. Clinical examination of the elbow was performed immediately after the injury and when magnetic resonance imaging (MRI) was performed. The radiography showed no changes. Clinical examination detected specific tender points on the medial and anterior topography of the elbows, but no ligamentous instability of the elbow was seen during dynamic testing. The main MRI findings were injury to the common flexor tendon and the ulnar collateral ligament, bone contusion of the distal humerus and olecranon, and joint effusion. The main pattern of injury indicated by the MRI in the athletes was injury to the medial elbow complex. The primary mechanism that determined the injury was most likely elbow hyperextension applied with the forearm in neutral position of forearm. Level of Evidence IV, Case Series.

  5. Reduction in the incidence of elbow dysplasia in four breeds of dog as measured by the New Zealand Veterinary Association scoring scheme.

    Science.gov (United States)

    Worth, A J; Bridges, J P; Jones, G

    2010-08-01

    To determine if there has been any reduction in the incidence of elbow dysplasia in four popular large-dog breeds as measured by the New Zealand Veterinary Association (NZVA) scoring scheme. A retrospective analysis of the NZVA elbow dysplasia database was performed using records of all German Shepherd dogs, Labrador Retrievers, Golden Retrievers and Rottweilers that had undergone evaluation since the scheme's inception in 1992. The data for each dog included date of birth, date of radiography, gender, grade of left and right elbow (0, 1, 2 or 3), and accredited or dysplastic status. Ordinal logistic regression was used to model the grade of the worst-affected elbow over time. The model included age at scoring and gender as additional variables. Given the known heritability of elbow dysplasia, the hypothesis was that if the NZVA scheme effectively identifies elbow dysplasia, and that dog breeders have been using the data responsibly, there should have been a trend towards a lower incidence of dogs graded dysplastic over time. In all four breeds, there was a significant trend towards lower grades of the worst-affected elbow over time. For German Shepherd dogs the incidence of elbow dysplasia (worst elbow grade not zero) fell from 75% to 47% between dogs born in 1991 vs those born in 2008. The corresponding figures were a drop from 86% to 68% for the Labrador Retriever, from 89% to 77% for Golden Retrievers, but only 98% to 95% for Rottweilers. In the Rottweiler and Golden Retriever, gender had a significant effect on the worst elbow grade. In the Golden Retriever, age at scoring also had a significant effect. There has been a significant reduction in the incidence of elbow dysplasia in four popular large-dog breeds as scored by the NZVA elbow dysplasia scoring scheme. The limitations of the study are the non-compulsory nature of the elbow dysplasia scheme, and the potential bias caused by dog breeders or veterinarians pre-screening potential submissions. The results

  6. 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

  7. 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.

  8. Prevalence and co-occurrence of hip dysplasia and elbow dysplasia in Dutch pure-bred dogs

    NARCIS (Netherlands)

    Lavrijsen, I.C.M.; Heuven, H.C.M.; Meij, B.P.; Theyse, L.F.H.; Nap, R.C.; Leegwater, P.A.J.; Hazewinkel, H.A.W.

    2014-01-01

    Hip as well as elbow dysplasia (HD, ED) are developmental disorders leading to malformation of their respective joints. For a long time both disorders have been scored and targeted for improvement using selective breeding in several Dutch dog populations. In this paper all scores for both HD and ED,

  9. Prevalence and co-occurrence of hip dysplasia and elbow dysplasia in Dutch pure-bred dogs

    NARCIS (Netherlands)

    Lavrijsen, Ineke; Heuven, Henri; Meij, Bjorn; Theyse, Lars; Nap, R.C.; Leegwater, Peter; Hazewinkel, Herman

    2014-01-01

    tHip as well as elbow dysplasia (HD, ED) are developmental disorders leading to malforma-tion of their respective joints. For a long time both disorders have been scored and targetedfor improvement using selective breeding in several Dutch dog populations. In this paperall scores for both HD and ED,

  10. Percutaneous Tennis Elbow Release Under Local Anaesthesia

    Science.gov (United States)

    Nazar, MA; Lipscombe, S; Morapudi, S; Tuvo, G; Kebrle, R; Marlow, W; Waseem, M

    2012-01-01

    Introduction: When the non-operative treatment of tennis elbow fails to improve the symptoms a surgical procedure can be performed. Many different techniques are available. The percutaneous release of the common extensor origin was first presented by Loose at a meeting in 1962. Despite the simplicity of the operation and its effectiveness in relieving pain with minimal scarring this procedure is still not widely accepted. This study presents the long-term results of percutaneous tennis elbow release in patients when conservative measures including local steroid injections have failed to relieve the symptoms. Patients and Methods: Percutaneous release of the extensor origin was performed in 24 consecutive patients (seven male and seventeen female), providing 30 elbows for this study. The age of the patients ranged from 26 to 71 years with mean age of 55 years. The technique involved a day case procedure in the operating theatre using local anaesthesia without the need for a tourniquet. The lateral elbow was infiltrated with 5mls 1% lignocaine and 5mls 0.5% bupivicaine with 1:200,000 adrenaline. All operations were performed by the senior author. The patients were assessed post operatively by using DASH (disabilities of arm, shoulder and hand) score and Oxford elbow scores. The mean follow up period was 36 months (1-71months). Results: Twenty one patients returned the DASH and Oxford elbow questionnaires. Four patients were lost in the follow up. The post operative outcome was good to excellent in most patients. Eighty seven percent of patients had complete pain relief. The mean post-op DASH score was 8.47 (range 0 to 42.9) and the mean Oxford elbow score was 42.8 (range 16 to 48). There were no complications reported. All the patients returned to their normal jobs, hobbies such as gardening, horse riding and playing musical instruments. Conclusion: In our experience Percutaneous release of the epicondylar muscles for humeral epicondylitis has a high rate of success

  11. 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

  12. 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...

  13. 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...

  14. 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

  15. [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

  16. 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.

  17. A test of the validity of range of motion studies of fossil archosaur elbow mobility using repeated-measures analysis and the extant phylogenetic bracket.

    Science.gov (United States)

    Hutson, Joel D; Hutson, Kelda N

    2012-06-15

    Recent studies have presented range of motion (ROM) data in degrees for dinosaur forelimb joints, usually via physical manipulation of one individual. Using these data, researchers have inferred limb orientations, postures, gaits, ecological functions and even phylogenetic trends within clades. However, important areas of concern remain unaddressed; for example, how does ROM at a forelimb joint change after soft tissues are lost in archosaurs? And are fossil ROM methodologies amenable to reproducibility and statistical analysis? Here, we investigated these questions using the extant phylogenetic bracket of dinosaurs. Repeated measures of elbow joint ROM from Struthio camelus and Alligator mississippiensis forelimbs were statistically analyzed as they were sequentially dissected through five levels of tissue removal treatment. Our data indicate that there are no statistically significant differences in repeated measures of ROM between observers who use the same techniques. Extrinsic soft tissues, such as integument, muscles and ligaments were found to impede ROM at the elbow joint. Intrinsic soft tissues, such as articular cartilage, may increase ROM. The hypothesis that the articular surfaces of the bones within the elbow joints of archosaurs provide a general approximation of mobility is supported. Final ROMs were less than the initial ROMs in both taxa, which suggests that prior reports of elbow joint ROMs in degrees for nonavian dinosaurs may represent conservative estimates. We conclude that if observer bias and other variables are controlled for, ROM studies of fossil archosaur limbs can obtain useful degree data for inferring joint mobility in vivo.

  18. Subacromial Anesthetics Increase Proprioceptive Deficit in the Shoulder and Elbow in Patients With Subacromial Impingement Syndrome

    Directory of Open Access Journals (Sweden)

    Lucas R Ettinger

    2017-06-01

    Full Text Available Shoulder proprioception gives information regarding arm joint position and movement direction. Several studies have investigated shoulder proprioceptive acuity in patients with subacromial impingement syndrome (SIS; however, differences in protocols and between-subjects designs have limited scientific inferences regarding proprioception and SIS. We aimed to determine within-subject differences in shoulder and elbow proprioceptive acuity in 17 patients with stage 2 SIS following treatment of a local anesthetic injection. In addition, we used 17 healthy, age-, sex-, and arm dominance–matched controls to determine the magnitude of differences after treatment. Joint position sense (JPS was measured before and after treatment in both groups in the sagittal plane for the shoulder and elbow. Our results indicate that patients with SIS have less sensitivity to angular position and tended to overshoot their targets with greater variability during angle-matching tasks for the shoulder (1.8° difference, P  = .042 and elbow (5.6° difference, P  = .001 than controls. The disparities in JPS found in patients with SIS were not resolved following subacromial injection; in fact, the magnitude of the errors increased after treatment where postinjection errors were significantly greater ( P  = .046 than controls, with an average difference of 2.4°. These findings suggest that patients with SIS have decrements in either the signaling or processing of proprioceptive information and may use pain to reduce these inequalities.

  19. Subacromial Anesthetics Increase Proprioceptive Deficit in the Shoulder and Elbow in Patients With Subacromial Impingement Syndrome.

    Science.gov (United States)

    Ettinger, Lucas R; Shapiro, Matthew; Karduna, Andrew

    2017-01-01

    Shoulder proprioception gives information regarding arm joint position and movement direction. Several studies have investigated shoulder proprioceptive acuity in patients with subacromial impingement syndrome (SIS); however, differences in protocols and between-subjects designs have limited scientific inferences regarding proprioception and SIS. We aimed to determine within-subject differences in shoulder and elbow proprioceptive acuity in 17 patients with stage 2 SIS following treatment of a local anesthetic injection. In addition, we used 17 healthy, age-, sex-, and arm dominance-matched controls to determine the magnitude of differences after treatment. Joint position sense (JPS) was measured before and after treatment in both groups in the sagittal plane for the shoulder and elbow. Our results indicate that patients with SIS have less sensitivity to angular position and tended to overshoot their targets with greater variability during angle-matching tasks for the shoulder (1.8° difference, P = .042) and elbow (5.6° difference, P = .001) than controls. The disparities in JPS found in patients with SIS were not resolved following subacromial injection; in fact, the magnitude of the errors increased after treatment where postinjection errors were significantly greater ( P = .046) than controls, with an average difference of 2.4°. These findings suggest that patients with SIS have decrements in either the signaling or processing of proprioceptive information and may use pain to reduce these inequalities.

  20. 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

  1. Computed tomographic evaluation of elbow congruity during arthroscopy in a canine cadaveric model.

    Science.gov (United States)

    Skinner, O T; Warren-Smith, C M R; Burton, N J; Parsons, K J

    2015-01-01

    To assess the effect of arthroscope insertion, using a carbon-fibre rod model, on humero-radial, humero-ulnar and radio-ulnar congruity, as assessed by computed tomography (CT). Cadaveric Greyhound elbow joints were assessed at a flexion angle of 135 ± 5° using CT. For condition 1, a 36 mm fulcrum induced cubital valgus, as used to aid arthroscope insertion. For conditions 2 and 3, a single 1.8 or 2.5 mm diameter rod was inserted under arthroscopic guidance to simulate arthroscope position for assessment of the medial coronoid process. Repeat CT scans were obtained for all conditions and parasagittal sections were reconstructed to evaluate medial, axial and lateral positions within the elbow. Humero-radial, humero-ulnar, and radio-ulnar congruity measurements were obtained. Differences between groups were assessed using repeated measures analysis of variance. Mean (±SD) change in radio-ulnar step between conditions 1 and 3 was 0.6 ± 0.3 mm (axial), 0.8 ± 0.6 mm (medial), and 0.5 ± 0.1 mm (lateral). Insertion of rods induced a significant decrease in radio-ulnar step in all planes. Significant differences were also identified between groups for humero-radial, humero-ulnar, and radio-ulnar congruity. Insertion of carbon-fibre rods as a model for elbow arthroscope insertion induces elbow incongruity. Changes in radio-ulnar congruity are small but the effect of arthroscope diameter should be considered when assessing elbow congruity.

  2. ARTHROSCOPIC TREATMENT OF ELBOW CONTRACTURE IN SPORTSMAN

    Directory of Open Access Journals (Sweden)

    L. A. Kuznetsov

    2010-01-01

    Full Text Available This is an example of treatment of a professional sportsman with osteochondritis dissecans and flexion-extension contracture of an elbow. As a result of treatment it was proven, that the arthroscopic method of treatment undoubtedly had an obvious positive effect compared to the traditional non-operative treatment. The course of treatment for such patients with similar pathologies should be an active one - the use of arthroscopy followed by a rehabilitation in order to achieve the best result possible.

  3. 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.

  4. Performance of the 4-way range of motion test for radiographic injuries after blunt elbow trauma.

    Science.gov (United States)

    Vinson, David R; Kann, Gregory S; Gaona, Samuel D; Panacek, Edward A

    2016-02-01

    Acute elbow injuries are common in the acute care setting. A previous study observed that limited active range of motion (ROM) was highly sensitive for radiographic injuries after blunt trauma. Our aim was to validate these findings in patients ≥5 years old with an acute (undergoing plain radiographs of an injured elbow in 3 emergency departments. Before imaging, treating clinicians completed a standardized data collection sheet including mechanism of injury and 4-way ROM findings (full extension, flexion to 90°, full pronation and supination). Radiographic interpretation by a staff radiologist was used to ascertain the presence of fracture or joint effusion. The median age of the 251 patients was 24 years. Ninety-two patients (36.7%) had active 4-way ROM, and 159 patients (63.3%) demonstrated limited ROM. Negative radiographs were present in 152 patients (60.6%), whereas 99 patients (39.4%) had abnormal radiographs: 75 with explicit fractures and 24 with only joint effusions. The 4-way ROM elbow test had a sensitivity of 0.99 (95% confidence interval [CI], 0.94-1.00), specificity of 0.60 (95% CI, 0.52-0.68), positive predictive value of 0.62 (95% CI, 0.54-0.69), and negative predictive value of 0.99 (95% CI, 0.94-1.00). Active 4-way ROM test is 99% sensitive for all radiographic injures following blunt elbow trauma and 100% sensitive for injuries requiring surgical intervention. Caution should be used in relying on this test in the pediatric population until it is validated in a larger cohort. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Septic Arthritis of the Elbow in Children: Clinical Presentation and Microbiological Profile.

    Science.gov (United States)

    Nduaguba, Afamefuna M; Flynn, John M; Sankar, Wudbhav N

    2016-01-01

    Septic arthritis of the elbow in children is a rare but important musculoskeletal infection, and there is little published data to guide treating clinicians. The purpose of this study was to describe the clinical presentation and diagnostic findings, associated pathology, and microbiological profile of septic arthritis of the elbow in a pediatric population. We retrospectively analyzed a consecutive series of children who had an elbow arthrocentesis for presumed septic arthritis and whose joint aspirates were positive for microbial growth. Data collected included demographics, presenting signs and symptoms, imaging, and laboratory data, including culture results. Twelve children underwent diagnostic arthrocentesis of the elbow joint for septic arthritis at an average age of 6 years and 9 months (range, 2 mo to 13 y and 7 mo). Every child had pain, localized erythema and edema, and restricted range of motion; 10/12 were febrile. Mean duration of symptoms prior to joint tap was 4 days (range, 1 to 14 d). Concurrent osteomyelitis was found in 7 patients, as confirmed with magnetic resonance imaging (MRI): 5 at initial presentation and 2 after readmission for persistent symptoms. Causative pathogens were MSSA (7), MRSA (2), Group G streptococcus (1), Pseuodomonas aureginosa (1), and Streptococcus pneumonia (1). ESR was >40 mm/h in 8/11 patients, CRP was >2 mg/dL in all patients, and synovial WBC count was >50,000 cells/mm in 8/9 patients. One patient developed fulminant sepsis during hospitalization and 2 children were readmitted within 30 days of discharge for unrecognized osteomyelitis and/or recurrence of septic arthritis of the elbow. In 12 children studied with septic arthritis, S. aureus was the most common pathogen. Diagnosis is often delayed, and in most cases inflammatory markers were elevated (ESR>40 mm/h, CRP>2 mg/dL). Concomitant osteomyelitis is quite common, and therefore magnetic resonance imaging should be considered as part of the diagnostic work

  6. 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.

  7. 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.

  8. Evaluating the versatility of EEG models generated from motor imagery tasks: An exploratory investigation on upper-limb elbow-centered motor imagery tasks.

    Science.gov (United States)

    Zhang, Xin; Yong, Xinyi; Menon, Carlo

    2017-01-01

    Electroencephalography (EEG) has recently been considered for use in rehabilitation of people with motor deficits. EEG data from the motor imagery of different body movements have been used, for instance, as an EEG-based control method to send commands to rehabilitation devices that assist people to perform a variety of different motor tasks. However, it is both time and effort consuming to go through data collection and model training for every rehabilitation task. In this paper, we investigate the possibility of using an EEG model from one type of motor imagery (e.g.: elbow extension and flexion) to classify EEG from other types of motor imagery activities (e.g.: open a drawer). In order to study the problem, we focused on the elbow joint. Specifically, nine kinesthetic motor imagery tasks involving the elbow were investigated in twelve healthy individuals who participated in the study. While results reported that models from goal-oriented motor imagery tasks had higher accuracy than models from the simple joint tasks in intra-task testing (e.g., model from elbow extension and flexion task was tested on EEG data collected from elbow extension and flexion task), models from simple joint tasks had higher accuracies than the others in inter-task testing (e.g., model from elbow extension and flexion task tested on EEG data collected from drawer opening task). Simple single joint motor imagery tasks could, therefore, be considered for training models to potentially reduce the number of repetitive data acquisitions and model training in rehabilitation applications.

  9. A Biomechanical Analysis of the Association Between Forearm Mechanics and the Elbow Varus Moment in Collegiate Baseball Pitchers.

    Science.gov (United States)

    Solomito, Matthew J; Garibay, Erin J; Nissen, Carl W

    2018-01-01

    The incidence of upper extremity injury in baseball pitchers has increased over the past decade. This has resulted in a large body of research mainly focused on the kinematic and kinetic patterns of the elbow and shoulder to elucidate the cause of these injuries, with little attention on studying the associations of forearm rotation and upper arm joint moments. There will be significant differences in forearm kinematics and kinetics when comparing the fastball pitch with the curveball pitch. There will be a positive association between forearm kinetics, specifically supination and pronation moments, and the elbow varus moment. Descriptive laboratory study. A total of 78 pitchers were recruited for this study, and they underwent a pitching analysis using motion analysis techniques. A random-intercept, mixed-effects regression model was used to determine differences in forearm kinematics and kinetics when pitching a fastball compared with a curveball, as well as to determine if associations existed between forearm supination and pronation moments and the elbow varus moment. There were a number of significant differences in forearm position when pitching a fastball compared with a curveball, with the curveball producing a more supinated forearm position. Significant associations were found between increasing forearm supination moments and an increase in elbow varus moment for both the fastball and the curveball ( P = .002 and P varus moment for the fastball and curveball, respectively. The results demonstrated that the forearm position was not associated with the elbow varus moment. However, the supination moment was associated with the elbow varus moment. On the basis of these findings, pitching coaches and trainers can understand the implications of proper lower arm pitching mechanics in the later portion of the pitch cycle as a potential risk of injury and, therefore, can develop coaching strategies to reduce incorrect positioning, especially when players are

  10. 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.

  11. [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.

  12. 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

  13. Manipulative interventions for reducing pulled elbow in young children.

    Science.gov (United States)

    Krul, Marjolein; van der Wouden, Johannes C; Kruithof, Emma J; van Suijlekom-Smit, Lisette Wa; Koes, Bart W

    2017-07-28

    Pulled elbow (nursemaid's elbow) is a common injury in young children. It often results from a sudden pull on the arm, usually by an adult or taller person, which pulls the radius through the annular ligament, resulting in subluxation (partial dislocation) of the radial head. It can also be caused by a fall or twist. The child experiences sudden acute pain and loss of function in the affected arm. Pulled elbow is usually treated by manual reduction of the subluxed radial head. Various manoeuvres can be applied; most commonly, supination of the forearm, often combined with flexion, and (hyper-)pronation. It is unclear which is most successful. This is an update of a Cochrane review first published in 2009 and last updated in 2011. To compare the effects (benefits and harms) of the different methods used to manipulate pulled elbow in young children. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, LILACS, PEDro, clinical trial registers and reference lists of articles. Date of last search: September 2016. Randomised or quasi-randomised controlled clinical trials evaluating manipulative interventions for pulled elbow were included. Our primary outcome was failure at the first attempt, necessitating further treatment. Two review authors independently evaluated trials for inclusion, assessed risk of bias, and extracted data. We pooled data using a fixed-effect model. Overall, nine trials with 906 children (all younger than seven years old and 58% of whom were female) were included, of which five trials were newly identified in this update. Eight trials were performed in emergency departments or ambulatory care centres, and one was performed in a tertiary paediatric orthopaedic unit. Four trials were conducted in the USA, three in Turkey, one in Iran, and one in Spain. Five trials were at high risk of selection bias because allocation was not concealed and all

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. In vivo and 3-dimensional functional anatomy of the anterior bundle of the medial collateral ligament of the elbow.

    Science.gov (United States)

    Miyake, Junichi; Moritomo, Hisao; Masatomi, Takashi; Kataoka, Toshiyuki; Murase, Tsuyoshi; Yoshikawa, Hideki; Sugamoto, Kazuomi

    2012-08-01

    Although the anterior bundle of the medial collateral ligament (AMCL) is a critical stabilizer of the elbow joint, little information exists on in vivo and 3-dimensional functional anatomy of the AMCL. The purposes of this study were to investigate in vivo changes in the length of the AMCL during elbow flexion and to clarify the 3-dimensional functional anatomy of the AMCL. We created 3-dimensional models of the AMCL and bones from computed tomography data of 4 healthy elbows in 5 different elbow positions. The AMCL was subdivided into 9 ligaments. We calculated changes in lengths of ligaments during flexion and related ligament origins to the axis of rotation of the elbow joint. There were 4 uniquely configured isometric ligaments, where their origins aligned broadly along the course of the axis of rotation in the coronal plane. The medially originating ligaments inserted on the posterior portion of the tubercle of the coronoid process, whereas the laterally originating ligaments inserted on its anterior portion. There were 5 non-isometric ligaments, 3 of which had origins proximal to the axis and became taut only in extension and the other 2 having origins distal to the axis and becoming taut only in flexion. Isometric ligaments within the AMCL do not originate from a narrow area; rather, they originate from a broader area that extends more medially in the coronal plane than previously thought, which explains how the AMCL reconciles isometricity and robustness. The proximal and distal ligaments act as checkreins that work only at the limits of elbow motion. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  19. Ipsilateral dislocation of the shoulder and elbow: A case report

    African Journals Online (AJOL)

    Pr KODO

    There was deformity and painful swelling of the right shoulder and elbow. No neurovascular deficit was found and other clinical. findings were normal. Plain radiograph revealed ipsilateral anterior shoulder and posterior elbow dislocations (Fig 1). Under general anesthesia, the dislocations were readily reduced by closed.

  20. Results of open reduction for neglected elbow dislocations in adult ...

    African Journals Online (AJOL)

    Objective: To present the results of open reduction of neglected elbow dislocations using a consistent surgical protocol. Patients and methods: Between 2000 and 2005 eight patients with neglected elbow dislocations were operated on using the Speed\\'s posterior approach with lengthening of the triceps by V-Y ...

  1. 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

  2. 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...

  3. The treatment of recurrent posterolateral instability of the elbow

    DEFF Research Database (Denmark)

    Olsen, Bo Sanderhoff; Søjbjerg, Jens Ole

    2003-01-01

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

  4. 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)

  5. Non-Linear aspects of joint coordination in blackboard writing

    NARCIS (Netherlands)

    Bosga, J.; Meulenbroek, R.G.J.; Bouwhuisen, C.F.; Meulenbroek, R.G.J.; Steenbergen, B.

    2001-01-01

    The present study focuses on the inter-joint coordination of the shoulder, elbow and wrist joints in circular hand displacements that were performed in the sagittal and fronto-parallel plane. In the latter plane, the experimental task was comparable to blackboard writing. Twelve right-handed

  6. 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.

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

  8. Appendicular joint dislocations.

    Science.gov (United States)

    Hindle, Paul; Davidson, Eleanor K; Biant, Leela C; Court-Brown, Charles M

    2013-08-01

    This study defines the incidence and epidemiology of joint dislocations and subluxations of the appendicular skeleton. All patients presenting acutely to hospital with a dislocation or subluxation of the appendicular skeleton from a defined population were included in the study. There were 974 dislocations or subluxations over one year between the 1st November 2008 and the 31st October 2009. There was an overall joint dislocation incidence of 157/10(5)/year (188/10(5)/year in males and 128/10(5)/year in females). Males demonstrated a bimodal distribution with a peak incidence of 446/10(5)/year at 15-24 years old and another of 349/10(5)/year in those over 90 years. Females demonstrate an increasing incidence from the seventh decade with a maximum incidence of 520/10(5)/year in those over 90 years. The most commonly affected joints are the glenohumeral (51.2/10(5)/year), the small joints of the hand (29.9/10(5)/year), the patellofemoral joint (21.6/10(5)/year), the prosthetic hip (19.0/10(5)/year), the ankle (11.5/10(5)/year), the acromioclavicular joint (8.9/10(5)/year) and the elbow (5.5/10(5)/year). Unlike fractures, dislocations are more common in the both the most affluent and the most socially deprived sections of the population. Joint disruptions are more common than previously estimated. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Relationship of orthopedic examination, goniometric measurements, and radiographic signs of degenerative joint disease in cats.

    Science.gov (United States)

    Lascelles, B Duncan X; Dong, Yaa-Hui; Marcellin-Little, Denis J; Thomson, Andrea; Wheeler, Simon; Correa, Maria

    2012-01-27

    Available information suggests a mismatch between radiographic and orthopedic examination findings in cats with DJD. However, the extent of the discrepancy between clinical and radiographic signs of OA in companion animals has not been described in detail. This study aimed to evaluate the relationship between orthopedic examination findings, joint goniometry, and radiographic signs of DJD in 100 cats, in a prospective observational design. Cat temperament, pain response to palpation, joint crepitus, effusion and thickening were graded. Radiographs of appendicular joints and the axial skeleton were made under sedation. Joint motion was measured by use of a plastic goniometer before and after sedation. Associations between radiographic degenerative joint disease (DJD) and examination findings were assessed to determine sensitivity, specificity and likelihood estimations. Pain response to palpation was elicited in 0-67% of the joints with DJD, with a specificity ranging from 62-99%; crepitus was detected in 0-56% of the joints and its specificity varied between 87 and 99%; for effusion, values ranged between 6 and 38% (specificity, 82-100%), and thickening, 0-59% (specificity, 74-99%). Joints with DJD tended to have a decreased range of motion. The presence of pain increased the odds of having DJD in the elbow (right: 5.5; left: 4.5); the presence of pain in the lower back increased the odds of spinal DJD being present (2.97 for lumbar; 4.67 for lumbo-sacral). Radiographic DJD cannot be diagnosed with certainty using palpation or goniometry. However, negative findings tend to predict radiographically normal joints. Palpation and goniometry may be used as a tool to help to screen cats, mostly to rule out DJD.

  10. Relationship of orthopedic examination, goniometric measurements, and radiographic signs of degenerative joint disease in cats

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    Lascelles B Duncan X

    2012-01-01

    Full Text Available Abstract Background Available information suggests a mismatch between radiographic and orthopedic examination findings in cats with DJD. However, the extent of the discrepancy between clinical and radiographic signs of OA in companion animals has not been described in detail. This study aimed to evaluate the relationship between orthopedic examination findings, joint goniometry, and radiographic signs of DJD in 100 cats, in a prospective observational design. Cat temperament, pain response to palpation, joint crepitus, effusion and thickening were graded. Radiographs of appendicular joints and the axial skeleton were made under sedation. Joint motion was measured by use of a plastic goniometer before and after sedation. Associations between radiographic degenerative joint disease (DJD and examination findings were assessed to determine sensitivity, specificity and likelihood estimations. Results Pain response to palpation was elicited in 0-67% of the joints with DJD, with a specificity ranging from 62-99%; crepitus was detected in 0-56% of the joints and its specificity varied between 87 and 99%; for effusion, values ranged between 6 and 38% (specificity, 82-100%, and thickening, 0-59% (specificity, 74-99%. Joints with DJD tended to have a decreased range of motion. The presence of pain increased the odds of having DJD in the elbow (right: 5.5; left: 4.5; the presence of pain in the lower back increased the odds of spinal DJD being present (2.97 for lumbar; 4.67 for lumbo-sacral. Conclusions Radiographic DJD cannot be diagnosed with certainty using palpation or goniometry. However, negative findings tend to predict radiographically normal joints. Palpation and goniometry may be used as a tool to help to screen cats, mostly to rule out DJD.

  11. Intenzivna rehabilitacija osemletnega otroka po popolni amputaciji in replantaciji roke nad komolcem: Intensive rehabilitation of eight-year-old child after upper extremity replantation above the elbow:

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    Bajuk, Slavica; Damjan, Hermina; Korelc, Simona

    2008-01-01

    Background: The paper presents the rehabilitation of an 8-year-old left-handed boy after replantation of the left arm, which was amputated above the elbow by heavy workshop machinery. Methods: An intensive dynamic rehabilitation program for pain, edema, and function was performed and extended to 14 months based on continued improvement. Circumferential, range of motion (ROM), and muscle strength measurements of both upper extremities were taken to assess functionality of the replanted extremi...

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

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    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.

  13. Evaluation of common elbow pathologies: a focus on physical examination.

    Science.gov (United States)

    Laratta, Joseph; Caldwell, Jon-Michael; Lombardi, Joseph; Levine, William; Ahmad, Christopher

    2017-05-01

    Elbow tendinopathy accounts for the majority of elbow pathology in patients presenting to upper extremity and sports medicine surgeons. With increased participation in overhead sports in an aging population, the incidence of elbow injuries has risen. A comprehensive knowledge of elbow anatomy and biomechanical function of the elbow complex is prerequisite in the assessment of patients with elbow injuries; however, a thorough understanding of alternative and confounding pathologies is essential for accurate diagnosis. Because tendinopathy, tendonitis, and tendon tears have an anatomic basis for their pathology, a targeted history and meticulous physical examination often yields an accurate clinical diagnosis. The importance of physical examination and provocative examination maneuvers must be stressed in a technologically advanced era where clinical diagnosis is too commonly attained solely by advanced imaging modalities. A revived dedication to the physical examination may enhance our ability to correctly diagnose various pathologies about the elbow. Early and accurate clinical diagnosis is the first step in the proper initiation of treatment modalities and improvement in overall patient outcome.

  14. Upper limb joint dynamics during manual wheelchair propulsion.

    Science.gov (United States)

    Desroches, Guillaume; Dumas, Raphaël; Pradon, Didier; Vaslin, Philippe; Lepoutre, François-Xavier; Chèze, Laurence

    2010-05-01

    Inverse dynamic methods have been widely used to estimate joint loads during manual wheelchair propulsion. However, the interpretation of 3D net joint moments and powers is not always straightforward. It has been suggested to use joint coordinate systems (expression of joint moment on anatomical axes) and the 3D angle between joint moment and angular velocity vectors (propulsion, resistance or stabilization joint configuration) for a better understanding of joint dynamics. Nine spinal cord injured subjects equipped with reflective markers propelled in a wheelchair with an instrumented wheel. Inverse dynamic results were interpreted using joint coordinate systems, 3D joint power and the 3D angle between the joint moment and joint angular velocity vectors at the three upper limb joints. The 3D angle was used to determine if the joints were predominantly driven (angle close to 0 or 180 degrees) or stabilized (angle close to 90 degrees ). The wrist and elbow joints are mainly in a stabilization configuration (angle close to 90 degrees ) with a combination of extension and ulnar deviation moments and an adduction moment respectively. The shoulder is in a propulsion configuration, but close to stabilization (angle hardly below 60 degrees ) with a combination of flexion and internal rotation moments. Stabilization configuration at the joints could partly explain the low mechanical efficiency of manual wheelchair propulsion and could give insight about injury risk at the wrist, elbow and shoulder joints. Copyright 2009 Elsevier Ltd. All rights reserved.

  15. Mycobacterium avium intracellulare complex causing olecranon bursitis and prosthetic joint infection in an immunocompromised host

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    Eugene M. Tan

    2016-01-01

    Full Text Available Case: A 73-year-old immunocompromised male presented with recurrent left elbow swelling due to Mycobacterium avium intracellulare complex (MAC olecranon bursitis. 3 years after completing MAC treatment, he underwent right total knee arthroplasty (TKA. 1 year later, he developed TKA pain and swelling and was diagnosed with MAC prosthetic joint infection (PJI. He underwent TKA resection, reimplantation, and 12 months of anti-MAC therapy. This patient is the seventh case report of MAC olecranon bursitis and the third case report of MAC PJI. He is the only report of both MAC olecranon bursitis and PJI occurring in the same patient. Informed consent: This patient was informed and agreed to the publication of this material.

  16. 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.

  17. Ex vivo kinematic studies of a canine unlinked semi-constrained hybrid total elbow arthroplasty system.

    Science.gov (United States)

    Lorenz, N D; Channon, S; Pettitt, R; Smirthwaite, P; Innes, J F

    2015-01-01

    Introduction of the Sirius® canine total elbow arthroplasty system, and presentation of the results of a passive range-of-motion analysis based on ex vivo kinematic studies pre-and post-implantation. Thoracic limbs (n = 4) of medium sized dogs were harvested by forequarter amputation. Plain orthogonal radiographs of each limb were obtained pre- and post-implantation. Limbs were prepared by placement of external fixator pins and Kirschner wires into the humerus and radius. Each limb was secured into a custom-made box frame and retro-reflective markers were placed on the exposed ends of the pins and wires. Each elbow was manually moved through five ranges-of-motion manoeuvres. Data collected included six trials of i) full extension to full flexion and ii) pronation and supination in 90° flexion; a three-dimensional motion capture system was used to collect and analyse the data. The Sirius elbow prosthesis was subsequently implanted and the same measurements were repeated. Data sets were tested for normality. Paired t-tests were used for comparison of pre- and post-implantation motion parameters. Kinematic analysis showed that the range-of-motion (mean and SD) for flexion and extension pre-implantation was 115° ± 6 (range: 25° to 140°). The range-of-motion in the sagittal plane post-implantation was 90° ± 4 (range: 36° to 130°) and this reduction was significant (p = 0.0001). The ranges-of-motion (mean and SD) for supination and pronation at 90° were 50° ± 5, whereas the corresponding mean ranges-of-motion post-implantation were 38° ± 6 (p = 0.0188). Compared to a normal elbow, the range-of-motion was reduced. Post-implantation, supination and pronation range-of-motion was significantly reduced at 90° over pre-implantation values. These results provide valuable information regarding the effect of the Sirius system on ex vivo kinematics of the normal canine elbow joint. Further, this particular ex vivo model allowed for satisfactory and repeatable

  18. Multi-objective optimisation for musculoskeletal modelling: application to a planar elbow model.

    Science.gov (United States)

    Dumas, Raphaël; Moissenet, Florent; Lafon, Yoann; Cheze, Laurence

    2014-10-01

    One of the open issues in musculoskeletal modelling remains the choice of the objective function that is used to solve the muscular redundancy problem. Some authors have recently proposed to introduce joint reaction forces in the objective function, and the question of the weights associated with musculo-tendon forces and joint reaction forces arose. This question typically deals with a multi-objective optimisation problem. The aim of this study is to illustrate, on a planar elbow model, the ensemble of optimal solutions (i.e. Pareto front) and the solution of a global objective method that represent different compromises between musculo-tendon forces, joint compression force, and joint shear force. The solutions of the global objective method, based either on the minimisation of the sum of the squared musculo-tendon forces alone or on the minimisation of the squared joint compression force and shear force together, are in the same range. Minimising either the squared joint compression force or shear force alone leads to extreme force values. The exploration of the compromises between these forces illustrates the existence of major interactions between the muscular and joint structures. Indeed, the joint reaction forces relate to the projection of the sum of the musculo-tendon forces. An illustration of these interactions, due to the projection relation, is that the Pareto front is not a large surface, like in a typical three-objective optimisation, but almost a curve. These interactions, and the possibility to take them into account by a multi-objective optimisation, seem essential for the application of musculoskeletal modelling to joint pathologies. © IMechE 2014.

  19. 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.

  20. Simple elbow dislocations: a systematic review of the literature

    NARCIS (Netherlands)

    J. de Haan (Jeroen); N.W.L. Schep (Niels); P. Patka (Peter); D. den Hartog (Dennis)

    2010-01-01

    textabstractObjective: To identify if functional treatment is the best available treatment for simple elbow dislocations. Search strategy: Electronic databases MEDLINE, EMBASE, LILACS, and the Cochrane Central Register of Controlled Trials. Selection criteria: Studies were eligible for inclusion if

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

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    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

  2. 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

  3. 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.

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

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    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.

  5. Radiosynovectomy in haemophilic synovitis of elbows and ankles: Is the effectiveness of yttrium-90 and rhenium-186 different?

    Science.gov (United States)

    Rodriguez-Merchan, E C; De La Corte-Rodriguez, H

    2016-04-01

    Radiosynovectomy (RS) reduces the number of haemarthroses and the synovial size in chronic haemophilic synovitis. The purpose of this study was to quantitatively compare the effectiveness of two types of RS (yttrium-90 vs. rhenium-186) in terms of the objective improvement of haemarthroses and synovial size. Seventy RSs were performed in 70 joints (44 elbows, 26 ankles) of 70 haemophiliacs diagnosed with chronic synovitis. Yttrium-90 was used in 21 joints and rhenium-186 was used in 49 joints. The mean patient age was 20.61 years. RS resulted in significant improvement in the three variables studied (six months before RS vs. six months after RS), namely in the number of episodes of haemarthrosis (67.8% improvement); the size of the synovium as measured by means of a clinical scale (43.8% improvement) and imaging techniques in millimetres (26.7% improvement). We did not find significant statistical differences between yttrium-90 and rhenium-186 regarding their efficacy. No correlation was found between the results and other variables: age, joint (ankle or elbow), presence or absence of radiological involvement, type of haemophilia (A or B), grade of haemophilia (mild, moderate or severe), previous haematological treatment (on demand or prophylaxis), and the presence or absence of inhibitor Yttrium-90 RS and rhenium-186 RS were equally effective in reducing the number of haemarthroses and the size of the synovium in ankles and elbows in the short-term (6 months). No correlation was found between the results and other patients' characteristics. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. 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.

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

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    Nakanishi, Katsunuki [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-city, Osaka 565 (Japan); Masatomi, Takashi [Department of Orthopedic Surgery, Osaka University Medical School, Osaka (Japan); Ochi, Takahiro [Department of Orthopedic Surgery, Osaka University Medical School, Osaka (Japan); Ishida, Takeshi [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-city, Osaka 565 (Japan); Hori, Shinichi [Department of Radiology, Izumisano Municipal Hospital, Osaka (Japan); Ikezoe, Junpei [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-city, Osaka 565 (Japan); Nakamura, Hironobu [Department of Radiology, Osaka University Medical School, 2-2 Yamadaoka, Suita-city, Osaka 565 (Japan)

    1996-10-01

    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.

  8. Ultrasonic guided wave propagation in pipes with elbows

    Science.gov (United States)

    Breon, Luke J.

    Guided wave inspection of pipelines is an important and growing area of Non-Destructive Evaluation (NDE). This technique can be used for remote inspection or monitoring of buried pipelines, or pipelines with insulation. Guided waves are sensitive to flaws such as corrosion pits and cracks. They can be used to locate flaws existing on either the outer or the inner surface of a pipe. Guided wave energy focusing can be performed to concentrate guided wave energy at particular combinations of circumferential and axial locations in straight pipes. When it can be used, this practice enhances the circumferential resolution of defects. Elbows in a piping system are sufficiently disruptive to guided wave energy that the focusing methods used in practical inspections of straight pipe have not been extended to the region beyond an elbow. Counter-intuitively, elbows with a 45 degree bend are more harmful to guided waves than those with a 90 degree bend. A simple and elegant explanation for this phenomenon is provided in this dissertation. Theoretical advancements to guided wave physics propagating around an elbow have tended to be few and slow. This is at least partly due to the complexity of the mathematics involved in the conventional description of guided wave mechanics. Parametric focusing for pipes with bends has not been previously possible as it is for straight sections of pipes. While some techniques such as time-reversal mirrors and blind finite-element-method modeling have existed for focusing beyond elbows, these techniques have been limited and largely of academic value. Also, the understanding of wave behavior in a pipe elbow has in the past been generally unclear. Consequently, signal interpretation has also been very limited for guided waves initiating in, or returning from, the far side of an elbow. A new approach to understanding guided wave propagation is developed in this work. This understanding consists of the idea that the pathway a guided wave will take

  9. 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.

  10. Automatic anatomical calibration for IMU-based elbow angle measurement in disturbed magnetic fields

    Directory of Open Access Journals (Sweden)

    Laidig Daniel

    2017-09-01

    Full Text Available Inertial Measurement Units (IMUs are increasingly used for human motion analysis. However, two major challenges remain: First, one must know precisely in which orientation the sensor is attached to the respective body segment. This is commonly achieved by accurate manual placement of the sensors or by letting the subject perform tedious calibration movements. Second, standard methods for inertial motion analysis rely on a homogeneous magnetic field, which is rarely found in indoor environments. To address both challenges, we introduce an automatic calibration method for joints with two degrees of freedom such as the combined radioulnar and elbow joint. While the user performs arbitrary movements, the method automatically identifies the sensor-to-segment orientations by exploiting the kinematic constraints of the joint. Simultaneously, the method identifies and compensates the influence of magnetic disturbances on the sensor orientation quaternions and the joint angles. In experimental trials, we obtain angles that agree well with reference values from optical motion capture. We conclude that the proposed method overcomes mounting and calibration restrictions and improves measurement accuracy in indoor environments. It therefore improves the practical usability of IMUs for many medical applications.

  11. Effect of eccentric contraction velocity on muscle damage in repeated bouts of elbow flexor exercise.

    Science.gov (United States)

    Barroso, Renato; Roschel, Hamilton; Ugrinowitsch, Carlos; Araújo, Rubens; Nosaka, Kazunori; Tricoli, Valmor

    2010-08-01

    Eccentric exercise induces muscle damage, but controversy exists concerning the effect of contraction velocity on the magnitude of muscle damage, and little is known about the effect of contraction velocity on the repeated-bout effect. This study examined slow (60 degrees.s(-1)) and fast (180 degrees.s(-1)) velocity eccentric exercises for changes in indirect markers of muscle damage following 3 exercise bouts that were performed every 2 weeks. Fifteen young men were divided into 2 groups based on the velocity of eccentric exercise: 7 in the Ecc60 (60 degrees.s(-1)) group, and 8 in the Ecc180 (180 degrees.s(-1)) group. The exercise consisted of 30 maximal eccentric contractions of the elbow flexors at each velocity, in which the elbow joint was forcibly extended from 60 degrees to 180 degrees (full extension) on an isokinetic dynamometer. Changes in maximal voluntary isometric contraction strength, range of motion, muscle soreness, and plasma creatine kinase activity before and for 4 days after the exercise were compared in the 2 groups using a mixed-model analysis (groupxboutxtime). No significant differences between groups were evident for changes in any variables following exercise bouts; however, the changes were significantly smaller (pcontraction velocity does not influence muscle damage or the repeated-bout effect.

  12. Characterization and therapeutic application of canine adipose mesenchymal stem cells to treat elbow osteoarthritis.

    Science.gov (United States)

    Kriston-Pál, Éva; Czibula, Ágnes; Gyuris, Zoltán; Balka, Gyula; Seregi, Antal; Sükösd, Farkas; Süth, Miklós; Kiss-Tóth, Endre; Haracska, Lajos; Uher, Ferenc; Monostori, Éva

    2017-01-01

    Visceral adipose tissue (AT) obtained from surgical waste during routine ovariectomies was used as a source for isolating canine mesenchymal stem cells (MSCs). As determined by cytofluorimetry, passage 2 cells expressed MSC markers CD44 and CD90 and were negative for lineage-specific markers CD34 and CD45. The cells differentiated toward osteogenic, adipogenic, and chondrogenic directions. With therapeutic aims, 30 dogs (39 joints) suffering from elbow dysplasia (ED) and osteoarthritis (OA) were intra-articularly transplanted with allogeneic MSCs suspended in 0.5% hyaluronic acid (HA). A highly significant improvement was achieved without any medication as demonstrated by the degree of lameness during the follow-up period of 1 y. Control arthroscopy of 1 transplanted dog indicated that the cartilage had regenerated. Histological analysis of the cartilage biopsy confirmed that the regenerated cartilage was of hyaline type. These results demonstrate that transplantation of allogeneic adipose tissue-derived mesenchymal stem cells (AT-MSCs) is a novel, noninvasive, and highly effective therapeutic tool in treating canine elbow dysplasia.

  13. Biomechanical differences between left- and right-handed baseball pitchers.

    Science.gov (United States)

    Solomito, Matthew J; Ferreira, Joel V; Nissen, Carl W

    2017-06-01

    Left-handed baseball pitchers are thought to have a number of theoretical advantages compared to right-handed pitchers; however, there is limited scientific research detailing differences in the pitching mechanics of right- and left-handed pitchers. Therefore, this study sought to understand whether any kinematic and kinetic differences existed between right- and left-handed baseball pitchers. A total of 52 collegiate pitchers were included in this study; 26 left-handed pitchers were compared to 26 age-, height-, weight- and ball velocity-matched right-handed pitchers. Demographic information, passive shoulder range of motion and kinematic and kinetic data were obtained for each pitcher participating in the study. Results indicated that left-handed pitchers did not have a glenohumeral internal rotation deficit as compared to right-handed pitchers. Kinematic analysis indicated that elbow flexion, horizontal glenohumeral abduction and wrist coronal plane motion were significantly different between the two study cohorts. It was also noted that left-handed pitchers had increased elbow varus moments. The findings of this study suggest that pitching coaches should be aware that there are biomechanical differences between left- and right-handed pitchers.

  14. Radial head subluxation in an 8-year-old girl with joint hypermobility.

    Science.gov (United States)

    Barton, Marc Alan

    2010-01-01

    An 8-year-old girl attended the children's emergency department after having been play-fighting with her younger brother. Her arm had been pushed away by her father during the fight. The girl immediately complained of pain in her arm and refused to move it. Following analgesia and investigation with a plain radiograph of the elbow it was decided to attempt a manipulation procedure with the possibility that this could represent a 'pulled elbow' in an unusual age group. Soon after the manipulation the child was completely pain-free and moving her arm fully at the elbow, suggesting a diagnosis of radial head subluxation. The patient demonstrated hypermobility of several joints and she was able to hyperextend her unaffected elbow by >10°. This case highlights the association between radial head subluxation and joint hypermobility.

  15. Risk factors for shoulder and elbow pain in youth baseball players.

    Science.gov (United States)

    Matsuura, Tetsuya; Iwame, Toshiyuki; Suzue, Naoto; Arisawa, Kokichi; Sairyo, Koichi

    2017-05-01

    This study sought to quantify the 1-year cumulative incidence of shoulder and elbow pain among youth baseball players and identify risk factors associated with the occurrence of shoulder and elbow pain. In total, 900 youth baseball players (aged 7-11 years) were enrolled in a 1-year prospective follow-up study. One year later, the players were asked whether they had experienced episodes of shoulder or elbow pain and the following risk factors for such pain were investigated: age, position, length of baseball experience, training hours per week, and history of shoulder or elbow pain. Data for the groups with and without shoulder or elbow pain were analyzed using multivariate logistic regression models. Episodes of shoulder pain were reported by 18.3% of players and episodes of elbow pain were reported by 35.2% of players. Multivariate analysis showed that shoulder pain was associated with pitcher position, catcher position, longer training hours per week, and history of shoulder and elbow pain, and that elbow pain was associated with age, pitcher position, catcher position, longer training hours per week, and history of elbow pain. Length of baseball experience was not associated with shoulder or elbow pain. History of elbow pain, pitcher position, catcher position, and longer training hours per week were associated with both types of pain. History of shoulder pain was associated with shoulder pain but not elbow pain. Age was associated with elbow pain but not shoulder pain.

  16. Intrarater reliability of goniometry and hand-held dynamometry for shoulder and elbow examinations in female team handball athletes and asymptomatic volunteers.

    Science.gov (United States)

    Fieseler, Georg; Molitor, Thomas; Irlenbusch, Lars; Delank, Karl-Stefan; Laudner, Kevin G; Hermassi, Souhail; Schwesig, Rene

    2015-12-01

    To evaluate the intrarater reliability for examining active range of motion (ROM) and isometric strength of the shoulder and elbow among asymptomatic female team handball athletes and a control group using a manual goniometer and hand-held dynamometry (HHD). 22 female team handball athletes (age: 21.0 ± 3.7 years) and 25 volunteers (13 female, 12 male, age: 21.9 ± 1.24 years) participated to determine bilateral ROM for shoulder rotation and elbow flexion/extension, as well as isometric shoulder rotation and elbow flexion/extension strength. Subjects were assessed on two separate test sessions with 7 days between sessions. Relative (intraclass correlation coefficients (ICC) and standard error of measurement (SEM) reliability were calculated. Reliability for ROM and strength were good to excellent for both shoulders and groups (athletes: ICC = 0.94-0.97, SEM 1.07°-4.76 N, controls: ICC = 0.96-1.00, SEM = 0.00 N-4.48 N). Elbow measurements for both groups also showed good-to-excellent reliability (athletes: ICC = 0.79-0.97, SEM = 0.98°-5.94 N, controls: ICC = 0.87-1.00, SEM = 0.00 N-5.43 N). It is important to be able to reliably reproduce active ROM and isometric strength evaluations. Using a standardized testing position, goniometry and HHD are reliable instruments in the assessment of shoulder and elbow joint performance testing. We showed good-to-excellent reproducible results for male and female control subjects and female handball athletes, although the single parameters in ROM and strength were different for each group and between the shoulders and elbows.

  17. 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

  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. 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

  1. 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.

  2. Inter-observer agreement of standard joint count examination and disease global assessment in a cohort of Egyptian Rheumatoid Arthritis patients.

    Science.gov (United States)

    El-Hadidi, Khaled; Gamal, Sherif M; Saad, Sahar

    2017-12-21

    To assess the inter-observer agreement of standard joint count between experienced Rheumatology professor (Prof) and young Rheumatology fellow (candidate), and to compare disease global assessment between professor, young candidate and patients. This study included one hundred rheumatoid arthritis patients. For all patients independent clinical evaluation was done by two rheumatologists (professor and candidate) for detection of tenderness in 28 joints and swelling in 26 joints. The study also involved global assessment of disease activity by the provider (Prof and candidate) (EGA) as well as by the patient (PGA). The EGA was determined without previous knowledge of the patient's laboratory test results. A highly significant accordance (correlation) between professor and candidate was found in both the number of tender joints (p<0.001) (r=0.946), and the number of swollen joints (p<0.001) (r=0.797). Regarding swollen joints, the highest agreement was in right knee (0.929), while poor agreement was found in the right 5th MCP (0.049). Regarding tender joints, the highest analogy was in the right elbow (0.899), in contrast to the left 3rd PIP (0.462) which showed the least congruence. Agreement study using kappa measurement for disease global assessment showed: moderate agreement (between professor and candidate) (0.405), fair agreement between (professor and patient) (0.213), fair agreement between (candidate and patient) (0.367). Inter-observer reliability was better for TJCs than SJCs. Regarding SJCs agreement was better in large joints such as the knees compared to the small joints such as the MCPs. Disease global assessment may show discrepancy between patients and physicians. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  3. The GSB III elbow prosthesis in rheumatoid arthritis: a 2- to 9-year follow-up

    DEFF Research Database (Denmark)

    Jensen, Claus Hjorth; Jacobsen, Steffen; Ratchke, Martin

    2006-01-01

    BACKGROUND: The optimal design of an elbow prosthesis for badly damaged elbows is unkown. We evaluated 23 GSB III semi-constrained (sloppy-hinged) total elbow arthroplasties in 16 consecutive patients with rheumatoid arthritis. PATIENTS AND METHODS: After a mean follow-up period of 5 (2-9) years...

  4. 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.

  5. 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

  6. 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.

  7. [Elbow abscess revealing cat-scratch disease: about a case].

    Science.gov (United States)

    Nkaoui, Mustafa; El Bardouni, Ahmed; Lazrek, Omar; Ibo, Nasser; Zouaidia, Fouad; Kharmaz, Mohamed; Elouadghiri, Mohamed; Lamrani, Omar; Mahfoud, Mustapha; Berrada, Mohamed Saleh

    2017-01-01

    Cat-scratch disease (CSD) is a common cause of chronic benign lymphadenopathy in the child and the young adult. Bartonella henselae is the agent responsible for this disease. Common symptoms include regional lymphadenopathy associated with fever. We report a clinically atypical and potentially misleading case of a 18-year old girl with CSD revealed by elbow abscess.

  8. The Unstable Elbow: Current Concepts in Diagnosis and Treatment.

    Science.gov (United States)

    Tashjian, Robert Z; Wolf, Brian R; van Riet, Roger P; Steinmann, Scott P

    2016-01-01

    Elbow instability is common and may occur after a variety of injuries, including falls or direct blows. Instability can be classified as either acute or chronic. Acute instability is classified as simple (without fracture) or complex (with associated fracture). Chronic instability is classified as a chronically dislocated or recurrently unstable elbow. Recurrent instability commonly presents as isolated medial or lateral collateral ligament insufficiency. A chronically dislocated elbow is often more complex, involving both osseous and ligamentous injuries. The treatment of simple dislocations typically involves closed reduction and nonsurgical management. Chronic recurrent lateral and medial collateral ligament insufficiencies have very different clinical characteristics, but definitive treatment frequently involves ligament reconstruction. Complex instability usually requires surgery, which includes open reduction and internal fixation of coronoid and olecranon fractures, repair or replacement of radial head fractures, and lateral collateral ligament repair. Medial collateral ligament repair and/or external fixation are rarely required to restore stability. It is important for surgeons to understand current concepts in the diagnosis and management of acute and chronic elbow instability as well as the preferred surgical treatments and techniques for the management of these injuries.

  9. Fascial deformation in the lateral elbow region: A conceptual approach

    NARCIS (Netherlands)

    R. Stoeckart (Rob); A. Vleeming (Andry); J.L. Simons; R.P. van Helvoirt (R.); C.J. Snijders (Chris)

    1991-01-01

    markdownabstractAbstract In embalmed preparations, the antebrachial fascia in the lateral elbow region is shown to be deformed by load application to the triceps muscle. From this fascia, muscles arise which are primarily concerned with the extension of wrist and fingers. In the case of lateral

  10. Pediatric open elbow dislocation without fracture: A case report

    Directory of Open Access Journals (Sweden)

    Gökhan Polat

    2014-01-01

    CONCLUSION: Pediatric elbow dislocations are rare injuries and the management of these injuries can be technically demanding due to concurrent neurovascular injuries. An open dislocation without fracture is very rare and it should be treated with immediate intervention, an effective teamwork and good rehabilitation.

  11. Fractures around child's elbow-radiological patterns | Biruk | East ...

    African Journals Online (AJOL)

    Background: This was a one-year prospective study aimed at evaluating the clinical and radiological patterns of the paediatric elbow fractures and determining the magnitude of the problem. The clinical and radiological pitfalls in managing such fractures were also studied and addressed. The setting was in Addis Ababa ...

  12. Do autologous blood and PRP injections effectively treat tennis elbow?

    Science.gov (United States)

    Widstrom, Luke; Slattengren, Andrew

    2016-09-01

    Both approaches reduce pain, but the improvement with platelet-rich plasma (PRP) is not clinically meaningful. Autologous blood injections (ABIs) are more effective than corticosteroid injections for reducing pain and disability in patients with tennis elbow in both the short and long term.

  13. Intermanual transfer effects in below-elbow myoelectric prosthesis users

    NARCIS (Netherlands)

    de Boer, Errit; Romkema, Sietske; Cutti, Andrea G; Brouwers, Michael A H; Bongers, Raoul M; van der Sluis, Corry K

    2016-01-01

    OBJECTIVE: To determine intermanual transfer effects in patients with a below-elbow amputation using a myoelectric prosthesis, and to establish whether laterality affects these effects. DESIGN: Case-control. SETTING: A standardized setting in a rehabilitation clinic. PARTICIPANTS: A convenience

  14. Simple elbow dislocations: a systematic review of the literature

    NARCIS (Netherlands)

    de Haan, J.; Schep, N. W. L.; Tuinebreijer, W. E.; Patka, P.; den Hartog, D.

    2010-01-01

    To identify if functional treatment is the best available treatment for simple elbow dislocations. Electronic databases MEDLINE, EMBASE, LILACS, and the Cochrane Central Register of Controlled Trials. Studies were eligible for inclusion if they were trials comparing different techniques for the

  15. Osteochondritis dissecans of the elbow: excellent mid-term follow-up results in teenage athletes treated by arthroscopic debridement and microfracture

    Science.gov (United States)

    Bojanić, Ivan; Smoljanović, Tomislav; Dokuzović, Stjepan

    2012-01-01

    Aim To extend the microfracture procedure, which has been proven successful on osteochondritis dissecans (OCD) lesions in the knee and ankle, to OCD lesions in the elbow. Methods Nine young patients were treated by arthroscopic debridement and microfracture by a single surgeon. The average age at operation was 15.0 years (median 15; range 12-19). The average length of the follow-up was 5.3 years (median 5; range 2-9). The follow-up included physical examination and patient interview with elbow function scoring. Success of treatment was determined according to pre-operative and follow-up Mayo Elbow Performance Index scores and the patients’ return to sports. Results Eight patients scored excellent results on the follow-up and 1 scored a good result. Four out of 9 patients were able to increase their training intensity, 2 returned to the same level of activity, 2 changed sports (due to reasons unrelated to the health of their elbow), and 1 left professional sports and started training only recreationally. No patients stopped participating in sports altogether. Conclusions We advocate arthroscopic microfracturing, followed by a strict rehabilitation regime, as a highly effective treatment for OCD of the humeral capitellum. PMID:22351577

  16. Imaging of the Proximal and Distal Radioulnar Joints.

    Science.gov (United States)

    Ehman, Eric C; Felmlee, Joel P; Frick, Matthew A

    2015-08-01

    The proximal and distal radioulnar joints form a unique articular arrangement between the radius and ulna, allowing pivot motion of the forearm and positioning the hand in space. Typically imaged in conjunction with the elbow, radiographs, computed tomography (CT), and MR imaging of the proximal radioulnar joint contribute unique diagnostic information. Because dysfunction of the distal radioulnar joint is often a result of instability, dynamic CT protocols stressing the joint in addition to anatomic imaging with radiographs and MR imaging is valuable. Detailed knowledge of the patient's clinical condition and careful selection of imaging protocols will maximize the benefits. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. A survey of practice patterns for rehabilitation post elbow fracture.

    Science.gov (United States)

    Macdermid, Joy C; Vincent, Joshua I; Kieffer, Leah; Kieffer, Ashley; Demaiter, Jennifer; Macintosh, Stephanie

    2012-01-01

    Elbow fractures amount to 4.3% of all the fractures. The elbow is prone to stiffness after injury and fractures can often lead to significant functional impairment. Rehabilitation is commonly used to restore range of motion (ROM) and function. Practice patterns in elbow fracture rehabilitation have not been defined. The purpose of this study was to describe current elbow fracture rehabilitation practices; and compare those to the existing evidence base. Hand therapists (n=315) from the USA (92%) and Canada (8%) completed a web-based survey on their practice patterns and beliefs related to the acute (0-6 weeks) and functional (6-12 weeks) phases of elbow fracture rehabilitation. More than 99% of respondents agreed that fracture severity, co-morbidities, time since fracture, compliance with an exercise program, psychological factors, and occupational demands are important prognostic indicators for optimal function. Strong agreement was found with the use of patient education (95%) and active ROM (86%) in the acute stage while, home exercise programs (99%), active ROM (99%), stretching (97%), strengthening (97%), functional activities (ADLs and routine tasks) (97%), passive ROM (95%), and active assisted ROM (95%) were generally used in the functional stage. The most commonly used impairment measures were goniometry (99%), Jamar dynamometry (97%), and hand held dynamometry (97%). Agreement on the use of patient-reported outcome measures was very minimal (1.3%- 35.6%). Exercise, education, and functional activity have high consensus as components of elbo fracture rehabilitation. Future research should focus on defining the optimal dosage and type of exercise/activity, and establish core measures to monitor outcomes of these interventions.

  18. Radiographic damage in large joints in early rheumatoid arthritis : Relationship with radiographic damage in hands and feet, disease activity, and physical disability

    NARCIS (Netherlands)

    Kuper, HH; VanLeeuwen, MA; VanRiel, PLCM; Prevoo, MLL; Houtman, PM; Lolkema, WF; VanRijwijk, MH

    An assessment of the onset of radiographic damage in the large joints (hip, knees, shoulders, elbows, ankles and tarsus) in patients with early rheumatoid arthritis, and the relationship of the progression of large joint damage with joint damage in hands and feet, with physical disability, and with

  19. 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

  20. Radiologic examination and measurement of the wrist and distal radio-ulnar joint

    International Nuclear Information System (INIS)

    Toernvall, A.H.; Ekenstam, F. af; Hagert, C.G.; Irstam, L.; Sahlgrenska Sjukhuset, Goeteborg; Uppsala Univ.

    1986-01-01

    Following fractures of the distal radius, a relatively high incidence of complications is caused by malalignment in the distal radio-ulnar (DRU) joint; recent anatomic and clinical investigations have shown a congruity of that joint to be of significant importance for restoring the function of the wrist. The radius forms a moderately arched bone, which moves around the ulna in pronation and supination. Biomechanically, the ulna may be regarded as the pillar around which the radius moves. In an anatomic investigation of 5 arm specimens, we have shown that the maximum cartilage contact in the DRU joint between the ulna head and the distal radius occurs in the neutral rotation position. A proposed routine examination method of the wrist and forearm includes a true antero-posterior and a lateral projection of the radius and the ulna, performed with the forearm and wrist in a neutral rotation, a neutral wrist deviation and with the elbow angled 90 degrees. Such an examination implies a standardized and reproducible method. In a radioanatomic investigation, a series of 50 healthy wrists and forearms were examined. A simple measuring technique is presented, applicable to the DRU joint and wrist favouring the ulna as the bone through which a reproducible long axis of the forearm/wrist may be drawn. It is suggested that the length of the radius should be judged relative to the ulna. Ulnar head inclination and radio-ulnar angle are new concepts, being major characteristics of the DRU joint. These angles of the right and left wrist were equal and no difference was found between the sexes. Minor alterations of the distal radius may be revealed when estimating these angles. (orig.)

  1. Radiologic examination and measurement of the wrist and distal radio-ulnar joint. New aspects

    Energy Technology Data Exchange (ETDEWEB)

    Toernvall, A.H.; Ekenstam, F. af; Hagert, C.G.; Irstam, L.

    Following fractures of the distal radius, a relatively high incidence of complications is caused by malalignment in the distal radio-ulnar (DRU) joint; recent anatomic and clinical investigations have shown a congruity of that joint to be of significant importance for restoring the function of the wrist. The radius forms a moderately arched bone, which moves around the ulna in pronation and supination. Biomechanically, the ulna may be regarded as the pillar around which the radius moves. In an anatomic investigation of 5 arm specimens, we have shown that the maximum cartilage contact in the DRU joint between the ulna head and the distal radius occurs in the neutral rotation position. A proposed routine examination method of the wrist and forearm includes a true antero-posterior and a lateral projection of the radius and the ulna, performed with the forearm and wrist in a neutral rotation, a neutral wrist deviation and with the elbow angled 90 degrees. Such an examination implies a standardized and reproducible method. In a radioanatomic investigation, a series of 50 healthy wrists and forearms were examined. A simple measuring technique is presented, applicable to the DRU joint and wrist favouring the ulna as the bone through which a reproducible long axis of the forearm/wrist may be drawn. It is suggested that the length of the radius should be judged relative to the ulna. Ulnar head inclination and radio-ulnar angle are new concepts, being major characteristics of the DRU joint. These angles of the right and left wrist were equal and no difference was found between the sexes. Minor alterations of the distal radius may be revealed when estimating these angles.

  2. ARE LEFT HANDED SURGEONS LEFT OUT?

    OpenAIRE

    SriKamkshi Kothandaraman; Balasubramanian Thiagarajan

    2012-01-01

    Being a left-handed surgeon, more specifically a left-handed ENT surgeon, presents a unique pattern of difficulties.This article is an overview of left-handedness and a personal account of the specific difficulties a left-handed ENT surgeon faces.

  3. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-12-01

    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.)

  5. Single motor unit firing behaviour in the right trapezius muscle during rapid movement of right or left index finger.

    Directory of Open Access Journals (Sweden)

    Karen eSøgaard

    2014-11-01

    Full Text Available Computer work is associated with low level sustained activity in the trapezius muscle that may cause myalgia. The activity may be attention related or part of a general multijoint motor program providing stabilization of the shoulder girdle for precise finger manipulation. This study examines single motor unit (MU firing pattern in the right trapezius muscle during fast movements of ipsi or contralateral index finger. Modulated firing rate would support a general multi joint motor program, while a generally increased and continuous firing rate would support attention related activation. 12 healthy female subjects were seated at a computer work place with elbows and forearms supported. Ten double clicks (DC were performed with right and left index finger on a computer mouse instrumented with a trigger.Surface EMG was recorded from right and left trapezius muscle. Intramuscular EMG was recorded with a quadripolar wire electrode in the right trapezius.Surface EMG was analysed as %MVE. The intramuscular EMG was decomposed into individual MU action potential trains. Instantaneous firing rate (IFR was calculated from inter-spike interval with ISI shorter than 20 ms defined as doublets. IFR was averaged across 10 DC to show IFR modulation.Surface EMG in both right and left trapezius was 1.8-2.5%MVE. During right hand DC a total of 32 MUs were identified. Four subjects showed no activity. Four showed MU activity with weak or no variations related to the timing of DC. Four subjects showed large modulation in IFR with temporal relation to DC. During left hand DC 15 MUs were identified in 4 subjects, for two of the subjects with IFR modulations related to DC. Doublets was found as an integrated part of MU activation in the trapezius muscle and for one subject temporarily related to DC. In conclusion, DC with ipsi- and contralateral fast movements of the index finger was found to evoke biomechanically as well as attention related activity pattern in the

  6. 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.

  7. Electromyographic study of the flexor muscles of the elbow articulation in weightlifting trained subjects.

    Science.gov (United States)

    Bankoff, A D P; Gushi, M S; Boer, N P

    2007-01-01

    The purpose of this work was to register the electromyography data of the muscles brachialis, biceps brachii long portion, biceps brachii short portion and brachioradialis in the movements of elbow flexion, in the "Larry Scott" bench, in supination and pronation positions, in weightlifting trained subjects. Ten male right-handed subjects were selected, with at least one-year experience in weightlifting exercises, without previous neuromuscular diseases, age between 21 and 26 years. After taking the "Maximum Load" (M.L.) test, or a maximum repetition, we had the percent pattern to establish the loads used in the tests, which was 80%0 of the M. L. For the electromyography records was used a six-channel electromyography (lynx) and the AqDados software in four different moments for each subject: an isometric phase lasting five seconds in supination (1), keeping a 90 degrees angle between the arm and forearm; another one in isometric pronation (2); ten repetitions lasting fifty seconds in supination (3); and ten repetitions in pronation (4). The results of the normalization showed a level of similar activation between the involved muscles in one same moment, as much in supination as in pronation. From the analysis of variance ANOVA, having as level of significance p < 0,05, concludes that it did not have significant difference in the performance of these muscles. When compared between itself all the values of p were bigger than 0,05. Of this form we can perceive a joint action of all the flexion muscle of the elbow to resist the load imposed during the effort.

  8. 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

  9. Acromioclavicular joint separation

    Directory of Open Access Journals (Sweden)

    Devan Pandya, BS

    2018-04-01

    Full Text Available History of present illness: A 30-year-old male was brought in by ambulance to the emergency department as a trauma activation after a motorcycle accident. The patient was the helmeted rider of a motorcycle traveling at an unknown speed when he lost control and was thrown off his vehicle. He denied loss of consciousness, nausea, or vomiting. The patient’s vital signs were stable and his only complaint was pain around his left shoulder. On exam, the patient had a prominent left clavicle without skin compromise. He had adequate range of motion in the left shoulder with moderate pain, and his left upper extremity was neurovascularly intact. Significant findings: Plain films of the left shoulder showed elevation of the left clavicle above the acromion. There was an increase in the acromioclavicular (AC and coracoclavicular (CC distances (increased joint distances marked with red and blue arrows, respectively. A normal AC joint measures 1-3 mm whereas a normal CC distance measures 11-13 mm.1 The injury was classified as a Rockwood type III AC joint separation. Discussion: The AC joint is a synovial joint between an oval facet on the acromion and a similar facet on the distal end of the clavicle. Horizontal stability is provided by the AC joint while axial stability is provided by the CC joint.2,3 AC joint injuries account for about 9%-12% of shoulder girdle injuries, and the most common mechanism is direct trauma.4,5 Initial evaluation with imaging includes plain films with three views: the anterior-posterior (AP view with the shoulder in internal and external rotation as well as an axillary, or scapula-Y view (sensitivity 40%, specificity 90% for all films.6,7 AC joint injuries are classified by the Rockwood system.8 Type I involves a sprain or incomplete tear of the AC ligaments with an intact CC ligament. The AC joint appears normal on X-ray, but can become widened with stress, achieved by having the patient hold a 10-15 pound weight from each

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

    Directory of Open Access Journals (Sweden)

    William R. Holcomb

    2006-06-01

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

  11. 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.

  12. 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)

  13. Myositis ossificans of the elbow after a trigger point injection.

    Science.gov (United States)

    Shin, Sang-Jin; Kang, Sung Shik

    2011-03-01

    Trigger point injection is a simple procedure that is widely performed for relieving pain. Even though there are several complications of trigger point injection, myositis ossificans has not been documented as one of its complications. We treated a patient who suffered from painful limitation of elbow motion and this was caused by myositis ossificans between the insertions of brachialis and supinator muscles after a trigger point injection containing lidocaine mixed with saline, and we also review the relevant medical literature.

  14. Myositis Ossificans of the Elbow after a Trigger Point Injection

    OpenAIRE

    Shin, Sang-Jin; Kang, Sung Shik

    2011-01-01

    Trigger point injection is a simple procedure that is widely performed for relieving pain. Even though there are several complications of trigger point injection, myositis ossificans has not been documented as one of its complications. We treated a patient who suffered from painful limitation of elbow motion and this was caused by myositis ossificans between the insertions of brachialis and supinator muscles after a trigger point injection containing lidocaine mixed with saline, and we also r...

  15. The effect of elbow hyperextension on ball speed in cricket fast bowling.

    Science.gov (United States)

    Felton, P J; King, M A

    2016-09-01

    This study investigates how elbow hyperextension affects ball release speed in fast bowling. A two-segment planar computer simulation model comprising an upper arm and forearm + hand was customised to an elite fast bowler. A constant torque was applied at the shoulder and elbow hyperextension was represented using a damped linear torsional spring at the elbow. The magnitude of the constant shoulder torque and the torsional spring parameters were determined by concurrently matching three performances. Close agreement was found between the simulations and the performances with an average difference of 3.8%. The simulation model with these parameter values was then evaluated using one additional performance. Optimising ball speed by varying the torsional spring parameters found that elbow hyperextension increased ball release speed. Perturbing the elbow torsional spring stiffness indicated that the increase in ball release speed was governed by the magnitude of peak elbow hyperextension and the amount that the elbow recoils back towards a straight arm after reaching peak elbow hyperextension. This finding provides a clear understanding that a bowler who hyperextends at the elbow and recoils optimally will have an increase in ball speed compared to a similar bowler who cannot hyperextend. A fast bowler with 20° of elbow hyperextension and an optimal level of recoil will have increased ball speeds of around 5% over a bowler without hyperextension.

  16. 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.)

  17. A randomized controlled trial of eccentric vs. concentric graded exercise in chronic tennis elbow (lateral elbow tendinopathy).

    Science.gov (United States)

    Peterson, Magnus; Butler, Stephen; Eriksson, Margaretha; Svärdsudd, Kurt

    2014-09-01

    To analyse treatment effects of eccentric vs. concentric graded exercise in chronic tennis elbow. Randomized controlled trial. Primary care in Uppsala County, Sweden. A total of 120 subjects with tennis elbow lasting more than three months were recruited from primary care and by advertisement. Eccentric (n = 60) or concentric exercise (n = 60), by lowering or lifting a weight, at home daily, for three months with gradually increasing load. Pain during muscle contraction and muscle elongation, as well as strength, was assessed at baseline and after one, two, three, six, and 12 months. Function and quality of life was assessed at baseline and after three, six and 12 months. The eccentric exercise group had faster regression of pain, with an average of 10% higher responder rate at all levels of pain reduction, both during muscle contraction and elongation, (p eccentric vs. the concentric group and a number-needed-to-treat of 10. The eccentric group also had a greater increase of muscle strength than the concentric (p Eccentric graded exercise reduced pain and increased muscle strength in chronic tennis elbow more effectively than concentric graded exercise. © The Author(s) 2014.

  18. Radius neck-to-humerus trochlea transposition elbow reconstruction after proximal ulnar metastatic tumor resection: case and literature review.

    Science.gov (United States)

    Chen, Feiyan; Xia, Jun; Wei, Yibing; Wang, Siqun; Wu, Jianguo; Huang, Gangyong; Chen, Jie; Shi, Jingsheng

    2012-07-16

    Wide en bloc excision of proximal ulna sections is used to treat traumatic and pathological fractures of the ulna, though poor standardization of clinical treatment often results in long-term failure of such reconstructed biomechanical structures. In order to provide insight into effective ulnar reconstructive treatments, the case of an 80-year-old Chinese Han male presenting with pathological fracture caused by a proximal ulnar metastatic tumor concurrent with metastatic renal cancer complicated by occurrence in the brain and lungs is reported and contrasted with alternative treatment techniques. Wide resectioning of the proximal ulna and reconstruction with local radius neck-to-humerus trochlea transposition resulted in preservation of functionality, sensitivity, and biomechanical integrity after postsurgical immobilization, 6 weeks of passive- and active-assisted flexion, and extension with a hinged brace. The resultant Musculoskeletal Tumor Society rating score was 25 of 30 (83 %). Full sensitivity and mobility of the left hand and elbow (10° to 90° with minimally impaired supination and pronation) was restored with minimal discomfort. No evidence of local recurrence or other pathological complications were observed within a 1-year follow-up period. Efficient reconstruction of osseous and capsuloligamentous structures in the elbow is often accomplished by allografts, prosthesis, and soft tissue reconstruction, though wide variations in risk and prognosis associated with these techniques has resulted in disagreements regarding the most effective standards for clinical treatment. Current findings suggest that radius neck-to-humerus trochlea transposition offers a superior range of elbow movement and fewer complications than similar allograft and prosthetic techniques for patients with multiple metastatic cancers.

  19. Radius neck-to-humerus trochlea transposition elbow reconstruction after proximal ulnar metastatic tumor resection: case and literature review

    Directory of Open Access Journals (Sweden)

    Chen FeiYan

    2012-07-01

    Full Text Available Abstract Wide en bloc excision of proximal ulna sections is used to treat traumatic and pathological fractures of the ulna, though poor standardization of clinical treatment often results in long-term failure of such reconstructed biomechanical structures. In order to provide insight into effective ulnar reconstructive treatments, the case of an 80-year-old Chinese Han male presenting with pathological fracture caused by a proximal ulnar metastatic tumor concurrent with metastatic renal cancer complicated by occurrence in the brain and lungs is reported and contrasted with alternative treatment techniques. Wide resectioning of the proximal ulna and reconstruction with local radius neck-to-humerus trochlea transposition resulted in preservation of functionality, sensitivity, and biomechanical integrity after postsurgical immobilization, 6 weeks of passive- and active-assisted flexion, and extension with a hinged brace. The resultant Musculoskeletal Tumor Society rating score was 25 of 30 (83 %. Full sensitivity and mobility of the left hand and elbow (10° to 90° with minimally impaired supination and pronation was restored with minimal discomfort. No evidence of local recurrence or other pathological complications were observed within a 1-year follow-up period. Efficient reconstruction of osseous and capsuloligamentous structures in the elbow is often accomplished by allografts, prosthesis, and soft tissue reconstruction, though wide variations in risk and prognosis associated with these techniques has resulted in disagreements regarding the most effective standards for clinical treatment. Current findings suggest that radius neck-to-humerus trochlea transposition offers a superior range of elbow movement and fewer complications than similar allograft and prosthetic techniques for patients with multiple metastatic cancers.

  20. 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.

  1. The interaction of pressure, in-plane moment and torque loadings on piping elbows

    International Nuclear Information System (INIS)

    Ayob, A.B.; Moffat, D.G.; Mistry, J.

    2003-01-01

    This study concerns the load interaction behaviour of 90 deg. smooth piping elbows with circular cross-section and long straight tangent pipes. The finite element method is used for stress analysis of elbows having a wide range of bend and pipe factors. The main aim of the study is to establish the first yield interaction behaviour when an elbow is subjected to a combination loading of in-plane bending, torsion and internal pressure. The study shows that load interaction is influenced by pipe factor, bend radius and load coupling effect, with thinner elbows being affected to a larger degree

  2. 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.

  3. Inserting the Ulnar Prosthesis into Radius as a Novel Salvage Surgery for Revision Total Elbow Arthroplasty with Massive Bone Defect.

    Science.gov (United States)

    Gong, Mao-Qi; Jiang, Ji-Le; Jiang, Xie-Yuan; Zha, Ye-Jun; Li, Ting

    2016-08-20

    Infection and aseptic loosening are common complications of total elbow arthroplasty (TEA) and often require revision surgery. However, bone defects, along with other complications, bring an extra difficulty to the second surgery, especially for patients with a massive bone defect in the proximal ulna. Several methods including allograft or autograft have been introduced into practice, but none sufficiently solves these problems. We conducted a new surgical method for patients with a massive ulnar bone defect needing revision TEA. During revision arthroplasty, the ulnar prosthesis was inserted into the radius as a salvage procedure. Four consecutive patients received revision arthroplasty with this method between 2013 and 2016. Patients' data were collected to evaluate the clinical outcome. All patients had a Grade III ulnar bone defect. At the last follow-up session, all patients reported a painless, functional elbow joint. Three patients suffered from a periprosthetic infection that was completely cured using the two-stage method. No major complications, including infection, aseptic loosening, or wound problems were found. One patient had a transient ulnar neuritis, and another had a transient radial neuritis. Both patients had full recovery at the last follow-up session. Inserting an ulnar prosthesis into the radius is a novel procedure for patients with a massive bone defect due to infection or aseptic loosening. It is a safe, quick, and effective treatment with a promising short-term outcome. This method should be provided as a salvage procedure for patients with a nonreconstructable ulnar bone defect.

  4. 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.

  5. 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.

  6. Design and characterization of a powered elbow prosthesis.

    Science.gov (United States)

    Bennett, Daniel A; Mitchell, Jason; Goldfarb, Michael

    2015-01-01

    This paper describes the design of a powered elbow prosthesis, which incorporates a belt and cable drive transmission with a brushless DC motor to achieve an output torque of approximately 18.4 Nm, a backdrive torque of 1.5 Nm, and a speed of up to 360 deg/s while remaining within the anthropomorphic envelope with regard to mass and size. The measured torque and speed of the prosthesis is commensurate with nominal capability of the natural limb (for purposes of performing activities of daily living).

  7. 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

  8. [Circumscribed myositis ossificans of the elbow: about a case].

    Science.gov (United States)

    Nhamoucha, Yassine; Alaoui, Othmane; Alaoui, Charifa; Abdellaoui, Hicham; Tazi, Mohammed; Oukhoya, Mohammed; Chater, Lamyae; Atarraf, Karima; Arroud, Mounir; Afifi, Abderahman

    2016-01-01

    Circumscribed myositis ossificans (CMO) is a heterotopic ossification of the striated muscles. Its location at the level of the elbow is rare. It occurs in young patients, often following trauma as it can also develop without experiencing any traumatic event. Its predominant location is at the level of the larger muscles limbs root (gluteus, deltoid) or of the areas which are most exposed to direct shocks (the quadriceps in more than 40% of post-traumatic cases). Our study aims to highlight the aspects of a circumscribed myositis ossificans in conventional radiology and tomodensitometry to avoid potential diagnostic confusion with a malignant bone tumor.

  9. Impaction grafting in revision total elbow arthroplasty due to aseptic loosening and bone loss.

    Science.gov (United States)

    Rhee, Yong Girl; Cho, Nam Su; Parke, Chong Suck

    2013-06-05

    With the increase in the number of total elbow arthroplasties being performed, there has been a parallel increase in revision surgery. There is limited information about the outcome of impaction grafting following failed elbow arthroplasty. We retrospectively analyzed sixteen cases of revision arthroplasty performed following aseptic loosening of a semiconstrained total elbow replacement. There were three men and thirteen women with a mean age of 58.4 years (range, twenty-eight to seventy-five years). Fourteen elbows had loosening of both the humeral and the ulnar component, and two elbows had only humeral loosening. Two elbows had perforation of the humeral cortex by the humeral component, and one had perforation of the ulnar cortex. Grade-II bone loss as described by King et al. was found in three elbows; grade III, in six elbows; and grade IV, in seven elbows. The impaction grafting was performed with only allograft in thirteen elbows, and it was done with allograft as well as autograft from the iliac crest in the other three elbows. The mean duration of follow-up was 7.4 years (range, 4.1 to 11.2 years). The mean Mayo Elbow Performance Score (MEPS) for pain significantly improved from 15.0 points preoperatively to 32.8 points at the time of latest follow-up (p = 0.003). The mean arc of flexion also significantly increased, from 60.3° to 115.6° (p < 0.01). Stability according to the MEPS significantly increased from a mean of 2.2 points to a mean of 9.4 points (p = 0.001). The mean total MEPS improved from 41.0 points to 82.8 points (p = 0.001). The result was excellent for four elbows, good for eleven, and fair for one. Follow-up radiographs demonstrated fifteen cases with grade-I resorption of the bone graft and one case with grade-II resorption. A type-I radiolucent line was observed in twelve of the elbows; type II, in three; and type IV, in one. Additional surgery was required in two cases. Impaction grafting is an effective technique when revision total

  10. 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.

  11. Computed tomographic identification of dysplasia and progression of osteoarthritis in dog elbows previously assigned OFA grades 0 and 1.

    Science.gov (United States)

    Kunst, Chelsea M; Pease, Anthony P; Nelson, Nathan C; Habing, Greg; Ballegeer, Elizabeth A

    2014-01-01

    Elbow dysplasia is a heritable disease that is a common cause of lameness and progressive elbow osteoarthritis in young large breed dogs. The Orthopedic Foundation for Animals (OFA) screens elbow radiographs, and assigns grades 0-3 based on presence and severity of bony proliferation on the anconeal process. Grade 1 is assigned when less than 3 mm is present and considered positive for dysplasia. We investigated the incidence of elbow dysplasia and progression of osteoarthritis in elbows with grades 0 and 1 in 46 elbows screened at least 1 year previously, using CT as a gold standard and with the addition of CT absorptiometry. The incidence of dysplasia based on CT was 62% in grade 0, and 75% in grade 1 elbows, all of which had medial coronoid disease. Progressive osteoarthritis at recheck was consistent with elbow dysplasia. The sensitivity and specificity of the OFA grade for elbow dysplasia compared to CT findings was 75% and 38%, respectively. Increased bone mineral density of the medial coronoid process as characterized by osteoabsorptiometry warrants further investigation with respect to elbow dysplasia. Proliferation on the anconeal process without CT evidence of dysplasia or osteoarthritis was present in 20% of the elbows, and is theorized to be an anatomic variant or enthesopathy of the olecranon ligament/synovium. Results of our study suggest that the "anconeal bump" used for elbow screening by the OFA is a relatively insensitive characteristic, and support the use of CT for identifying additional characteristics of elbow dysplasia. © 2014 American College of Veterinary Radiology.

  12. 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...

  13. 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

  14. Power grip force is modulated in repeated elbow movement.

    Science.gov (United States)

    Gao, Fan

    2012-01-01

    The objective of this study was to quantitatively investigate the modulation of power grip force under repeated elbow movement and its relation to muscle cocontraction and potential risk of developing cumulative trauma disorders (CTD). Thirteen right-handed participants without any neuromuscular disorders were recruited. Participants were instructed to hold a digital dynamometer in the hand with three levels of grip forces (20%, 40% and 60% of the maximum grip force) and perform repeated arm movement in the sagittal plane at three speeds (slow, self-paced and fast) with the upper arm voluntarily held by side by the participant. With the increase of motion rate and target force level, the grip force fluctuation, finger flexor muscle activities, elbow muscles cocontraction and apparent stiffness were significantly increased (p movement be avoided as much as possible in the workplace. Power grip is usually accompanied with arm movement in workplaces and the increased physical demand might result in higher muscle activities and potentially higher risk of repetitive musculoskeletal injuries.

  15. Intermanual Transfer Effects in Below-Elbow Myoelectric Prosthesis Users.

    Science.gov (United States)

    de Boer, Errit; Romkema, Sietske; Cutti, Andrea G; Brouwers, Michael A; Bongers, Raoul M; van der Sluis, Corry K

    2016-11-01

    To determine intermanual transfer effects in patients with a below-elbow amputation using a myoelectric prosthesis and to establish whether laterality affects these effects. Case-control. A standardized setting in a rehabilitation clinic. A convenience sample (N=44) of experienced myoelectric prosthesis users (n=22) and matched controls (n=22). Controls were matched on sex, age (±5y), and hand dominance. Both the experienced group and the control group performed several tasks using a prosthesis simulator attached to their nonaffected arm. Movement time, force control, Box and Block test (BBT) scores, and duration of hand opening. Movement times of myoelectric prosthesis users were shorter, and these users had significantly higher BBT scores and shorter hand opening durations than those of controls. No intermanual transfer effects on force control and no laterality effects were found. Intermanual transfer effects were present in experienced myoelectric prosthesis users with a below-elbow amputation, independent of laterality. These findings support the clinical relevance of intermanual transfer training, which may facilitate persons with an upper limb amputation to start training directly after the amputation. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  16. 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...

  17. 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

    : thickening of the cartilage, lesion in the subchondral bone, irregular cartilage surface, fissure under the cartilage, an irregular sagittal central groove and depression of the proximal edge of the radius. The study comprised 7172 finishing pigs from crossing 12 Duroc boars with 600 crossbred Landrace...... locations, whereas the QTLs associated with depression of the proximal edge of the radius in general were on the same chromosomes but at separate locations. The detected QTLs explain a large part of the genetic variation, which is promising for incorporating osteochondrosis into a breeding programme using...

  18. 21 CFR 888.3150 - Elbow joint metal/polymer constrained cemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... “Orthopaedic Implants—General Requirements for Marking, Packaging, and Labeling,” (vii) ISO 9001:1994 “Quality... are: (1) FDA's: (i) “Use of International Standard ISO 10993 ‘Biological Evaluation of Medical Devices... Implant Components,” (2) International Organization for Standardization's (ISO): (i) ISO 5832-3:1996...

  19. 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.

  20. Experimental fracture studies on carbon steel elbows with and without internal pressure

    International Nuclear Information System (INIS)

    Gandhi, P.; Saravanan, M.; Vishnuvardhan, S.; Pukazhendhi, D.M.; Raghava, G.; Sahu, M.K.; Chattopadhyay, J.; Dutta, B.K.; Vaze, K.K.

    2013-01-01

    Pipe bends or elbows are commonly used components for nuclear power plant piping system. In service, these piping components are subjected to internal pressure in addition to bending loads and the internal pressure is known to have a significant effect on the load carrying capacity of these components. Hence, a systematic study was carried out to investigate and quantify the effect of internal pressure on the fracture behaviour of elbows used in nuclear power plant piping system. Fracture studies were conducted on five 219 mm diameter carbon steel elbows with and without internal pressure under in-plane opening moment. The investigations have shown that the presence of a circumferential notch at the intrados has a more detrimental effect on the fracture behaviour of the elbow, when compared with the presence of an axial notch at the intrados. It is also found that internal pressure plays a significant role in reducing the ovalization. -- Highlights: • Fracture studies were conducted on elbows with and without internal pressure. • Effect of internal pressure on load carrying capacity of the elbows was studied. • Various data acquired during the study include load, LLD, CMOD, ovality of the elbow. • Circumferential notch at intrados significantly affects elbow load carrying capacity

  1. THE ROLE OF SHOULDER MAXIMUM EXTERNAL ROTATION DURING THROWING FOR ELBOW INJURY PREVENTION IN BASEBALL PLAYERS

    Directory of Open Access Journals (Sweden)

    Kunio Ida

    2008-06-01

    Full Text Available The objective of the present study was to examine whether the passive range of shoulder external rotation (ER, the maximum shoulder external rotation angle (MER during throwing, and the ratio of MER to ER are related to the incidence of the elbow injury. A mixed design with one between-factor (a history of the elbow injury and two within-factors (ER and MER was used to analyze the difference between baseball players with and without a history of medial elbow pain. Twenty high school baseball players who had experienced the medial elbow pain within the previous month but who were not experiencing the pain on the day of the experiment were recruited (elbow-injured group. Another twenty baseball players who had never experienced the medial elbow pain were also used for testing (control group. MER during throwing, ER, and the ratio of MER to ER were obtained in both of the group. A Mann-Whitney test was used for the group comparison (p < 0.05. The ratio of MER to ER was significantly greater in the elbow-injured group (1.52 ± 0.19 than that in the control group (1.33 ± 0.23 (p = 0.008. On the other hand, there was no statistical significance in MER and ER between two groups. The findings of the study indicate that MER/ER relation could be associated with the incidence of the elbow injury in baseball players

  2. 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.

  3. Damage Analysis of Elbow Fitting at Condenser Air Conditioning Cooling System

    Directory of Open Access Journals (Sweden)

    Hari Prastowo

    2017-09-01

    Full Text Available Elbow fittings is one type of fitting on the piping installation that serves to change the flow direction. With the sudden flow of changes, it will affect the physical condition of the elbow. The flow changes in the elbow will result in changes of  flow velocity that affect wall of elbow, the condition will cause erosion corrosion phenomenon.  Erosion corrotion is a type of corrosion that uses a mechanical process through the relative movement of the flow and metal. Corrosion erosion can also be caused by impingment corrotion or very rapid flow movement. This study aims to determine the cause of damage elbow by using a CFD simulation and troubleshooting by adding a Vortex Generator or a installed disturber system in the pipeline installation and simulating it again. From the results of research conducted that elbow damage caused by high flow velocity that concerns the outer elbow. The addition of Vortex Generator is proven to be used to reduce excessive flow velocity on erosion-corroded parts. According to the results of the investigation the placement of the most efficient vortex generator if placed at a distance of 0.1 R from elbow inlet.

  4. 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

  5. Accuracy in identifying the elbow rotation axis on simulated fluoroscopic images using a new anatomical landmark

    NARCIS (Netherlands)

    Wiggers, J. K.; Snijders, R. M.; Dobbe, J. G. G.; Streekstra, G. J.; den Hartog, D.; Schep, N. W. L.

    2017-01-01

    External fixation of the elbow requires identification of the elbow rotation axis, but the accuracy of traditional landmarks (capitellum and trochlea) on fluoroscopy is limited. The relative distance (RD) of the humerus may be helpful as additional landmark. The first aim of this study was to

  6. 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.

  7. 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

  8. Dislocation of the elbow: a retrospective multicentre study of 86 patients

    NARCIS (Netherlands)

    de Haan, Jeroen; Schep, Niels W. L.; Zengerink, Imme; van Buijtenen, Jesse; Tuinebreijer, Wim E.; den Hartog, Dennis

    2010-01-01

    The objective of this retrospective multicentre cohort study was to prospectively assess the long-term functional outcomes of simple and complex elbow dislocations.We analysed the hospital and outpatient records of 86 patients between 01.03.1999 and 25.02.2009 with an elbow dislocation. After a mean

  9. Dislocation of the Elbow: A Retrospective Multicentre Study of 86 Patients

    NARCIS (Netherlands)

    J. de Haan (Jeroen); J.F. Zengerink; D. den Hartog (Dennis); W.E. Tuinebreijer (Wim); J. Buijtenen (Jesse van); N.W.L. Schep (Niels)

    2010-01-01

    textabstractThe objective of this retrospective multicentre cohort study was to prospectively assess the long-term functional outcomes of simple and complex elbow dislocations.We analysed the hospital and outpatient records of 86 patients between 01.03.1999 and 25.02.2009 with an elbow dislocation.

  10. 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

  11. Accuracy in identifying the elbow rotation axis on simulated fluoroscopic images using a new anatomical landmark

    NARCIS (Netherlands)

    Wiggers, J.K.; Snijders, R.M.; J.G. Dobbe (Johannes); G.J. Streekstra; D. den Hartog (Dennis); N.W.L. Schep (Niels)

    2017-01-01

    textabstractExternal fixation of the elbow requires identification of the elbow rotation axis, but the accuracy of traditional landmarks (capitellum and trochlea) on fluoroscopy is limited. The relative distance (RD) of the humerus may be helpful as additional landmark. The first aim of this study

  12. Surgical accuracy in identifying the elbow rotation axis on fluoroscopic images

    NARCIS (Netherlands)

    Wiggers, J. K.; Streekstra, G. J.; Kloen, P.; Mader, K.; Goslings, J. C.; Schep, N. W. L.

    2014-01-01

    To assess the accuracy of surgeons in identifying elbow rotation axis (RA) on fluoroscopic images and to measure the interobserver variability. Five healthy subjects underwent 3-dimensional computed tomography (CT) analysis of their nondominant elbow. Real-time rotation software enabled surgeons to

  13. Elbow-specific clinical rating systems : extent of established validity, reliability, and responsiveness

    NARCIS (Netherlands)

    The, Bertram; Reininga, Inge H. F.; El Moumni, Mostafa; Eygendaal, Denise

    2013-01-01

    Background: The modern standard of evaluating treatment results includes the use of rating systems. Elbow-specific rating systems are frequently used in studies aiming at elbow-specific pathology. However, proper validation studies seem to be relatively sparse. In addition, these scoring systems

  14. 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

  15. Complex and Unstable Simple Elbow Dislocations: A Review and Quantitative Analysis of Individual Patient Data

    NARCIS (Netherlands)

    J. de Haan (Jeroen); N.W.L. Schep (Niels); D. den Hartog (Dennis); W.E. Tuinebreijer (Wim)

    2010-01-01

    textabstractThe 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

  16. 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

  17. Multi-Joint Coordination of Vertical Arm Movement

    Directory of Open Access Journals (Sweden)

    Ajay Seth

    2003-01-01

    Full Text Available A model of the human arm was developed to study coordination of multi-joint movement in the vertical plane. The arm was represented as a two-segment, two-degree of freedom dynamic system with net muscle torques acting at the shoulder and elbow. Kinematic data were collected from a subject who performed unrestrained vertical movements with only the initial and final hand elevations prescribed. Movements were performed with and without a hand-held load. The method of computed torques was implemented to obtain net muscle torques, which enables position and velocity feedback to be used to estimate joint angular accelerations that produce a more stable simulation of arm movement. The model simulation was then used to calculate the contributions of the net muscle torques, gravitational torques and velocity-interaction torques to the angular accelerations of the shoulder and elbow and also to the vertical acceleration of the hand. The net muscle torques and gravity were the prime movers of the arm. The velocity-dependent effects contributed little to the dynamics of arm movement and were, in fact, insignificant when the hand was loaded. The muscles of the shoulder and elbow acted synergistically to elevate the arm in the sagittal plane. The hand was accelerated upward by the elbow first, until the point of maximum elbow flexion, after which the shoulder became the prime mover. Gravity acted consistently to accelerate the hand downward. Coordination was notably invariant to changes in external load. Some compensation for load was observed in the control, and these differences were attributed mainly to an increase in system inertia.

  18. 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.

  19. 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.

  20. 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....

  1. 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.

  2. Reconstruction of Elbow by Free Fibular Graft in a Case of Osteoclastoma of Proximal Ulna: A Rare Case Report

    Directory of Open Access Journals (Sweden)

    Kiran Kalaiah

    2015-01-01

    swelling around right elbow since 4 months. Proximal ulna along with tumour was resected and elbow was reconstructed using nonvascularized free fibular graft. At two years of follow-up, patient is tumour-free and has functional range of movement in elbow. We are reporting the case because of its rare location and for the indigenous treatment modality of using free fibular graft for elbow reconstruction.

  3. 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.

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

    Science.gov (United States)

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

    2012-02-15

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

  5. Benefits and disadvantages of joint hypermobility among musicians.

    Science.gov (United States)

    Larsson, L G; Baum, J; Mudholkar, G S; Kollia, G D

    1993-10-07

    Joint hypermobility is considered to be both an advantage and a disadvantage. However, the degree of hypermobility in members of particular occupations requiring intense physical activity and the nature of the association between symptoms referable to specific joints and their hypermobility are unknown. We interviewed 660 musicians (300 women and 360 men) about work-related symptoms such as joint pain and swelling and examined them for joint hypermobility according to a standard protocol. We then determined the relation between the mobility of their fingers, thumbs, elbows, knees, and spine and any symptoms referable to these regions. Five of the 96 musicians (5 percent) with hypermobility of the wrists, mostly instrumentalists who played the flute, violin, or piano, had pain and stiffness in this region, whereas 100 of the 564 musicians (18 percent) without such hypermobility had symptoms (P = 0.001). Hypermobility of the elbow was associated with symptoms in only 1 of 208 musicians (< 1 percent), whereas 7 of 452 (2 percent) without this hypermobility had symptoms (P = 0.45). Among the 132 musicians who had hypermobile knees, 6 (5 percent) had symptoms, whereas only 1 of 528 (< 1 percent) with normal knees had symptoms (P < 0.001). Of the 462 musicians who had normal mobility of the spine, 50 (11 percent) had symptoms involving the back, as compared with 46 of the 198 musicians (23 percent) who had hypermobility of the spine (P < 0.001). Among musicians who play instruments requiring repetitive motion, hypermobility of joints such as the wrists and elbows may be an asset, whereas hypermobility of less frequently moved joints such as the knees and spine may be a liability.

  6. Probabilistic assessment of critically flawed LMFBR PHTS piping elbows

    International Nuclear Information System (INIS)

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

    1982-01-01

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

  7. Progression of Heterotopic Ossification around the Elbow after Trauma

    Directory of Open Access Journals (Sweden)

    Dirk P. ter Meulen

    2016-07-01

    Full Text Available Background: This study addresses the null hypothesis that there is no expansion of heterotopic ossification (HO in the elbow beyond what can be seen early on.   Methods: The area of HO was measured on lateral radiographs of 38 consecutive patients that had operative treatment of HO between 2000 and 2013. Measurements from radiographs obtained between 3 to 7 weeks were compared to measurements from radiographs made 3 months or more after injury. Results: There was no significant difference between the average area of HO on the first (median 2.8 square centimeters, Q1: 1.5, Q3: 5.1 and later radiographs (median of 2.8 square centimeters, Q1: 1.4, Q3: 5.0 (P = 0.99. Discussion: According to our results the area of HO does not expand beyond what can be seen early in the disease process.

  8. Joint Commission

    Science.gov (United States)

    ... FAQs Universal Protocol Standards Quick Links E-dition - Electronic Standards Manuals Joint Commission Requirements Patient Safety Systems Chapter Measurement Measurement Performance Measurement Pioneers ...

  9. The Structure Design and Simulation of Ultrasonic Inspection Instrument for Inside Pressurized Pipe Elbows

    Science.gov (United States)

    Miao, Cunjian; Du, Xingji; Xia, Junfang; Wang, Min; Ling, Zhangwei; Tang, Ping

    2018-01-01

    Elbows in pressure pipes are important parts which may become serious corrosion locations. Ultrasonic detection is a main technique for pipe inner inspection, and the use of traditional ultrasound and phased array technique for in-line inspection are advanced, long-term interesting and known by researchers. Several devices were invented for inside pipeline inspection and suitable to some extent such as detecting long-distance pipelines. However, elbows especially tight elbows are still difficult to implement inner detection or travelling. To obtain good effect in detecting elbows, the inner inspection technique was investigated. Spherical and flat cylindrical probe holder structures were proposed to ensure the ability to pass through elbows, while the spherical holder has many conventional probes in its shell with a uniform distribution. The flat cylindrical probe structures are suitable for phased array ultrasonic technique to form a convex array. CIVA simulation was conducted and the focal effects were analyzed. Comparing with detecting precision and manufacture process, the phased array technique was chosen, and the elbow inspection experiments were carried out. The ultrasonic system was taken by a robot to travel through the elbow, and the experimental data were used to verify the applicability of the ultrasonic inspection technique.

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

    Directory of Open Access Journals (Sweden)

    R.M. Kirberger

    1998-07-01

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

  11. No correlation between physicians administered elbow rating systems and patient's satisfaction.

    Science.gov (United States)

    Capuano, L; Poulain, S; Hardy, P; Longo, U G; Denaro, V; Maffulli, N

    2011-06-01

    The aim of this study was to assess the functional outcome of patients who had undergone elbow arthroscopy, evaluating the correlation between three elbow scoring systems and the patients' subjective perception of satisfaction Fourteen patients who had undergone elbow arthroscopy were retrospective reviewed to evaluate the correlation between three elbow scoring systems and the patients' subjective perception of satisfaction at a mean follow-up time of 24 months (range 12-64 months). Two independent orthopedic surgeons evaluated all patients using three elbow scoring systems, a simple satisfaction question and a visual analogue scale. The three scoring systems showed significant correlation with each other (Pscoring systems and patients' satisfaction: patients with the same level of satisfaction could perform differently at the scoring systems. Although the three scoring systems used to evaluate the patients showed significant correlation with each other, they failed to correlate to patients' satisfaction. In reporting the results of arthroscopic elbow procedures, emphasis should be placed on individual variables, rather than on global elbow ratings. Further studies are needed to develop a single outcome evaluation system which is reliable, valid and sensitive to changes of clinical importance, which takes into account both patients' and physicians perspective, and which is short and practical to use.

  12. A portable telerehabilitation system for remote evaluations of impaired elbows in neurological disorders.

    Science.gov (United States)

    Park, Hyung-Soon; Peng, Qiyu; Zhang, Li-Qun

    2008-06-01

    A portable teleassessment system was designed for remote evaluation of elbow impairments in patients with neurological disorders. A master device and a slave device were used to drive a mannequin arm and the patient's arm, respectively. The elbow flexion angle and torque were measured at both the master and slave devices, and sent to each other for teleoperation. To evaluate spasticity/contracture of the patient's elbow remotely, the clinician asked the patient to relax the elbow, moved the mannequin arm at a selected velocity, and haptically felt the resistance from the patient's elbow. In other tasks, the patient moved his/her elbow voluntarily and the clinician observed the corresponding mannequin arm movement and determined the active range of motion (ROM). The clinician could also remotely resist the patient's movement and evaluate the muscle strength. To minimize the effect of network latency, two different teleoperation schemes were used depending on the speed of the tasks. For slow movement tasks, real-time teleoperations were performed using control architectures that considered causality of the tasks, with performance similar to that during an in-person examination. For tasks involving fast movements, a teach-and-replay teleoperation scheme was used which provided the examiner with transparent and stable haptic feeling. Overall, the teleassessment system allowed the clinician to remotely evaluate the impaired elbow of stroke survivors, including assessment of the passive ROM, active ROM, muscle strength, velocity-dependent spasticity, and catch angle.

  13. Percutaneous biopsy of the synovial membrane of large joints

    International Nuclear Information System (INIS)

    Begule, V.

    1989-01-01

    Using flouroscopy, the authors have developed new techniques of percutaneous synovial biopsy (PSB) of large joints of limbs (other than the knee). PSB was performed on outpatients under local anesthesia. They have performed 84 biopsies (hips: 57), shoulders: 10, elbows: six, wrists: five, ankles: six). The PSB technique was gradually improved. Main technical refinements were use of a Tru-Cut needle introduced through a Jamshidi trephine needle, placement of the cutting window parallel to the anterior aspect of the joint, and selection of an optimal approach and biopsy site. With these improvements, the success rate of attaining synovial membrane was raised from 49% to 81%. No complications were encountered

  14. Analysis of elbow muscle strength parameters in Brazilian jiu-jitsu practitioners.

    Science.gov (United States)

    Follmer, Bruno; Dellagrana, Rodolfo André; de Lima, Luis Antonio Pereira; Herzog, Walter; Diefenthaeler, Fernando

    2017-12-01

    Upper-body dynamic and isometric maximum strength are essential components for success in Brazilian jiu-jitsu (BJJ). This study was aimed at analysing strength parameters in the elbow flexor and extensor muscles of BJJ practitioners. Participants (n = 28) performed maximum isometric contractions of elbow flexors and extensors to determine peak torque (PT), rate of force development (RFD), and the torque-angle (T-A) relationship at elbow angles of 45°, 60°, 75°, 90°, 105°, and 120°. Additionally, concentric and eccentric PTs were measured at 1.04 rad·s -1 . Student t-test and ANOVA were performed using α = 0.05. Elbow flexors were stronger isometrically (P < 0.001, ES = 1.23) but weaker concentrically (P < 0.05, ES = 0.54) than extensor muscles, possibly because of the extensive grip disputes and pushing of opponents in BJJ. The T-A relationship had an inverted "U"-shape. Torque differences across elbow angles were moderate (ES = 0.62) for the extensor and large (ES = 0.92) for the flexor muscles. Isometric torque was greatest for elbow angles of 105° and 75° and smallest for 45° and 120° for extensor and flexor muscles, respectively. Elbow flexors had a greater RFD than extensors, regardless of elbow angle. The present study provides comprehensive results for elbow muscle strength in BJJ practitioners.

  15. Reconstruction of medial collateral ligament defects with a flexor-pronator fascia patch in complete open release of stiff elbows.

    Science.gov (United States)

    Chen, Shuai; Yan, Hede; Wang, Wei; Zhang, Mei; Hildebrand, Kevin A; Fan, Cun-Yi

    2017-01-01

    Because medial elbow stability is essential for stiff elbow release, surgical techniques have been reported for reconstructing medial elbow stability. However, medial collateral ligament (MCL) defects, caused by inevitable detachment and resection performed for complete release, make the reconstruction more challenging. To our knowledge, no study has evaluated the outcomes after using a flexor-pronator fascia patch in medial elbow reconstruction for open release of stiff elbows. We hypothesized that this technique is effective for repairing MCL defects. We retrospectively reviewed the records of 10 patients. The MCL defects were all reconstructed with a flexor-pronator fascia patch. An external fixator was used in all patients. One patient could not be contacted and was thus excluded from the study. Outcome measures included stability, range of motion, Mayo Elbow Performance Score, ulnar nerve symptoms, power grip, and radiographic findings. The mean follow-up period was 19.6 months; all elbows were stable by the last follow-up. One patient presented with moderate elbow instability and then regained stability 3 months after the external fixator was removed. The Mayo Elbow Performance Score improved from 58 points to 94 points, and the mean flexion arc improved from 40° to 133°. No radiographic manifestations of elbow dislocation or suture anchor looseness were observed. A flexor-pronator fascia patch provides sufficient stability for repairing MCL defects without restricting the range of motion gained during arthrolysis. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

  16. A new arthroscopic-assisted drilling method through the radius in a distal-to-proximal direction for osteochondritis dissecans of the elbow.

    Science.gov (United States)

    Arai, Yuji; Hara, Kunio; Fujiwara, Hiroyoshi; Minami, Ginjiro; Nakagawa, Shuji; Kubo, Toshikazu

    2008-02-01

    We developed a new arthroscopic-assisted drilling method through the radius in a distal-to-proximal direction for osteochondritis dissecans (OCD) of the elbow. Only 1 drill hole is created in the radius by use of a single 1.8-mm K-wire inserted from the shaft of the radius approximately 3 cm distal to the humeroradial joint into the joint, which allows drilling of the entire OCD lesion. The forearm is supinated so that the tip of the K-wire is at the lateral side of the lesion in the humeral capitellum, and drilling is performed at 30 degrees elbow flexion. The flexion angle is changed from 30 degrees to 60 degrees to 90 degrees to 120 degrees while maintaining supination, to drill in 4 sites (1 site for each angle of flexion) of the lateral side of the OCD lesion. Next, we move the forearm from supination to pronation so that the tip of the K-wire is placed in the medial side of the lesion in the humeral capitellum, and as with the lateral side, drilling is performed in 4 sites. With this technique, the entire OCD lesion can be vertically drilled under arthroscopic guidance. This method is minimally invasive, and an early return to sports could be possible.

  17. Temporomandibular joint

    International Nuclear Information System (INIS)

    Westesson, P.L.; Hatala, M.; Tallents, R.H.; Katzberg, R.W.; Musgrave, M.; Levitt, S.

    1990-01-01

    This paper determines the frequency of MR signs of abnormal temporomandibular joints (TMJs) in asymptomatic volunteers. Forty-two volunteers with 84 clinically normal TMJs were imaged in the sagittal and coronal planes with surface coil MR imaging. Sagittal closed and open and coronal closed views were obtained bilaterally in all volunteers. The images were classified as normal (superior disk position) or abnormal (disk displacement of degenerative joint disease). Eighteen joints in 11 volunteers were abnormal; 12 had disk displacement with reduction and six had disk displacement without reduction, with associated degenerative joint disease in three of the six. Asymptomatic internal derangement and degenerative joint disease occur in about one-fourth of asymptomatic volunteers

  18. Joint Replacement (Finger and Wrist Joints)

    Science.gov (United States)

    ... wrist joints can all be replaced (Figure 1). Artificial joints in the hand may help: Reduce joint pain Restore or maintain joint motion Improve the look and alignment of the joint(s) Improve overall hand function Causes In a normal joint, bones have a smooth surface made of a substance ...

  19. Qualitative and Quantitative Analyses of the Dynamic and Static Stabilizers of the Medial Elbow: An Anatomic Study.

    Science.gov (United States)

    Frangiamore, Salvatore J; Moatshe, Gilbert; Kruckeberg, Bradley M; Civitarese, David M; Muckenhirn, Kyle J; Chahla, Jorge; Brady, Alex W; Cinque, Mark E; Oleson, Morten Lykke; Provencher, Matthew T; Hackett, Thomas R; LaPrade, Robert F

    2018-03-01

    The anterior bundle of the medial ulnar collateral ligament (UCL) and the forearm flexors provide primary static and dynamic stability to valgus stress of the elbow in overhead-throwing athletes. Quantitative anatomic relationships between the dynamic and static stabilizers have not been described. To perform qualitative and quantitative anatomic evaluations of the medial elbow-UCL complex with specific attention to pertinent osseous and soft tissue landmarks. Descriptive laboratory study. Ten nonpaired, fresh-frozen human cadaveric elbows (mean age, 54.1 years [range, 42-64 years]; all male) were utilized for this study. Quantitative analysis was performed with a 3-dimensional coordinate measuring device to quantify the location of pertinent bony landmarks and tendon and ligament footprints on the humerus, ulna, and radius. The anterior bundle of the UCL attached 8.5 mm (95% CI, 6.9-10.0) distal and 7.8 mm (95% CI, 6.6-9.1) lateral to the medial epicondyle, 1.5 mm (95% CI, 0.5-2.5) distal to the sublime tubercle, and 7.3 mm (95% CI, 6.1-8.5) distal to the joint line on the ulna along the ulnar ridge. The flexor digitorum superficialis (FDS) ulnar tendinous insertion was closely related and interposed within the anterior bundle of the UCL, overlapping with 45.6% (95% CI, 38.1-53.6) of the length of the anterior bundle of the UCL. The flexor carpi ulnaris (FCU) attached 1.9 mm (95% CI, 0.8-2.9) posterior and 1.3 mm (95% CI, 0.6-3.2) proximal to the sublime tubercle and overlapped with 20.9% (95% CI, 7.2-34.5) of the area of the distal footprint of the anterior bundle of the UCL. The anterior bundle of the UCL had consistent attachment points relative to the medial epicondyle and sublime tubercle. The ulnar limb of the FDS and FCU tendons demonstrated consistent insertions onto the ulnar attachment of the anterior bundle of the UCL. These anatomic relationships are important to consider when evaluating distal UCL tears both operatively and nonoperatively. Excessive

  20. Time course analysis of the effects of botulinum toxin type a on elbow spasticity based on biomechanic and electromyographic parameters.

    Science.gov (United States)

    Lee, Hsin-Min; Chen, Jia-Jin Jason; Wu, Yi-Ning; Wang, Yu-Lin; Huang, Sheng-Chih; Piotrkiewicz, Maria

    2008-04-01

    To quantify changes of elbow spasticity over time after botulinum toxin type A (BTX-A) injection in the upper extremity of stroke patients. Before-after trial in which the therapeutic effects were followed up at 2, 6, and 9 weeks after the BTX-A injection (Botox). Hospital. Chronic stroke patients (N=8) with upper-limb spasticity. BTX-A was injected in upper-limb muscles, including the biceps brachii. Treatment effects were quantified as the changes in the velocity and the length dependence of hyperexcitable stretch reflexes. Manual sinusoid stretches of the elbow joint at 4 frequencies (1/3, 1/2, 1, 3/2Hz) over a movement range of 60 degrees were performed on patients by using a portable device. The Modified Ashworth Scale (MAS), biomechanic viscosity, and the reflexive electromyography threshold (RET) of the biceps brachii were used to evaluate the degree of hypertonia. The statistical analyses of the MAS score, biomechanic viscosity, and RET revealed a significant decrease in spasticity after the injection (all Pbiomechanic viscosity, RET) revealed small changes in spasticity after the BTX-A injection that could not be observed from clinical MAS evaluations. Five of 8 subjects showed a maximal reduction in spasticity (in terms of biomechanic viscosity value) within 6 weeks after the injection, whereas it was notable that all subjects exhibited peak RET values at either 2 or 6 weeks after the injection with variable degrees of relapse of spasticity. Early relapse of spasticity (within 9 weeks of the injection) can be detected from biomechanic and neurophysiologic assessments in a clinical setup. These quantitative indices provide valuable information for clinicians when making decisions to perform additional rehabilitation interventions or another BTX-A injection in the early stages of treatment.

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

    NARCIS (Netherlands)

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

    1999-01-01

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

  2. Serial casting for elbow flexion contractures in neonatal brachial plexus palsy.

    Science.gov (United States)

    Duijnisveld, B J; Steenbeek, D; Nelissen, R G H H

    2016-09-02

    The objective of this study was to evaluate the effectiveness of serial casting of elbow flexion contractures in neonatal brachial plexus palsy. A prospective consecutive cohort study was performed with a median follow-up of 5 years. Forty-one patients with elbow flexion contractures ≥ 30° were treated with serial casting until the contracture was ≤ 10°, for a maximum of 8 weeks. Range of motion, number of recurrences and patient satisfaction were recorded and analyzed using Wilcoxon signed-rank and Cox regression tests. Passive extension increased from a median of -40° (IQR -50 to -30) to -15° (IQR -10 to -20, p contractures, although recurrences were frequent. The severity of elbow flexion contracture is a predictor of recurrence. We recommend more research on muscle degeneration and determinants involved in elbow flexion contractures to improve treatment strategies and prevent side-effects.

  3. Concomitant Total Wrist and Total Elbow Arthroplasty in a Rheumatoid Patient

    OpenAIRE

    Kane, Patrick M.; Stull, Justin D.; Culp, Randall W.

    2015-01-01

    Background Concomitant arthroplasty has been described to have several benefits over multistage procedures. Ipsilateral total elbow and total shoulder arthroplasty has been reported with good outcomes in upper extremity concomitant arthroplasty.

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

    Directory of Open Access Journals (Sweden)

    Haytham Samy Diab

    2015-04-01

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

  5. Bimanual elbow robotic orthoses: preliminary investigations on an impairment force feedback rehabilitation method

    Directory of Open Access Journals (Sweden)

    Gil eHerrnstadt

    2015-03-01

    Full Text Available Modern rehabilitation practices have begun integrating robots, recognizing their significant role in recovery. New and alternative stroke rehabilitation treatments are essential to enhance efficacy and mitigate associated health costs. Today’s robotic interventions can play a significant role in advancing rehabilitation. In addition, robots have an inherent ability to perform tasks accurately and reliably and are typically well suited to measure and quantify performance.Most rehabilitation strategies predominantly target activation of the paretic arm. However, bimanual upper limb rehabilitation research suggests potential in enhancing functional recovery. Moreover studies suggest limb coordination and synchronization can improve treatment efficacy.In this preliminary study, we aimed to investigate and validate our user-driven bimanual system in a reduced intensity rehab practice. A Bimanual Wearable Robotic Device (BWRD with a Master-Slave configuration for the elbow joint was developed to carry out the investigation. The BWRD incorporates position and force sensors for which respective control loops are implemented, and offers varying modes of operation ranging from passive to active training. The proposed system enables the perception of the movements, as well as the forces applied by the hemiparetic arm, with the non-hemiparetic arm. Eight participants with chronic unilateral stroke were recruited to participate in a total of three one-hour sessions per participant, delivered in a week. Participants underwent pre and post training functional assessments along with proprioceptive measures. The post assessment was performed at the end of the last training session.The protocol was designed to engage the user in an assortment of static and dynamic arm matching and opposing tasks. The training incorporates force feedback movements, force feedback positioning, and force matching tasks with same and opposite direction movements. We are able to

  6. Radial shortening osteotomy reduces radiocapitellar contact pressures while preserving valgus stability of the elbow.

    Science.gov (United States)

    Hackl, Michael; Wegmann, Kilian; Kahmann, Stephanie L; Heinze, Nicolai; Staat, Manfred; Neiss, Wolfram F; Scaal, Martin; Müller, Lars P

    2017-07-01

    Shortening osteotomy of the proximal radius might represent a potential salvage procedure in symptomatic radiocapitellar osteoarthritis, which could decrease radiocapitellar load while preserving the native radial head. In an in-vitro biomechanical investigation, we sought to determine whether shortening osteotomy of the proximal radius (1) decreases the radiocapitellar joint pressure upon axial loading and (2) retains valgus stability of the elbow. In addition, the anatomic configuration of the lesser sigmoid notch was evaluated to assess possible contraindications. Axial loading (0-400 N) and valgus torque (7.5 N m) over the full range of motion were applied to 14 fresh-frozen specimens before and after shortening osteotomy of the proximal radius by 2.5 mm. Radiocapitellar and ulnohumeral load distribution during axial compression was evaluated using a digital pressure mapping sensor. Valgus displacement was analyzed with a 3D camera system. The inclination angle (α) of the lesser sigmoid notch was assessed via 50 CT scans. Up to axial loading of 250 N, shortening osteotomy caused a significant decrease in radiocapitellar contact pressures (p 20° (type III). Shortening osteotomy of the proximal radius can decrease radiocapitellar contact pressures during axial loading of up to 250 N. Primary valgus stability is not relevantly influenced by this procedure. In few patients, shortening osteotomy may cause radioulnar impingement of the radial head at the distal edge of the lesser sigmoid notch due to an inclination angle of >20°. Shortening osteotomy might be a promising treatment option to decrease pain levels in case of isolated radiocapitellar osteoarthritis.

  7. Luxation of the elbow complicated by proximal radio-ulnar translocation

    International Nuclear Information System (INIS)

    Ekloef, O.; Nybonde, T.; Karlsson, G.; St. Goeran's Children's Hospital, Stockholm

    1990-01-01

    Luxation of the elbow complicated by proximal radio-ulnar translocation is a rare entity. The clue to diagosis is the reversed position of the bones of the proxomal forearm. In the a.p. projection the radial head articulates with the trochlea and the ulna with the capitellum. This unexpected anatomic relationship is easily overlooked. Delayed reduction may result in permanent impairment of elbow motility. Our experience with three recent cases is presented. (orig.)

  8. Luxation of the elbow complicated by proximal radio-ulnar translocation

    Energy Technology Data Exchange (ETDEWEB)

    Ekloef, O.; Nybonde, T.; Karlsson, G. (St. Goeran' s Children' s Hospital, Stockholm (Sweden). Dept. of Radiology St. Goeran' s Children' s Hospital, Stockholm (Sweden). Dept. of Surgery)

    1990-03-01

    Luxation of the elbow complicated by proximal radio-ulnar translocation is a rare entity. The clue to diagosis is the reversed position of the bones of the proxomal forearm. In the a.p. projection the radial head articulates with the trochlea and the ulna with the capitellum. This unexpected anatomic relationship is easily overlooked. Delayed reduction may result in permanent impairment of elbow motility. Our experience with three recent cases is presented. (orig.).

  9. Experimental study on fluid mixing phenomena in T-pipe junction with upstream elbow

    International Nuclear Information System (INIS)

    Hiroshi Ogawa; Minoru Igarashi; Nobuyuki Kimura; Hideki Kamide

    2005-01-01

    Full text of publication follows: Temperature fluctuation in fluid causes high cycle thermal fatigue in shroud structure according to its amplitude and frequency. There are still some incidents of thermal fatigue and leakage in light water reactors (Japanese PWR Tomari-2 in 2003, French PWR CIVAUX in 1998), and also in sodium cooled reactors (French FBR Phenix in 1992). Mixing tee is a typical component where temperature fluctuation occurs. Water experiment has been carried out to investigate temperature fluctuation characteristics and flow velocity field in a simple T-pipe junction with straight inlet pipings for main and branch lines; test facility is named as WATLON (Water Experiment on Fluid Mixing in T-pipe with Long Cycle Fluctuation). Here, influence of upstream elbow in the main pipe was studied in the WATLON facility. Elbow can be set near the mixing tee in a real plant. Outlet of the elbow has biased velocity distribution and also the secondary flow, which decays unsteadily. Temperature distribution in the mixing tee was measured by a movable tree with 17 thermocouples and velocity field was measured by Dynamic PIV (high speed particle image velocimetry) with sampling frequency of 200 Hz. Measured temperature showed that fluctuation intensity near the wall was larger in the elbow geometry than in the straight inlet pipes in a case of wall jet (branch flow velocity is smaller than main pipe flow velocity); high intensity region in the elbow case was enlarged around the jet exiting from the branch pipe. The result of flow velocity measurement showed that secondary flow and biased flow velocity distributions due to the elbow influenced bending of the jet exiting from the branch pipe and the temperature fluctuation intensity around the jet. The detailed flow velocity distributions and the secondary flow of upstream elbow can be measured by Dynamic PIV. Influence of such elbow was discussed based on detailed temperature data together with fluctuated velocity

  10. Linking of the Patient Rated Elbow Evaluation (PREE) and the American Shoulder and Elbow Surgeons - Elbow questionnaire (pASES-e) to the International Classification of Functioning Disability and Health (ICF) and Hand Core Sets.

    Science.gov (United States)

    Vincent, Joshua I; MacDermid, Joy C; King, Graham J W; Grewal, Ruby

    2015-01-01

    Content analysis-ICF linking. The Patient Rated Elbow Evaluation (PREE) and the self-report section of the American Shoulder and Elbow Surgeons society - Elbow form (ASES-e) are the two commonly used elbow pain and disability self-report measures (PROs). The content of these questions have never been analyzed in light of the International Classification of Functioning Disability and Health (ICF) which is the current standard to describe health and health-related states. The purposes of this study were to analyze the conceptual basis of the PREE and the ASES-e by linking the meaningful concepts in these PROs to the ICF using standardized linking rules and to determine the extent to which the ICF core set for hand conditions cover the content of elbow questionnaires using summary ICF linkage indicators. Two raters linked the two PROs to the ICF using the linking rules proposed by Cieza and colleagues. Percentage agreement was calculated between the raters. Summary linkage indicators proposed by MacDermid were used to estimate the extent to which the ICF core set for hand conditions cover the content of the elbow questionnaires. All the items of the PREE (Measure to ICF linkage - 100%) and all but one item of the pASES-e (Measure to ICF linkage - 95%) were linked to the ICF. The satisfaction item on the ASES-e was not-covered by the ICF. Percentage agreement on linking between the raters was 96% and 95% for the PREE and the pASES-e respectively. The unique linkage of the PREE and the pASES-e to the unique codes on the brief and comprehensive core set were lower than absolute linkage to the core set for hand conditions. The PROs represented less than 20% of the comprehensive core set and more than 70% of the brief core set. While for the unique core set disability representation the 2 PROMs represented 100% brief core set unique disability codes and less than 35% of the comprehensive core set unique disability codes. The PREE and the ASES-e are aligned with the ICF

  11. Pinch and Elbow Extension Restoration in People With Tetraplegia: A Systematic Review of the Literature

    Science.gov (United States)

    Hamou, Cynthia; Shah, Nirav R.; DiPonio, Lisa; Curtin, Catherine M.

    2009-01-01

    Purpose We conducted a systematic review of the literature to summarize the available data on reconstructive surgeries involving pinch reconstruction and elbow extension restoration in people with tetraplegia. Methods English-language and French-language articles and abstracts published between 1966 and February 2007, identified through MEDLINE and EMBASE searches, bibliography review, and expert consultation, were reviewed for original reports of outcomes with pinch reconstruction and elbow extension restoration in tetraplegic patients after a spinal cord injury. Two reviewers independently extracted data on patient characteristics, surgical methods, and patient outcomes. Results Our search identified 765 articles, of which 37 met eligibility criteria (one article contained information on both elbow and pinch procedures). Results from 377 pinch reconstructions in 23 studies and 201 elbow extension restorations in 14 studies were summarized. The mean Medical Research Council score for elbow extension went from 0 to 3.3 after reconstruction. The overall mean postoperative strength measured after surgery for pinch reconstruction was 2 kg. Conclusions More than 500 patients having these procedures experienced a clinically important improvement for both procedures—one restoring elbow extension, and the other, pinch strength. Upper-limb surgeries markedly improved the hand function of people with tetraplegia. Type of study/level of evidence Therapeutic IV. PMID:19345872

  12. Pediatric elbow trauma: an orthopaedic perspective on the importance of radiographic interpretation.

    Science.gov (United States)

    Jacoby, Sidney M; Herman, Martin J; Morrison, William B; Osterman, A Lee

    2007-03-01

    Radiographic interpretation of pediatric elbow trauma presents a daunting task for both the radiologist and treating orthopaedic surgeon. Proper radiographic diagnosis and appropriate intervention requires a thorough understanding and appreciation of developmental anatomy. As the pediatric elbow matures, it transitions from multiple cartilaginous anlagen through a predictable pattern of ossification and fusion. When children sustain trauma to the elbow, they may have a limited capacity to communicate specific complaints and are sometimes difficult to examine reliably. Furthermore, the presence of multiple growth centers, and their variability, makes radiographic evaluation of pediatric elbow injuries particularly challenging. These variables, coupled with the known adverse long-term sequelae of pediatric elbow trauma (painful nonunion, malunion, elbow stiffness, growth disturbance, etc.) highlight the importance of accurate radiographic interpretation, which facilitates appropriate treatment. By using an orderly, systematic approach based on well-defined anatomical relationships and accepted radiographic markers, the radiologist may effectively interpret and communicate pertinent findings to the treating orthopaedic surgeon. Furthermore, using common classification systems may facilitate interdisciplinary communication. Finally, it is crucial that caregivers of children consider the possibility of child abuse in suspect cases.

  13. Joint pain

    Science.gov (United States)

    ... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: Gout (especially ...

  14. Acupuncture Treatment of Lateral Elbow Pain: A Nonrandomized Pilot Study

    Directory of Open Access Journals (Sweden)

    Yan-Song Liu

    2016-01-01

    Full Text Available In planning for a large-scale multicenter trial to evaluate the effect of acupuncture for the treatment of lateral elbow pain, a pilot study was conducted. This was a prospective, investigator- and patient-blinded, nonrandomized, placebo controlled trial. Subjects were evaluated at baseline, before fourth, seventh, and ninth treatment, and at a two-week posttreatment follow-up. The treatment group received unilateral acupuncture at LI 10 and LI 11 at the affected side with manual needle manipulation; the control group received sham-laser acupuncture at the same acupoints. Measures included (i disabilities of the arm, shoulder, and hand (DASH questionnaire, (ii pain-free grip strength (PFGS, and (iii a visual analogue scale (VAS for pain. Significant differences in DASH score, PFGS, and VAS between treatment and control group were found at the ninth treatment (n=20 for each group, P<0.05. Only DASH showed significant differences compared to the control for all the measurement time points after treatment commenced and appears to be a sensitive and appropriate primary outcome measure for the future multisite trial. Results from this pilot study provided relevant information about treatment efficacy, credibility of control treatment, and sensitivity of different outcome measures for the planning of the future trial.

  15. "Popeye muscle" morphology in OBPI elbow flexion contracture.

    Science.gov (United States)

    Coroneos, Christopher J; Maizlin, Zeev V; DeMatteo, Carol; Gjertsen, Deborah; Bain, James R

    2015-01-01

    The pathophysiology of elbow flexion contracture (EFC) in obstetrical brachial plexus injury (OBPI) is not established. In basic science models, neonatal denervation leads to impaired muscle growth. In clinical studies, diminished growth is correlated with extent of denervation, and improved with surgical repair. In EFC, the biceps are clinically short and round vs the contralateral size, termed the "Popeye muscle". The objective of this study was to determine if the biceps morphology (muscle belly and tendon length) in arms with EFC secondary to OBPI is different vs the contralateral. This is a retrospective matched-cohort study. Patients with unilateral EFC (>20°) secondary to OBPI were identified (median = 6.6 years, range = 4.7-16.8). A blinded radiologist used computed tomography to measure length of the biceps short head muscle belly, and tendon bilaterally using standardised anatomical landmarks. Twelve patients were analyzed. The biceps muscle belly in the injured arm was shorter in all patients vs contralateral, mean difference = 3.6 cm (80%), p muscle belly and overall length, but longer tendon vs normal. This is termed the "Popeye muscle" for its irregular morphology. Findings are consistent with impaired limb growth in denervation.

  16. Left atrial volume index

    DEFF Research Database (Denmark)

    Poulsen, Mikael K; Dahl, Jordi S; Henriksen, Jan Erik

    2013-01-01

    To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease.......To determine the prognostic importance of left atrial (LA) dilatation in patients with type 2 diabetes (T2DM) and no history of cardiovascular disease....

  17. Changes in EMG Activities of Upper Arm Muscles and in Shoulder Joint Angles in Post-stroke Patients

    Directory of Open Access Journals (Sweden)

    Rositsa Raikova

    2016-09-01

    Full Text Available The aim of the paper is to compare the electromyographic signals (EMGs and the joint angles of the affected upper limb muscles of stroke survivors to those of their non-affected limb as well as to those of the dominant and the non-dominant limbs of healthy volunteers. Twenty five volunteers, ten post-stroke survivors and fifteen healthy subjects as control group, participated in the experiments. EMGs of muscles of the upper limbs and two angles in the shoulder joint were registered and processed during three static and two dynamic tasks. The results showed a big variability of all investigated parameters (mean and median frequencies, ranges of motions, maximal normalized EMGs both for the patients and for the healthy subjects, for right and for left hand. This makes difficult a deduction of definitive conclusions about the changes in motor control of the upper limbs due to stroke. Moreover, natural differences in motor control exist for dominant and non-dominant limb. On the whole, the power-frequency analysis and the relevant statistical analysis indicated that the muscles of the affected limb had lower median frequencies than those of the healthy limb. Examination of full elbow flexions in the sagittal plane showed that the range of the motion in the shoulder joint of both limbs of the patients increased when compared to the healthy subjects and that this increase was larger for the affected limb. The post-stroke survivors used more of their muscle power although no increased co-contraction was observed.

  18. The reliability, validity and responsiveness of the Dutch version of the Oxford elbow score

    Directory of Open Access Journals (Sweden)

    Patka Peter

    2011-07-01

    Full Text Available Abstract Background The Oxford elbow score (OES is an English questionnaire that measures the patients' subjective experience of elbow surgery. The OES comprises three domains: elbow function, pain, and social-psychological effects. This questionnaire can be completed by the patient and used as an outcome measure after elbow surgery. The aim of this study was to develop and evaluate the Dutch version of the translated OES for reliability, validity and responsiveness with respect to patients after elbow trauma and surgery. Methods The 12 items of the English-language OES were translated into Dutch and then back-translated; the back-translated questionnaire was then compared to the original English version. The OES Dutch version was completed by 69 patients (group A, 60 of whom had an elbow luxation, four an elbow fracture and five an epicondylitis. QuickDASH, the visual analogue pain scale (VAS and the Mayo Elbow Performance Index (MEPI were also completed to examine the convergent validity of the OES in group A. To calculate the test-retest reliability and responsiveness of the OES, this questionnaire was completed three times by 43 different patients (group B. An average of 52 days elapsed between therapy and the administration of the third OES (SD = 24.1. Results The Cronbach's α coefficients for the function, pain and social-psychological domains were 0.90, 0.87 and 0.90, respectively. The intra-class correlation coefficients for the domains were 0.87 for function, 0.89 for pain and 0.87 for social-psychological. The standardised response means for the domains were 0.69, 0.46 and 0.60, respectively, and the minimal detectable changes were 27.6, 21.7 and 24.0, respectively. The convergent validity for the function, pain and social-psychological domains, which were measured as the Spearman's correlation of the OES domains with the MEPI, were 0.68, 0.77 and 0.77, respectively. The Spearman's correlations of the OES domains with QuickDASH were

  19. Evaluating the contributions of muscle activity and joint kinematics to weight perception across multiple joints.

    Science.gov (United States)

    Waddell, Morgan L; Amazeen, Eric L

    2017-08-01

    Perceived heaviness is clearly a function of muscle activity: objects feel heavy, in part because they are lifted with more force than lighter feeling objects. Recent research showed that participants scale their perceptions to the ratio of muscle activity to lift acceleration during elbow lifts (Waddell et al. J Exp Psychol Hum Percept Perform 42:363-374, 2016). The current study sought psychophysiological functions relating perceived heaviness to EMG and peak lift acceleration across multiple lifts employing different muscles as prime movers. Participants lifted objects with three arm lifts-shoulder, elbow, and wrist-and reported perceived heaviness. In each lift, EMG was recorded from the anterior deltoid, biceps brachii, and forearm flexors, and peak angular acceleration was recorded about each joint. The resulting psychophysiological functions revealed the hypothesized ratio of muscle activity to peak lift acceleration in all lifts. Principal component regressions showed that the EMG of the forearm flexors and peak acceleration of the lifting joint were most relevant for perceived heaviness. The special role of forearm flexors in perceiving heaviness across different lifts was interpreted in terms of the invariant structure of the inertia tensor about the wrist.

  20. Accuracy and inter-observer reliability of visual estimation compared to clinical goniometry of the elbow.

    Science.gov (United States)

    Blonna, Davide; Zarkadas, Peter C; Fitzsimmons, James S; O'Driscoll, Shawn W

    2012-07-01

    To test the hypothesis that visual estimation by a trained observer is as accurate and reliable as clinical goniometry for measuring elbow range of motion. Instrument validity and inter-observer reliability of visual estimation was evaluated on a consecutive series of 50 elbow contractures. Four observers with different levels of elbow experience first estimated extension and flexion of the contracted elbows and then measured them with a blinded goniometer. Instrument validity for visually-based goniometry was extremely high. ICC scores were 0.97 for both extension and flexion estimations. Systematic error was negligible (1°) with upper limits of agreement being 9° (95% CI: 7°-11°) and 8° (95% CI: 6°-10°), respectively, for extension and flexion. For the expert surgeon, 92% of the visual estimates were within 5° of the value obtained by clinical goniometry. Between experienced observers (elbow surgeon and physician assistant), the ICC's were very high-0.96 for extension and 0.93 for flexion. The systematic errors were low, from -1° to 1° with upper limit of agreement being 11° (95% CI: 8°-14°). However, agreement was poor between an inexperienced study coordinator and the others (ICC's: 0.51-0.38, systematic errors: 8°-18°, upper limit of agreement: 32°-40°). The accuracy of the visual estimations made by the experienced elbow surgeon was as good as the measurements taken with a goniometer by the physician assistant or the clinical fellow and better than those taken by an inexperienced study coordinator. The trained human eye is highly capable of accurately estimating the range of motion of the elbow, compared to conventional clinical goniometry, depending on the experience of the observer. Diagnostic study, Level II.

  1. 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.

  2. Epicondilite lateral do cotovelo Lateral epicondylitis of the elbow

    Directory of Open Access Journals (Sweden)

    Marcio Cohen

    2012-01-01

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

  3. Voluntary driven elbow orthosis with speed controlled tremor suppression

    Directory of Open Access Journals (Sweden)

    Gil eHerrnstadt

    2016-03-01

    Full Text Available Robotic technology is gradually becoming commonplace in the medical sector and in the service of patients. Medical conditions that have benefited from significant technological development include stroke, for which rehabilitation with robotic devices is administered, and surgery assisted by robots. Robotic devices have also been proposed for assistance of movement disorders. Pathological tremor, among the most common movement disorders, is such one example. In practice, the dissemination and availability of tremor suppression robotic systems has been limited. Devices in the marketplace tend to either be non-ambulatory or to target specific functions such as eating and drinking.We have developed a one degree-of-freedom (DOF elbow orthosis that could be worn by an individual with tremor. A speed controlled voluntary driven suppression approach is implemented with the orthosis. Typically tremor suppression methods estimate the tremor component of the signal and produce a canceling counterpart signal. The suggested approach, instead estimates the voluntary component of the motion. A controller then actuates the orthosis based on the voluntary signal while simultaneously rejecting the tremorous motion.In this work, we tested the suppressive orthosis using a 1 DOF robotic system that simulates the human arm. The suggested suppression approach does not require a model of the human arm. Moreover, the human input along with the orthosis forearm gravitational forces, of nonlinear nature, are considered as part of the disturbance to the suppression system. Therefore, the suppression system can be modeled linearly. Nevertheless, the orthosis forearm gravitational forces can be compensated by the suppression system.The electromechanical design of the orthosis is presented, and data from an Essential Tremor patient is used as the human input. Velocity tracking results demonstrate an RMS error of 0.31 rad/s, and a power spectral density shows a reduction of

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

    Directory of Open Access Journals (Sweden)

    Sacco G

    2015-02-01

    Full Text Available G Sacco,1–3,* JM Turpin,3,4,* A Marteu,5 C Sakarovitch,6 B Teboul,2 L Boscher,4,5 P Brocker,4 P Robert,1–3 O Guerin2,3,7 1Memory Center, Claude Pompidou Institut, Department of Geriatrics, University Hospital of Nice, Nice, France; 2Centre d’Innovation et d’Usages en Santé (CIU-S, University Hospital of Nice, Cimiez Hospital, Nice, France; 3CoBTeK Cognition Behaviour Technology EA 7276, Research Center Edmond and Lily Safra, Nice Sophia-Antipolis University, Nice, France; 4Rehabilitation Unit, Department of Geriatrics, University Hospital of Nice, Cimiez Hospital, Nice, France; 5Rehabilitation Unit, Department of Neurosciences, University Hospital of Nice, L’Archet Hospital, Nice, France; 6Department of Clinical Research and Innovation, University Hospital of Nice, Cimiez Hospital, Nice, France; 7Acute Geriatrics Unit, Department of Geriatrics, University Hospital of Nice, Cimiez Hospital, Nice, France *These authors contributed equally to this work Background and purpose: Musculoskeletal system deterioration among the aging is a major reason for loss of autonomy and directly affects the quality of life of the elderly. Articular evaluation is part of physiotherapeutic assessment and helps in establishing a precise diagnosis and deciding appropriate therapy. Reference instruments are valid but not easy to use for some joints. The main goal of our study was to determine reliability and intertester reproducibility of the MP-BV, an inertial sensor (the MotionPod® [MP] combined with specific software (BioVal [BV], for elbow passive range-of-motion measurements in geriatrics. Methods: This open, monocentric, randomized study compared inertial sensor to inclinometer in patients hospitalized in an acute, post-acute, and long-term-care gerontology unit. Results: Seventy-seven patients (mean age 83.5±6.4 years, sex ratio 1.08 [male/female] were analyzed. The MP-BV was reliable for each of the three measurements (flexion, pronation, and

  5. Moment arms and lengths of human upper limb muscles as functions of joint angles.

    Science.gov (United States)

    Pigeon, P; Yahia, L; Feldman, A G

    1996-10-01

    Modeling of musculoskeletal structures requires accurate data on anatomical parameters such as muscle lengths (MLs), moment arms (MAs) and those describing the upper limb position. Using a geometrical model of planar arm movements with three degrees of freedom, we present, in an analytical form, the available information on the relationship between MAs and MLs and joint angles for thirteen human upper limb muscles. The degrees of freedom included are shoulder flexion/extension, elbow flexion/extension, and either wrist flexion/extension (the forearm in supination) or radial/ulnar deviation (the forearm in mid-pronation). Previously published MA/angle curves were approximated by polynomials. ML/angle curves were obtained by combining the constant values of MLs (defined by the distance between the origin and insertion points for a specific upper limb position) with a variable part obtained by multiplying the MA (joint radius) and the joint angle. The MAs of the prime wrist movers in radial/ulnar deviation were linear functions of the joint angle (R2 > or = 0.9954), while quadratic polynomials accurately described their MAs during wrist flexion/extensions. The relationship between MAs and the elbow angle was described by 2nd, 3rd or 5th-order polynomials (R2 > or = 0.9904), with a lesser quality of fit for the anconeus (R2 = 0.9349). In the full range of angular displacements, the length of wrist, elbow and shoulder muscles can change by 8.5, 55 and 200%, respectively.

  6. Left heart catheterization

    Science.gov (United States)

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye (sometimes called "contrast") will be ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  7. Joint imaging

    International Nuclear Information System (INIS)

    Hengst, W.

    1984-01-01

    Joint imaging is a proven diagnostic procedure which has become indispensable to the detection and treatment of different joint diseases in almost all disciplines. The method is suited for early diagnosis of joint affections both in soft tissue and bone which cannot be detected by X-ray or other procedures. The local activity accumulation depends on the rate of metabolism and is visualized in the scan, which in turn enables the extension and floridity of focal lesions to be evaluated and followed-up. Although joint scans may often give hints to probabilities relevant to differential diagnosis, the method is non-specific and only useful if based on the underlying clinical picture and X-ray finding, if possible. The radiation exposure is very low and does not represent a hazard in cases of adequate assessment of indication. In pregnant women and children the assessment of indication has to be based on very strict principles. The method is suited for out-patient diagnosis and can be applied in all installations equipped with a gamma camera and a technetium generator. (orig.) [de

  8. Joint purpose?

    DEFF Research Database (Denmark)

    Pristed Nielsen, Helene

    2013-01-01

    of anti-discrimination in Europe today? And what empirical evidence may be found for such a joint approach? The paper discusses how the contemporary EU context differs from the American context which prompted Crenshaw to raise the point about intersectionality, and it analyses documents and interviews...

  9. A Failure Estimation Method of Steel Pipe Elbows under In-plane Cyclic Loading

    Directory of Open Access Journals (Sweden)

    Bub-Gyu Jeon

    2017-02-01

    Full Text Available The relative displacement of a piping system installed between isolated and nonisolated structures in a severe earthquake might be larger when without a seismic isolation system. As a result of the relative displacement, the seismic risks of some components in the building could increase. The possibility of an increase in seismic risks is especially high in the crossover piping system in the buildings. Previous studies found that an elbow which could be ruptured by low-cycle ratcheting fatigue is one of the weakest elements. Fatigue curves for elbows were suggested based on component tests. However, it is hard to find a quantitative evaluation of the ultimate state of piping elbows. Generally, the energy dissipation of a solid structure can be calculated from the relation between displacement and force. Therefore, in this study, the ultimate state of the pipe elbow, normally considered as failure of the pipe elbow, is defined as leakage under in-plane cyclic loading tests, and a failure estimation method is proposed using a damage index based on energy dissipation.

  10. A failure estimation method of steel pipe elbows under in-plane cyclic loading

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Bub Gyu; Kim, Sung Wan; Choi, Hyoung Suk; Park, Dong Uk [Seismic Simulation Tester Center, Pusan National University, Yangsan (Korea, Republic of); Kim, Nam Sik [Dept. of Civil and Environmental Engineering, Pusan National University, Busan (Korea, Republic of)

    2017-02-15

    The relative displacement of a piping system installed between isolated and nonisolated structures in a severe earthquake might be larger when without a seismic isolation system. As a result of the relative displacement, the seismic risks of some components in the building could increase. The possibility of an increase in seismic risks is especially high in the crossover piping system in the buildings. Previous studies found that an elbow which could be ruptured by low-cycle ratcheting fatigue is one of the weakest elements. Fatigue curves for elbows were suggested based on component tests. However, it is hard to find a quantitative evaluation of the ultimate state of piping elbows. Generally, the energy dissipation of a solid structure can be calculated from the relation between displacement and force. Therefore, in this study, the ultimate state of the pipe elbow, normally considered as failure of the pipe elbow, is defined as leakage under in-plane cyclic loading tests, and a failure estimation method is proposed using a damage index based on energy dissipation.

  11. Distribution of Platelet-rich Plasma after Ultrasound-Guided Injection for Chronic Elbow Tendinopathies.

    Science.gov (United States)

    Park, Gi-Young; Kwon, Dong Rak; Cho, Hee Kyung; Park, Jinyoung; Park, Jung Hyun

    2017-03-01

    Characteristics of the spreads of platelet-rich plasma (PRP) are not widely known despite commonly use. This study aims to evaluate whether PRP stays within the injected area by using ultrasonography, to improve understanding of the spreads of intratendinous injected PRP. Thirty-nine patients (15 males, 24 females; mean age, 49.3 years), who had symptoms on their elbows (> 6 months) and diagnosed as lateral (25 elbows) or medial (14 elbows) tendinopathies of elbow, were included. The severity of tendon pathology was assessed by ultrasonography as tear or no tear. Immediately after ultrasound-guided PRP injection, ultrasound images were evaluated to assess the area of PRP distribution, which was defined as the presence of fluid or microbubbles. Ultrasound revealed that 13 elbows had tendon tear and 26 had no tear, respectively. Post-injection ultrasound confirmed the injected PRP was within the tendon in all cases. The mean distance of distribution from the injection site was 12.6 mm (5.0-26.0 mm). There was no difference in the distance of PRP distribution between tendon tear and no tear. Injected PRP spread to soft tissue outside the tendon in 20 of 39 cases. Intra-articular extension of PRP was observed in 5 cases. Although PRP remained intratendinous after the injection in all cases, some portion tended to spread outside from the injection site in a short space of time. Postinjection ultrasonographic imaging has a value for observing the spreading patterns of intratendinous PRP injection.

  12. The effect of load-controlled bending load on the failure pressure of wall-thinned pipe elbows

    International Nuclear Information System (INIS)

    Kim, Jin Weon; Yoon, Min Soo; Park, Chi Yong

    2013-01-01

    Highlights: • We evaluated bending load effect on the failure pressure of wall-thinned pipe elbows. • Burst tests were conducted on real-scale elbow specimens with local wall thinning. • The tests were performed under combined pressure and load-controlled bending. • Load-controlled bending reduced the failure pressure of wall-thinned elbows. • Bending load effect was significant for opening-mode and intrados wall-thinning case. - Abstract: In this research, burst tests were conducted on real-scale elbow specimens, each with an artificial local wall-thinning defect, under combined internal pressure and constant in-plane bending load, as well as under simple internal pressure, to evaluate the effect of load-controlled bending load on the failure pressure of locally wall-thinned pipe elbows. Ninety-degree, 65A Schedule 80 elbows, with wall-thinning defects in the intrados and extrados, were used as specimens. The bending loads were in-plane opening- and closing-mode bending, applied in load-control mode. The results clearly indicated that a load-controlled in-plane bending load reduced the failure pressure of wall-thinned pipe elbows, in contrast to observations previously made under displacement-controlled bending conditions. The effect of the bending load was more significant for opening-mode than for closing-mode bending, regardless of the wall-thinning location in the elbow. Also, the effect was greater when the wall-thinning defect was located in the intrados region of the elbow, rather than the extrados region. Existing models that have been proposed to evaluate the failure of wall-thinned elbows under simple internal pressure conservatively predicted the failure pressure of elbows subjected to a combined internal pressure and load-controlled bending load

  13. Case of bilateral Galeazzi fractures associated with dislocation of the right elbow.

    Science.gov (United States)

    Nanno, Mitsuhiko; Sawaizumi, Takuya; Takai, Shinro

    2011-01-01

    We report an unusual case of bilateral Galeazzi fractures associated with dislocation of the right elbow and fracture of the right scaphoid caused by a motorbike accident in a 32-year-old man. Bilateral radiuses were fixed with plates, and the right scaphoid was fixed with a screw after closed reduction of the right elbow. A satisfactory result was obtained with a return to work and no radiographic problems 7 years after surgery. The mechanism of the injury was thought to be a high-velocity fall on the outstretched hands combined with extreme pronation of the forearms and extension of the wrists and the elbows. This case had a favorable outcome following operative stabilization of the fracture-dislocations and early mobilization.

  14. An accurate method for calculation of stress intensification factors in elbows

    International Nuclear Information System (INIS)

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

    1985-01-01

    Accurate knowledge of stress intensification factors in elbows is essential for global elastic calculations of a pipe line. Moreover, sound elastic basis are required for any plastic calculations. The currently used ASME values appear to be too conservative for combined loading configurations involving simultaneous torsion, in-plane and out-of-plane bending. This paper presents an approach to the calculation of ovalization, flexibility and stress intensification factors in an elbow and the adjacent straight portions. The proposed method is compared with shell and beam-type finite element calculations in the range of elbows currently used in French LMFBR loops, and is shown to provide results similar to shell-type finite element analysis for every combined loading configuration. (orig.)

  15. Computer users' risk factors for developing shoulder, elbow and back symptoms

    DEFF Research Database (Denmark)

    Juul-Kristensen, Birgit; Søgaard, Karen; Strøyer, Jesper

    2004-01-01

    to be afflicted than men in all regions. In the full-fit multivariate logistic regression analysis, little influence on the timing of a rest pause and being disturbed by glare or reflection were significant predictors of shoulder symptoms, screen below eye height was a significant predictor for elbow symptoms......OBJECTIVES: This prospective study concentrated on determining factors of computer work that predict musculoskeletal symptoms in the shoulder, elbow, and low-back regions. METHODS: A questionnaire on ergonomics, work pauses, work techniques, and psychosocial and work factors was delivered to 5033...... frequency below 8 days within the last 12 months or intensity score below 4 within the last 3 months). RESULTS: In the follow-up, 10%, 18%, and 23% had symptoms more often in the elbow, shoulder, and low back, respectively, and 14%, 20%, and 22% had more intense symptoms. Women were more likely...

  16. MR imaging of the most commonly injured and diseased structures of the elbow and ankle

    International Nuclear Information System (INIS)

    Mesgarzadeh, M.; Schneck, C.; Ross, G.; Bonakdarpour, A.

    1987-01-01

    Seventeen elbows and 23 ankles of cadavers, normal volunteers, and patients with various disorders were examined by MR imaging. The cadaver specimens were sectioned for direct image correlation. The exhibit illustrates (1) the ability of MR imaging to identify all of the commonly injured or diseased structures about the elbow and ankle, (2) the optimum imaging plane and positioning for each structure, (3) the value of T1- and T2-weighted images in identifying and specifically localizing the disruption, edema, hemorrhage, or effusion that occurs in pathologic processes such as ankle ligament injury and tendinitis at the elbow, and (4) the ability of serial axial sections to follow the ulnar, median, radial, and tibial nerves and their associated vessels through their common entrapment sites

  17. Developing a multi-joint upper limb exoskeleton robot for diagnosis, therapy, and outcome evaluation in neurorehabilitation.

    Science.gov (United States)

    Ren, Yupeng; Kang, Sang Hoon; Park, Hyung-Soon; Wu, Yi-Ning; Zhang, Li-Qun

    2013-05-01

    Arm impairments in patients post stroke involve the shoulder, elbow and wrist simultaneously. It is not very clear how patients develop spasticity and reduced range of motion (ROM) at the multiple joints and the abnormal couplings among the multiple joints and the multiple degrees-of-freedom (DOF) during passive movement. It is also not clear how they lose independent control of individual joints/DOFs and coordination among the joints/DOFs during voluntary movement. An upper limb exoskeleton robot, the IntelliArm, which can control the shoulder, elbow, and wrist, was developed, aiming to support clinicians and patients with the following integrated capabilities: 1) quantitative, objective, and comprehensive multi-joint neuromechanical pre-evaluation capabilities aiding multi-joint/DOF diagnosis for individual patients; 2) strenuous and safe passive stretching of hypertonic/deformed arm for loosening up muscles/joints based on the robot-aided diagnosis; 3) (assistive/resistive) active reaching training after passive stretching for regaining/improving motor control ability; and 4) quantitative, objective, and comprehensive neuromechanical outcome evaluation at the level of individual joints/DOFs, multiple joints, and whole arm. Feasibility of the integrated capabilities was demonstrated through experiments with stroke survivors and healthy subjects.

  18. Tratamento artroscópico da rigidez pós-traumática do cotovelo Arthroscopic treatment of post-traumatic elbow stiffness

    Directory of Open Access Journals (Sweden)

    Jose Carlos Garcia Júnior

    2012-01-01

    Full Text Available OBJETIVO: Avaliar pacientes submetidos à artroscopia para liberação do cotovelo rígido, discutindo a técnica, possíveis dificuldades e riscos. MÉTODOS: Foram realizadas 24 artroscopias de cotovelos. Todos os pacientes foram avaliados usando goniometria pré e seis meses pós-cirurgia e pontuados com o escore de cotovelo Mayo. RESULTADOS: Operados 15 homens e nove mulheres, 14 cotovelos direitos e 10 esquerdos, média de idade de 34,58 anos e de tempo de seguimento de 38,41 meses. A média do ganho do arco de movimento foi de 43,3º e MES de 85,4. CONCLUSÃO: A liberação artroscópica pode viabilizar melhor visualização e aumento das opções de mudança de estratégia durante a cirurgia, diminuição do trauma cirúrgico e possibilidade de reabilitação precoce, podendo atingir resultados similares ou melhores que os da cirurgia aberta. Contra a artroscopia há a grande curva de aprendizado e o maior custo do procedimento. Ambas as técnicas relatam complicações neurovasculares. Para evitar tais problemas, o protocolo para realização dos portais deve ser rigorosamente seguido. A liberação artroscópica mostrou ser opção segura e eficaz no ganho da ADM no cotovelo rígido pós-traumático.To evaluate patients undergoing arthroscopic release of a stiff elbow, with discussion of the technique, possible difficulties and risks. METHODS: Twenty-four elbow arthroscopy procedures were performed. All the patients were evaluated using goniometry before the operation and six months after wards and were rated using the Mayo elbow performance score (MEPS. RESULTS: Fifteen men and nine women underwent surgery (14 right elbows and ten left elbows. Their mean age was 34.58 years and length of follow-up, 38.41 months. Their mean gain of range of motion was 43.3º and of MEPS, 85.4. CONCLUSION: Arthroscopic liberation might enable better intrarticular visualization and enhance options to change strategy during surgery, reduction of surgical

  19. Clinical rating systems in elbow research-a systematic review exploring trends and distributions of use.

    Science.gov (United States)

    Evans, Jonathan P; Smith, Chris D; Fine, Nicola F; Porter, Ian; Gangannagaripalli, Jaheeda; Goodwin, Victoria A; Valderas, Jose M

    2018-04-01

    Clinical rating systems are used as outcome measures in clinical trials and attempt to gauge the patient's view of his or her own health. The choice of clinical rating system should be supported by its performance against established quality standards. A search strategy was developed to identify all studies that reported the use of clinical rating systems in the elbow literature. The strategy was run from inception in Medline Embase and CINHAL. Data extraction identified the date of publication, country of data collection, pathology assessed, and the outcome measure used. We identified 980 studies that reported clinical rating system use. Seventy-two separate rating systems were identified. Forty-one percent of studies used ≥2 separate measures. Overall, 54% of studies used the Mayo Elbow Performance Score (MEPS). For arthroplasty, 82% used MEPS, 17% used Disabilities of Arm, Shoulder and Hand (DASH), and 7% used QuickDASH. For trauma, 66.7% used MEPS, 32% used DASH, and 23% used the Morrey Score. For tendinopathy, 31% used DASH, 23% used Patient-Rated Tennis Elbow Evaluation (PRTEE), and 13% used MEPS. Over time, there was an increased proportional use of the MEPS, DASH, QuickDASH, PRTEE, and the Oxford Elbow Score. This study identified a wide choice and usage of clinical rating systems in the elbow literature. Numerous studies reported measures without a history of either a specific pathology or cross-cultural validation. Interpretability and comparison of outcomes is dependent on the unification of outcome measure choice. This was not demonstrated currently. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  20. What Factors are Associated With a Surgical Site Infection After Operative Treatment of an Elbow Fracture?

    Science.gov (United States)

    Claessen, Femke M A P; Braun, Yvonne; van Leeuwen, Wouter F; Dyer, George S; van den Bekerom, Michel P J; Ring, David

    2016-02-01

    Surgical site infections are one of the more common major complications of elbow fracture surgery and can contribute to other adverse outcomes, prolonged hospital stays, and increased healthcare costs. We asked: (1) What are the factors associated with a surgical site infection after elbow fracture surgery? (2) When taking the subset of closed elbow fractures only, what are the factors associated with a surgical site infection? (3) What are the common organisms isolated from an elbow infection after open treatment? One thousand three hundred twenty adult patients underwent surgery for an elbow fracture between January 2002 and July 2014 and were included in our study. Forty-eight of 1320 patients (4%) had a surgical site infection develop. Thirty-four of 1113 patients with a closed fracture (3%) had a surgical site infection develop. For all elbow fractures, use of plate and screw fixation (adjusted odds ratio [OR]= 2.2; 95% CI, 1.0-4.5; p = 0.041) and use of external fixation before surgery (adjusted OR = 4.7; 95% CI, 1.1-21; p = 0.035) were associated with higher infection rates. When subset analysis was performed for closed fractures, only smoking (adjusted OR = 2.2; 95% CI, 1.1-4.5; p = 0.023) was associated with higher infection rates. Staphylococcus aureus was the most common bacteria cultured (59%). The only modifiable risk factor for a surgical site infection after open reduction and internal fixation was cigarette smoking. Plate fixation and temporary external fixation are likely surrogates for more complex injuries, therefore no recommendations should be inferred from this association. Surgeons should counsel patients who smoke. Level IV, prognostic study.

  1. Firing of antagonist small-diameter muscle afferents reduces voluntary activation and torque of elbow flexors.

    Science.gov (United States)

    Kennedy, David S; McNeil, Chris J; Gandevia, Simon C; Taylor, Janet L

    2013-07-15

    During muscle fatigue, firing of small-diameter muscle afferents can decrease voluntary activation of the fatigued muscle. However, these afferents may have a more widespread effect on other muscles in the exercising limb. We examined if the firing of fatigue-sensitive afferents from elbow extensor muscles in the same arm reduces torque production and voluntary activation of elbow flexors. In nine subjects we examined voluntary activation of elbow flexors by measuring changes in superimposed twitches evoked by transcranial magnetic stimulation of the motor cortex during brief (2-3 s) maximal voluntary contractions (MVC). Inflation of a blood pressure cuff following a 2-min sustained MVC blocked blood flow to the fatigued muscle and maintained firing of small-diameter afferents. After a fatiguing elbow flexion contraction, maximal flexion torque was lower (26.0 ± 4.4% versus 67.9 ± 5.2% of initial maximal torque; means ± s.d.; P torque was also reduced (82.2 ± 4.9% versus 91.4 ± 2.3% of initial maximal torque; P = 0.007), superimposed twitches were larger (2.7 ± 0.7% versus 1.3 ± 0.2% ongoing MVC; P = 0.02) and voluntary activation lower (81.6 ± 8.2% versus 95.5 ± 6.9%; P = 0.04) with than without ischaemia. After a fatiguing contraction, voluntary drive to the fatigued muscles is reduced with continued input from small-diameter muscle afferents. Furthermore, fatigue of the elbow extensor muscles decreases voluntary drive to unfatigued elbow flexors of the same arm. Therefore, firing of small-diameter muscle afferents from one muscle can affect voluntary activation and hence torque generation of another muscle in the same limb.

  2. Three-dimensional analysis of elbow soft tissue footprints and anatomy.

    Science.gov (United States)

    Capo, John T; Collins, Christopher; Beutel, Bryan G; Danna, Natalie R; Manigrasso, Michaele; Uko, Linda A; Chen, Linda Y

    2014-11-01

    Tendinous and ligamentous injuries commonly occur in the elbow. This study characterized the location, surface areas, and origin and insertional footprints of major elbow capsuloligamentous and tendinous structures in relation to bony landmarks with the use of a precision 3-dimensional modeling system. Nine unpaired cadaveric elbow specimens were dissected and mounted on a custom jig. Mapping of the medial collateral ligament (MCL), lateral ulnar collateral ligament (LUCL), triceps, biceps, brachialis, and capsular reflections was then performed with 3-dimensional digitizing technology. The location, surface areas, and footprints of the soft tissues were calculated. The MCL had a mean origin (humeral) footprint of 216 mm(2), insertional footprint of 154 mm(2), and surface area of 421 mm(2). The LUCL had a mean origin footprint of 136 mm(2), an insertional footprint of 142 mm(2), and a surface area of 532 mm(2). Of the tendons, the triceps maintained the largest insertional footprint, followed by the brachialis and the biceps (P < .001-.03). The MCL, LUCL, and biceps footprint locations were consistent, with little variability. The surface areas of the anterior (1251 mm(2)) and posterior (1147 mm(2)) capsular reflections were similar (P = .82), and the anterior capsule extended farther proximally. Restoring the normal anatomy of key elbow capsuloligamentous and tendinous structures is crucial for effective reconstruction after bony or soft tissue trauma. This study provides the upper extremity surgeon with information that may aid in restoring elbow biomechanics and preserving range of motion in these patients. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  3. Joint and soft tissue injections: a survey of general practitioners.

    Science.gov (United States)

    Liddell, W G; Carmichael, C R; McHugh, N J

    2005-08-01

    To determine the type of joint and soft tissue injections carried out by general practitioners (GPs) in the Bath area and factors affecting activity. A questionnaire was sent to 360 GPs requesting information on injections carried out during the previous 12 months, referral pathways for injection, barriers to injecting and training. We received 251 replies. The commonest injections were for tennis elbow, glenohumeral joint, knee, supraspinatus tendonitis and carpal tunnel. The majority of GPs (66.4%) carry out most injections themselves, 26.3% refer to a colleague and 7.3% refer to secondary care. Over half (51%) of all the injections are carried out by 15.6% of the GPs. Factors associated with higher levels of injection activity were: male gender, partnership, more than 10 years' experience, a special interest in rheumatology or orthopaedics and working in a rural or mixed practice. The most important barriers to carrying out injections were lack of practical training, lack of confidence and inability to maintain skills. Most GPs have been trained on models. Most GPs carry out some joint and soft tissue injections, but limit themselves to knees, shoulders and elbows. A small highly active group receive referrals from colleagues. Gender and specialist training strongly influence activity. Many, especially female and part-time, GPs find it hard to maintain their skills and confidence. Training targeted at this group, based in practices and using models and other tools, is likely to increase the number of patients receiving timely injections in general practice.

  4. Using the American alligator and a repeated-measures design to place constraints on in vivo shoulder joint range of motion in dinosaurs and other fossil archosaurs.

    Science.gov (United States)

    Hutson, Joel D; Hutson, Kelda N

    2013-01-15

    Using the extant phylogenetic bracket of dinosaurs (crocodylians and birds), recent work has reported that elbow joint range of motion (ROM) studies of fossil dinosaur forearms may be providing conservative underestimates of fully fleshed in vivo ROM. As humeral ROM occupies a more central role in forelimb movements, the placement of quantitative constraints on shoulder joint ROM could improve fossil reconstructions. Here, we investigated whether soft tissues affect the more mobile shoulder joint in the same manner in which they affect elbow joint ROM in an extant archosaur. This test involved separately and repeatedly measuring humeral ROM in Alligator mississippiensis as soft tissues were dissected away in stages to bare bone. Our data show that the ROMs of humeral flexion and extension, as well as abduction and adduction, both show a statistically significant increase as flesh is removed, but then decrease when the bones must be physically articulated and moved until they separate from one another and/or visible joint surfaces. A similar ROM pattern is inferred for humeral pronation and supination. All final skeletonized ROMs were less than initial fully fleshed ROMs. These results are consistent with previously reported elbow joint ROM patterns from the extant phylogenetic bracket of dinosaurs. Thus, studies that avoid separation of complementary articular surfaces may be providing fossil shoulder joint ROMs that underestimate in vivo ROM in dinosaurs, as well as other fossil archosaurs.

  5. [Recurrent left atrial myxoma].

    Science.gov (United States)

    Moreno Martínez, Francisco L; Lagomasino Hidalgo, Alvaro; Mirabal Rodríguez, Roger; López Bermúdez, Félix H; López Bernal, Omaida J

    2003-01-01

    Primary cardiac tumors are rare. Mixomas are the most common among them; 75% are located in the left atrium, 20% in the right atrium, and the rest in the ventricles. The seldom appear in atrio-ventricular valves. Recidivant mixoma are also rare, appearing in 1-5% of all patients that have undergone surgical treatment of a mixoma. In this paper we present our experience with a female patient, who 8 years after having been operated of a left atrial mixoma, began with symptoms of mild heart failure. Transthoracic echocardiography revealed recurrence of the tumor, and was therefore subjected to a second open-heart surgery from which she recovered without complications.

  6. Flooding in a loop with a vertical and a horizontal tube connected by an elbow

    International Nuclear Information System (INIS)

    Yan Changqi

    1994-01-01

    The experimental research of flooding and flow-reverse in a test loop which a vertical and a horizontal tube connected by an elbow is introduced. According to the experimental results, the effects of the elbow on flooding and flow-reverse is analyzed. The experimental results is compared with the results obtained in vertical tubes. The effect of horizontal tube length and hysteresis in de-flooding are analyzed. Dimensionless parameters was used in data process. The correlations for predicting the flooding point, de-flooding point, completed carry up and flow reverse points are given

  7. Accuracy in identifying the elbow rotation axis on simulated fluoroscopic images using a new anatomical landmark.

    Science.gov (United States)

    Wiggers, J K; Snijders, R M; Dobbe, J G G; Streekstra, G J; den Hartog, D; Schep, N W L

    2017-11-01

    External fixation of the elbow requires identification of the elbow rotation axis, but the accuracy of traditional landmarks (capitellum and trochlea) on fluoroscopy is limited. The relative distance (RD) of the humerus may be helpful as additional landmark. The first aim of this study was to determine the optimal RD that corresponds to an on-axis lateral image of the elbow. The second aim was to assess whether the use of the optimal RD improves the surgical accuracy to identify the elbow rotation axis on fluoroscopy. CT scans of elbows from five volunteers were used to simulate fluoroscopy; the actual rotation axis was calculated with CT-based flexion-extension analysis. First, three observers measured the optimal RD on simulated fluoroscopy. The RD is defined as the distance between the dorsal part of the humerus and the projection of the posteromedial cortex of the distal humerus, divided by the anteroposterior diameter of the humerus. Second, eight trauma surgeons assessed the elbow rotation axis on simulated fluoroscopy. In a preteaching session, surgeons used traditional landmarks. The surgeons were then instructed how to use the optimal RD as additional landmark in a postteaching session. The deviation from the actual rotation axis was expressed as rotational and translational error (±SD). Measurement of the RD was robust and easily reproducible; the optimal RD was 45%. The surgeons identified the elbow rotation axis with a mean rotational error decreasing from 7.6° ± 3.4° to 6.7° ± 3.3° after teaching how to use the RD. The mean translational error decreased from 4.2 ± 2.0 to 3.7 ± 2.0 mm after teaching. The humeral RD as additional landmark yielded small but relevant improvements. Although fluoroscopy-based external fixator alignment to the elbow remains prone to error, it is recommended to use the RD as additional landmark.

  8. DETERMINING JOINT ANGLES OF ROBOT ARM BY ARTIFICIAL NEURAL NETWORK

    OpenAIRE

    ARSERİM, Muhammet Ali; DEMİR, Yakup

    2016-01-01

    Aim of this study is to solve inverse kinematic problem of a five axis articulated robot arm by using artificial neural network. Through this aim five axes articulated SCORBOT-ER VPlus robot arm is used. Experimental coordinate data for this robot arm is collected form a table, on which this robot arm is fixed and artificial neural network simulation, is implemented on MATLAB R2008A software for determining base, shoulder, and elbow joint angles. As a result it is seen that outputs of the ANN...

  9. Imaging of the elbow in children with wrist fracture: an unnecessary source of radiation and use of resources?

    International Nuclear Information System (INIS)

    Golding, Lauren P.; Yasin, Yousef; Singh, Jasmeet; Anthony, Evelyn; Gyr, Bettina M.; Gardner, Alison

    2015-01-01

    Anecdotally accepted practice for evaluation of children with clinically suspected or radiographically proven wrist fracture in many urgent care and primary care settings is concurrent imaging of the forearm and elbow, despite the lack of evidence to support additional images. These additional radiographs may be an unnecessary source of radiation and use of health care resources. Our study assesses the necessity of additional radiographs of the forearm and elbow in children with wrist injury. We reviewed electronic medical records of children 17 and younger in whom wrist fracture was diagnosed in the emergency department. We identified the frequency with which additional radiographs of the proximal forearm and distal humerus demonstrated another site of acute injury. We identified 214 children with wrist fracture. Of those, 129 received additional radiographs of the elbow. Physical examination findings proximal to the wrist were documented in only 16 (12%) of these 129 children. A second injury proximal to the wrist fracture was present in 4 (3%) of these 129 children, all of whom exhibited physical examination findings at the elbow. No fractures were documented in children with a negative physical examination of the elbow. Although elbow fractures occasionally complicate distal forearm fractures in children, our findings indicate that a careful physical evaluation of the elbow is sufficient to guide further radiographic investigation. Routine radiographs of both the wrist and elbow in children with distal forearm fracture appear to be unnecessary when an appropriate physical examination is performed. (orig.)

  10. Imaging of the elbow in children with wrist fracture: an unnecessary source of radiation and use of resources?

    Energy Technology Data Exchange (ETDEWEB)

    Golding, Lauren P. [Wake Forest University Baptist Health, Department of Radiology, Winston-Salem, NC (United States); Triad Radiology Associates, Winston-Salem, NC (United States); Yasin, Yousef; Singh, Jasmeet; Anthony, Evelyn [Wake Forest University Baptist Health, Department of Radiology, Winston-Salem, NC (United States); Gyr, Bettina M. [Wake Forest University Baptist Health, Department of Orthopedic Surgery, Winston-Salem, NC (United States); Gardner, Alison [Wake Forest University Baptist Health, Department of Pediatric Emergency Medicine, Winston-Salem, NC (United States)

    2015-08-15

    Anecdotally accepted practice for evaluation of children with clinically suspected or radiographically proven wrist fracture in many urgent care and primary care settings is concurrent imaging of the forearm and elbow, despite the lack of evidence to support additional images. These additional radiographs may be an unnecessary source of radiation and use of health care resources. Our study assesses the necessity of additional radiographs of the forearm and elbow in children with wrist injury. We reviewed electronic medical records of children 17 and younger in whom wrist fracture was diagnosed in the emergency department. We identified the frequency with which additional radiographs of the proximal forearm and distal humerus demonstrated another site of acute injury. We identified 214 children with wrist fracture. Of those, 129 received additional radiographs of the elbow. Physical examination findings proximal to the wrist were documented in only 16 (12%) of these 129 children. A second injury proximal to the wrist fracture was present in 4 (3%) of these 129 children, all of whom exhibited physical examination findings at the elbow. No fractures were documented in children with a negative physical examination of the elbow. Although elbow fractures occasionally complicate distal forearm fractures in children, our findings indicate that a careful physical evaluation of the elbow is sufficient to guide further radiographic investigation. Routine radiographs of both the wrist and elbow in children with distal forearm fracture appear to be unnecessary when an appropriate physical examination is performed. (orig.)

  11. Left atrial appendage occlusion

    Directory of Open Access Journals (Sweden)

    Ahmad Mirdamadi

    2013-01-01

    Full Text Available Left atrial appendage (LAA occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy (PTMC, it can be done during closed and open mitral valve commissurotomy (CMVC, OMVC and mitral valve replacement (MVR too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis (MS and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC.

  12. Comparing Two Exercise Programmes for the Management of Lateral Elbow Tendinopathy (Tennis Elbow/Lateral Epicondylitis—A Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Dimitrios Stasinopoulos

    2013-09-01

    Full Text Available Aim: To compare the effectiveness of supervised exercise programme as proposed by Stasinopoulos and colleagues with home exercise programme as proposed by Pienimaki and his coworkers in the treatment of lateral elbow tendinopathy. Design: Controlled clinical trial. Setting: Physiotherapy and rehabilitation centre. Participants: This trial was carried out with 60 patients, who had lateral elbow tendinopathy. Intervention: Group A (n = 30 had received supervised exercise programme, once per day for 4 weeks. Group B (n = 30 was treated with home exercise programme four to six times daily for 8 weeks. Outcome measures: pain, using a visual analogue scale, function, using a visual analogue scale for elbow function and the pain-free grip strength. Patients were evaluated at baseline, at the end of treatment (week 12, and 3 months (week 24 after the end of treatment. Results: Both the supervised and home exercise programme were found to be significantly effective in the reduction of pain and in the improvement of functional status. The supervised exercise programme resulted in significantly different improvement in comparison to those who received home exercise programme. Conclusion: A specific supervised exercise programme is superior to a specific home exercise programme in reducing pain and improving function in patients with LET at the end of the treatment and at the 3 month follow-up. Further research is needed to confirm our results.

  13. Hypoplastic left heart syndrome

    Directory of Open Access Journals (Sweden)

    Thiagarajan Ravi

    2007-05-01

    Full Text Available Abstract Hypoplastic left heart syndrome(HLHS refers to the abnormal development of the left-sided cardiac structures, resulting in obstruction to blood flow from the left ventricular outflow tract. In addition, the syndrome includes underdevelopment of the left ventricle, aorta, and aortic arch, as well as mitral atresia or stenosis. HLHS has been reported to occur in approximately 0.016 to 0.036% of all live births. Newborn infants with the condition generally are born at full term and initially appear healthy. As the arterial duct closes, the systemic perfusion becomes decreased, resulting in hypoxemia, acidosis, and shock. Usually, no heart murmur, or a non-specific heart murmur, may be detected. The second heart sound is loud and single because of aortic atresia. Often the liver is enlarged secondary to congestive heart failure. The embryologic cause of the disease, as in the case of most congenital cardiac defects, is not fully known. The most useful diagnostic modality is the echocardiogram. The syndrome can be diagnosed by fetal echocardiography between 18 and 22 weeks of gestation. Differential diagnosis includes other left-sided obstructive lesions where the systemic circulation is dependent on ductal flow (critical aortic stenosis, coarctation of the aorta, interrupted aortic arch. Children with the syndrome require surgery as neonates, as they have duct-dependent systemic circulation. Currently, there are two major modalities, primary cardiac transplantation or a series of staged functionally univentricular palliations. The treatment chosen is dependent on the preference of the institution, its experience, and also preference. Although survival following initial surgical intervention has improved significantly over the last 20 years, significant mortality and morbidity are present for both surgical strategies. As a result pediatric cardiologists continue to be challenged by discussions with families regarding initial decision

  14. Change in quality of life and cost/utility analysis in open stage-related surgical treatment of elbow stiffness.

    Science.gov (United States)

    Giannicola, Giuseppe; Bullitta, Gianluca; Sacchetti, Federico M; Scacchi, Marco; Polimanti, David; Citoni, Guido; Cinotti, Gianluca

    2013-07-01

    The goals of this study were to examine the improvement in quality of life achieved after open surgical treatment of elbow stiffness and to verify the cost/utility ratio of surgery. Thirty-three patients (22 men and 11 women) underwent surgery. The etiologies of elbow stiffness were posttraumatic conditions (n=26), primary osteoarthritis (n=5), and rheumatoid arthritis (n=2). Surgery included 14 ulnohumeral arthroplasties, 6 ulnohumeral arthroplasties associated with radiocapitellar replacement, 5 ulnohumeral arthroplasties associated with radial head replacement, and 8 total elbow arthroplasties. All patients were evaluated pre- and postoperatively with the Mayo Elbow Performance Score, the Mayo Elbow Performance Index, the modified American Shoulder and Elbow Surgeons score, the Quick Disabilities of the Arm, Shoulder and Hand score, and the Short Form 36 after a mean follow-up of 26 months. Possible variables affecting clinical outcome and quality of life improvement were assessed. The cost/utility ratio was evaluated as diagnosis-related group reimbursement per quality-adjusted life year. Mayo Elbow Performance Scores and modified American Shoulder and Elbow Surgeons scores increased, on average, by 43 and 41 points, respectively (Pquality-adjusted life year. A significant correlation was found between pain score and quality of life improvement. An inverse correlation emerged between pre- and postoperative quality of life score. The current study shows that open surgery significantly improves quality of life and elbow function. Selecting the surgical procedure that most effectively reduces pain appears to be the most relevant variable responsible for quality of life improvement. Surgery shows a satisfactory cost/utility ratio, justifying a health spending increase to reduce the social costs resulting from lingering elbow stiffness. Copyright 2013, SLACK Incorporated.

  15. Restoration of elbow flexion by performing contralateral lateral thoracic and thoracodorsal nerve transfers after experimental musculocutaneous nerve transection.

    Science.gov (United States)

    Moissonnier, Pierre; Cuvilliez, Valérie; Klein, Arnaud; Carozzo, Claude; Escriou, Catherine; Gnirs, Kirsten; Blot, Stéphane; Hidalgo, Antoine

    2005-07-01

    The immediate transfer of the right lateral thoracic nerve (LTN) and the thoracodorsal nerve (TDN) to the transected left musculocutaneous nerve (MCN), leading to nerve cross-neurotization, was performed in cats to evaluate reinnervation of the biceps brachii muscle (BBM). Surgery to produce cross-neurotization of the MCN was performed in 12 cats (treatment group). Transection of the MCN was performed without attempts at neurotization in three cats (control group). Reinnervation of the BBM was assessed by performing electromyography (EMG) 6 months (14 cats) and 26 months (one cat) postsurgery. True Blue retrograde axonal tracing studies, tensile force measurements (muscle extensometry), and histopathological analyses were performed. All cats in the treatment group recovered voluntary contraction of the BBM and regained elbow flexion. Electromyography revealed no abnormal spontaneous activity in the BBM. Muscle evoked potentials were recorded in that muscle after right C-8 ventral branch stimulation. The muscle contraction strength in the left BBM varied from 108 to 557 g. The BBMs regained their normal appearances. The region of the MCN distal to the anastomosis displayed a normal histological appearance. Fluorescence was detected in the ventral horn of the spinal cord in the right C-8 and T-1 segments. In contrast, in all cats in the control group there was atrophy of the BBM, no EMG signal, and no clinical sign of recovery. There was no contraction of the BBM, no labeled neuron in the spinal cord, and the MCN displayed major degenerative changes. These findings demonstrate that the LTN and TDN can be used to neurotize injured contralateral brachial plexus nerves and obtain successful reinnervation in cats.

  16. Endurance time is joint-specific: A modelling and meta-analysis investigation

    Science.gov (United States)

    Law, Laura A. Frey; Avin, Keith G.

    2010-01-01

    Static task intensity–endurance time (ET) relationships (e.g. Rohmert's curve) were first reported decades ago. However, a comprehensive meta-analysis to compare experimentally-observed ETs across bodily regions has not been reported. We performed a systematic literature review of ETs for static contractions, developed joint-specific power and exponential models of the intensity–ET relationships, and compared these models between each joint (ankle, trunk, hand/grip, elbow, knee, and shoulder) and the pooled data (generalised curve). 194 publications were found, representing a total of 369 data points. The power model provided the best fit to the experimental data. Significant intensity-dependent ET differences were predicted between each pair of joints. Overall, the ankle was most fatigue-resistant, followed by the trunk, hand/grip, elbow, knee and finally the shoulder was most fatigable. We conclude ET varies systematically between joints, in some cases with large effect sizes. Thus, a single generalised ET model does not adequately represent fatigue across joints. Statement of Relevance Rohmert curves have been used in ergonomic analyses of fatigue, as there are limited tools available to accurately predict force decrements. This study provides updated endurance time–intensity curves using a large meta-analysis of fatigue data. Specific models derived for five distinct joint regions should further increase prediction accuracy. PMID:20069487

  17. Development and testing of reduced joint counts in juvenile idiopathic arthritis.

    Science.gov (United States)

    Bazso, Anna; Consolaro, Alessandro; Ruperto, Nicolino; Pistorio, Angela; Viola, Stefania; Magni-Manzoni, Silvia; Malattia, Clara; Buoncompagni, Antonella; Loy, Anna; Martini, Alberto; Ravelli, Angelo

    2009-01-01

    To develop and test reduced joint counts in children with juvenile idiopathic arthritis (JIA). Four reduced joint counts including 45, 35, 27, and 10 joints were devised by a panel of experienced pediatric rheumatologists, who selected the joints to be included based on the ease of technical assessment, functional relevance, and frequency of involvement. Three large samples of patients with JIA (total n=4353) who had a detailed joint assessment available were used to develop and test reduced joint counts. Performance of reduced counts was examined by comparing their Spearman correlation with the standard (i.e., complete) joint count. Construct validity was evaluated by calculating Spearman correlation with other JIA outcome measures. Responsiveness to clinical change was determined through the standardized response mean (SRM). Spearman correlations of reduced joint counts with the whole joint count and with the other JIA outcome measures were comparable, revealing that they had similar ability to serve as surrogate for the whole joint count and construct validity. Responsiveness to clinical change was also comparable across reduced counts (SRM 0.83-1.09 for active joint counts and 0.63-0.81 for restricted joint counts). Based on these results and considering the relative feasibility of the different counts, the 27-joint reduced count is proposed for use in JIA. This joint count includes the cervical spine and the elbow, wrist, metacarpophalangeal (from first to third), proximal interphalangeal, hip, knee, and ankle joints. Reduced joint counts appear to be as reliable as standard joint counts in assessment of the severity of joint disease and its change over time in children with JIA.

  18. Inter-Joint Coordination Deficits Revealed in the Decomposition of Endpoint Jerk During Goal-Directed Arm Movement After Stroke.

    Science.gov (United States)

    Laczko, Jozsef; Scheidt, Robert A; Simo, Lucia S; Piovesan, Davide

    2017-07-01

    It is well documented that neurological deficits after stroke can disrupt motor control processes that affect the smoothness of reaching movements. The smoothness of hand trajectories during multi-joint reaching depends on shoulder and elbow joint angular velocities and their successive derivatives as well as on the instantaneous arm configuration and its rate of change. Right-handed survivors of unilateral hemiparetic stroke and neurologically-intact control participants held the handle of a two-joint robot and made horizontal planar reaching movements. We decomposed endpoint jerk into components related to shoulder and elbow joint angular velocity, acceleration, and jerk. We observed an abnormal decomposition pattern in the most severely impaired stroke survivors consistent with deficits of inter-joint coordination. We then used numerical simulations of reaching movements to test whether the specific pattern of inter-joint coordination deficits observed experimentally could be explained by either a general increase in motor noise related to weakness or by an impaired ability to compensate for multi-joint interaction torque. Simulation results suggest that observed deficits in movement smoothness after stroke more likely reflect an impaired ability to compensate for multi-joint interaction torques rather than the mere presence of elevated motor noise.

  19. Video imaging measurement of interfacial wave velocity in air-water flow through a horizontal elbow

    Science.gov (United States)

    Al-Wazzan, Amir; Than, Cheok F.; Moghavvemi, Mahmoud; Yew, Chia W.

    2001-10-01

    Two-phase flow in pipelines containing elbows represents a common situation in the oil and gas industries. This study deals with the stratified flow regime between the gas and liquid phase through an elbow. It is of interest to study the change in wave characteristics by measuring the wave velocity and wavelength at the inlet and outlet of the elbow. The experiments were performed under concurrent air-water stratified flow in a horizontal transparent polycarbonate pipe of 0.05m diameter and superficial air and water velocities up to 8.97 and 0.0778 m/s respectively. A non-intrusive video imaging technique was applied to capture the waves. For image analysis, a frame by frame direct overlapping method was used to detect for pulsating flow and a pixel shifting method based on the detection of minimum values in the overlap function was used to determine wave velocity and wavelength. Under superficial gas velocity of less than 4.44 m/s, the results suggest a regular pulsating outflow produced by the elbow. At higher gas velocities, more random pulsation was found and the emergence of localized interfacial waves was detected. Wave velocities measured by this technique were found to produce satisfactory agreement with direct measurements.

  20. Stress analysis of the radial head replacement in an elbow articulation

    Czech Academy of Sciences Publication Activity Database

    Hlavoň, Pavel; Fuis, Vladimír; Návrat, Tomáš; Florian, Z.

    2007-01-01

    Roč. 40, č. 2 (2007), S624-S624 ISSN 0021-9290. [ISB 2007. Taipei, 01.07.2007-05.07.2007] R&D Projects: GA ČR GA101/05/0136 Institutional research plan: CEZ:AV0Z20760514 Keywords : radial head replacement * elbow articulation Subject RIV: BO - Biophysics Impact factor: 2.897, year: 2007

  1. Resolution of thermal striping issue downstream of a horizontal pipe elbow in stratified pipe flow

    International Nuclear Information System (INIS)

    Kuzay, T.M.; Kasza, K.E.

    1985-01-01

    A thermally stratified pipe flow produced by a thermal transient when passing through a horizontal elbow as a result of secondary flow gives rise to large thermal fluctuations on the inner curvature wall of the downstream piping. These fluctuations were measured in a specially instrumented horizontal pipe and elbow system on a test set-up using water in the Mixing Components Technology Facility (MCTF) at Argonne National Laboratory (ANL). This study is part of a larger program which is studying the influence of thermal buoyancy on general reactor component performance. This paper discusses the influence of pipe flow generated thermal oscillations on the thermal stresses induced in the pipe walls. The instrumentation was concentrated around the exit plane of the 90 0 sweep elbow, since prior tests had indicated that the largest thermal fluctuations would occur within about one hydraulic diameter downstream of the elbow exit. The thermocouples were located along the inner curvature of the piping and measured the near surface fluid temperature. The test matrix involved thermal downramps under turbulent flow conditions

  2. CFD Analysis of Two-Phase Flow Characteristics in a 90 Degree Elbow

    Directory of Open Access Journals (Sweden)

    Quamrul H. Mazumder

    2011-09-01

    Full Text Available Computational fluid dynamics (CFD analysis was performed for a two-phase air-water flow through a horizontal to vertical 900 elbow with a 12.7 mm pipe diameter. Three different air velocities of 15.24, 30.48, and 45.72 m/sec along with three different water velocities of 0.1, 1.0, and 10.0 m/sec were used in this study. To analyze the flow behavior in the elbow, pressure and velocity profiles at six different upstream and downstream locations of the elbow were compared. Computational fluid dynamics (CFD analysis was performed for 9 different cases using FLUENT commercial code. A mixture model was used to account for different gas and liquid velocities to solve continuity, momentum and energy equations. CFD analysis results showed a decrease in pressure as fluid leaves the elbow in addition to a larger pressure drop at higher air velocities. No significant change in pressure was observed when water velocity was increased from 0.1 to 1.0 m/sec compared to water velocity change from 1.0 to 10.0 m/sec. The normalized pressure drop was larger at lower air velocities compared to higher water velocities. CFD analysis results were compared with available experimental data showing a reasonably good agreement.

  3. Stability of the unlinked Latitude total elbow prosthesis: A biomechanical in vitro analysis.

    NARCIS (Netherlands)

    Wagener, M.L.; Vos, M.J. de; Hendriks, J.C.M.; Eygendaal, D.; Verdonschot, N.J.J.

    2013-01-01

    BACKGROUND: The purpose of this study is to assess the valgus and varus laxity of the unlinked version of the Latitude total elbow prosthesis and the effects of radial head preservation or replacement. METHODS: Biomechanical analysis of the valgus and varus laxity of the unlinked Latitude was

  4. Stability of the unlinked Latitude total elbow prosthesis: A biomechanical in vitro analysis

    NARCIS (Netherlands)

    Wagener, Marc L.; de Vos, Maarten J.; Hendriks, Jan C.M.; Eygendaal, Denise; Verdonschot, Nicolaas Jacobus Joseph

    2013-01-01

    Background The purpose of this study is to assess the valgus and varus laxity of the unlinked version of the Latitude total elbow prosthesis and the effects of radial head preservation or replacement. Methods Biomechanical analysis of the valgus and varus laxity of the unlinked Latitude was

  5. Experimental stress analysis of four machined 10-in. NPS piping elbows with specified geometric distortions

    International Nuclear Information System (INIS)

    Moore, S.E.; Dodge, W.G.; Bolt, S.E.

    1983-09-01

    Four specially fabricated nominal 10-in. NPS, 90 0 , long-radius, schedule 40, carbon-steel piping elbows, welded to short lengths of straight pipe, were stress analyzed both experimentally and analytically. One elbow had a circular cross section and a uniform wall thickness, while the other three had either a circular or elliptical cross section with either a uniform or variable wall thickness. The objectives of the tests were primarily to study the influence of out of roundness and wall-thickness variations on the stresses in piping elbows under internal pressure and/or applied moment loadings. Analytical studies were made to isolate the various effects by comparing the experimental data with theoretical baseline solutions. Results of the studies showed that analytical solutions based on no-end-effects (NEE) theory capture the major characteristics of the stress distributions for elbows loaded with pressure and/or in-plane, out-of-plane, or torsional moment loadings. Of the four second-order effects addressed in this study, and effects had the most influence on the stresses, followed in order by out of roundness, wall-thickness variations, and pressure-moment interactions. Of these, the only significant increase in maximum stresses above those predicted by NEE theory was for the case of out of roundness with internal-pressure loading

  6. Optimal Elbow Angle for Extracting sEMG Signals During Fatiguing Dynamic Contraction

    Directory of Open Access Journals (Sweden)

    Mohamed R. Al-Mulla

    2015-09-01

    Full Text Available Surface electromyographic (sEMG activity of the biceps muscle was recorded from 13 subjects. Data was recorded while subjects performed dynamic contraction until fatigue and the signals were segmented into two parts (Non-Fatigue and Fatigue. An evolutionary algorithm was used to determine the elbow angles that best separate (using Davies-Bouldin Index, DBI both Non-Fatigue and Fatigue segments of the sEMG signal. Establishing the optimal elbow angle for feature extraction used in the evolutionary process was based on 70% of the conducted sEMG trials. After completing 26 independent evolution runs, the best run containing the optimal elbow angles for separation (Non-Fatigue and Fatigue was selected and then tested on the remaining 30% of the data to measure the classification performance. Testing the performance of the optimal angle was undertaken on nine features extracted from each of the two classes (Non-Fatigue and Fatigue to quantify the performance. Results showed that the optimal elbow angles can be used for fatigue classification, showing 87.90% highest correct classification for one of the features and on average of all eight features (including worst performing features giving 78.45%.

  7. Hydrodynamic Effect on the Inhibition for the Flow Accelerated Corrosion of an Elbow

    International Nuclear Information System (INIS)

    Zeng, L.; Zhang, G. A.; Guo, X. P.

    2017-01-01

    The inhibition effect of thioureido imidazoline inhibitor (TAI) for flow accelerated corrosion (FAC) at different locations for an X65 carbon steel elbow was studied by array electrode and computational fluid dynamics (CFD) simulations. The distribution of the inhibition efficiency measured by electrochemical impedance spectroscopy (EIS) is in good accordance with the distribution of the hydrodynamic parameters at the elbow. The inhibition efficiencies at the outer wall are higher than those at the inner wall meaning that the lower inhibition efficiency is associated with a higher flow velocity, shear stress, and turbulent kinetic energy at the inner wall of the elbow, as well as secondary flow at the elbow rather than the mass transport of inhibitor molecules. Compared to the static condition, the inhibition efficiency of TAI for FAC was relatively low. It is also due to a drastic turbulence flow and high wall shear stress during the FAC test, which prevents the adsorption of inhibitor and/or damages the adsorbed inhibitor film.

  8. 78 FR 36308 - Proposed Information Collection (Elbow and Forearm Conditions Disability Benefits Questionnaire...

    Science.gov (United States)

    2013-06-17

    ... and Forearm Conditions Disability Benefits Questionnaire) Activity: Comment Request AGENCY: Veterans... Questionnaire)'' in any correspondence. During the comment period, comments may be viewed online through the... INFORMATION: Title: Elbow and Forearm Conditions Disability Benefits Questionnaire, VA Form 21-0960M-4. OMB...

  9. The predictive value of diagnostic sonography for the effectiveness of conservative treatment of tennis elbow

    NARCIS (Netherlands)

    Struijs, P. A. A.; Spruyt, M.; Assendelft, W. J. J.; van Dijk, C. N.

    2005-01-01

    OBJECTIVE. Tennis elbow is a common complaint. Several treatment strategies have been described, but an optimal strategy has not been identified. Sonographic imaging as a predictive,factor has never been studied. The aim of our study was to determine the value of sonographic findings in predicting

  10. Guided wave propagation and scattering in pipeworks comprising elbows: Theoretical and experimental results

    International Nuclear Information System (INIS)

    Bakkali, M El; Lhémery, A; Baronian, V; Chapuis, B

    2015-01-01

    Elastic guided waves (GW) are used to inspect pipeworks in various industries. Modelling tools for simulating GW inspection are necessary to understand complex scattering phenomena occurring at specific features (welds, elbows, junctions...). In pipeworks, straight pipes coexist with elbows. GW propagation in the former cases is well-known, but is less documented in the latter. Their scattering at junction of straight and curved pipes constitutes a complex phenomenon. When a curved part is joined to two straight parts, these phenomena couple and give rise to even more complex wave structures. In a previous work, the SemiAnalytic Finite Element method extended to curvilinear coordinates was used to handle GW propagation in elbows, combined with a mode matching method to predict their scattering at the junction with a straight pipe. Here, a pipework comprising an arbitrary number of elbows of finite length and of different curvature linking straight pipes is considered. A modal scattering matrix is built by cascading local scattering and propagation matrices. The overall formulation only requires meshing the pipe section to compute both the modal solutions and the integrals resulting from the mode-matching method for computing local scattering matrices. Numerical predictions using this approach are studied and compared to experiments

  11. Valgus extension overload syndrome of the elbow in a test cricket ...

    African Journals Online (AJOL)

    tion and showed attenuation of the medial collateral ligament, with medullary oedema at the lateral side of the elbow (Fig. 2). The patient refused arthroscopy, and opted for total abstinence from throwing and fast-bowling for 12 weeks. He started a training programme designed to strengthen his forearm flexor-pronator and.

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

    NARCIS (Netherlands)

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

    2004-01-01

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

  13. LONG TERM EFFECT OF CYRIAX PHYSIOTHERPY WITH SUPERVISED EXERCISE PROGRAM IN SUBJECTS WITH TENNIS ELBOW

    Directory of Open Access Journals (Sweden)

    Pallavi Shridhar Thakare

    2014-06-01

    Full Text Available Background: The purpose is to find long term effect of Cyriax physiotherapy with supervised exercise program in the reduction of pain and improvement of functional ability for subjects with tennis elbow. Method: An experimental study design, 30 subjects with Tennis Elbow randomized 15 subjects each into Study and Control group. Control group received Supervised Exercise program while Study group received Cyriax Physiotherapy with Supervised exercises program thrice in a week for 4 weeks and post intervention follow up after 2 weeks. Outcome measurements were measured for pain using Visual analogue Scale (VAS and Patient Rated Tennis Elbow Evaluation (PRTEE for functional ability. Results: There is no statistically significant difference in pre- intervention means of VAS and PRTEE when compared between the groups using independent ‘t’ test as a parametric and Mann Whitney U test as a non-parametric test. When means of post intervention and follow-up measurements were compared there is a statistically significant (p<0.05 difference in VAS and PRTEE scores between the groups. However greater percentage of improvements was obtained in study group than control group. Conclusion: It is concluded that there is significant long term effect with greater percentage of improvement in pain and functional ability up to 2 weeks follow-up following 4 weeks of combined Cyriax physiotherapy with supervised exercise program than only supervised exercise program for subjects with tennis elbow.

  14. Orientation of axes in the elbow and forearm for biomechanical modelling

    NARCIS (Netherlands)

    Veeger, H. E J; Yu, B.

    1996-01-01

    To determine the three-dimensional positions and orientations of axes of rotation for elbow flexion and forearm prosupination, the flexion-extension and prosupination movements were measured for five arms. Four right and one arm were taken from four fresh cadavers. Movement was measured with a

  15. Performance Analysis of The Effect on Insertion Guide Vanes For Rectangular Elbow 900 Cross Section

    Directory of Open Access Journals (Sweden)

    Setyo Nugroho

    2016-12-01

    Full Text Available The use of elbow or curved pipe in the installation of piping has a loss of pressure (pressure drop which could lead the power of pump that drive the fluid and decrease the energy efficiency of the system. The pressure drop is caused by the curved shape of the elbow that cause pressure on the outer wall (outter larger and blocking off the pace of the fluid, and flow pressure losses caused by friction, flow separation and secondary flow. A method that can be used to reduce flow separation and pressure loss in the elbow is by the insertion guide vane. The test model in the form of rectangular elbow 900  with a radius ratio (rc/Dh = 1.1249 without using a guide vane and number of guide vane insertion one until three guide vanes. With Reynolds number ReDh ≈ 8.6 × 104. The velocity inlet is uniform, the measured variable is static pressure. Static pressure was measured using an inclined manometer. With variation the number of guide vane gives a more effect on the value of pressure drop, the largest pressure drop until 123.35% compared to that without guide vane. The velocity distribution profile on the outlet side becomes more uniform. The magnitude of this pressure drop occurs as a result of the increased flow friction and its secondary flow become smaller.

  16. Distinct Inter-Joint Coordination during Fast Alternate Keystrokes in Pianists with Superior Skill

    Science.gov (United States)

    Furuya, Shinichi; Goda, Tatsushi; Katayose, Haruhiro; Miwa, Hiroyoshi; Nagata, Noriko

    2011-01-01

    Musical performance requires motor skills to coordinate the movements of multiple joints in the hand and arm over a wide range of tempi. However, it is unclear whether the coordination of movement across joints would differ for musicians with different skill levels and how inter-joint coordination would vary in relation to music tempo. The present study addresses these issues by examining the kinematics and muscular activity of the hand and arm movements of professional and amateur pianists who strike two keys alternately with the thumb and little finger at various tempi. The professionals produced a smaller flexion velocity at the thumb and little finger and greater elbow pronation and supination velocity than did the amateurs. The experts also showed smaller extension angles at the metacarpo-phalangeal joint of the index and middle fingers, which were not being used to strike the keys. Furthermore, muscular activity in the extrinsic finger muscles was smaller for the experts than for the amateurs. These findings indicate that pianists with superior skill reduce the finger muscle load during keystrokes by taking advantage of differences in proximal joint motion and hand postural configuration. With an increase in tempo, the experts showed larger and smaller increases in elbow velocity and finger muscle co-activation, respectively, compared to the amateurs, highlighting skill level-dependent differences in movement strategies for tempo adjustment. Finally, when striking as fast as possible, individual differences in the striking tempo among players were explained by their elbow velocities but not by their digit velocities. These findings suggest that pianists who are capable of faster keystrokes benefit more from proximal joint motion than do pianists who are not capable of faster keystrokes. The distinct movement strategy for tempo adjustment in pianists with superior skill would therefore ensure a wider range of musical expression. PMID:21660290

  17. Effects of the racket polar moment of inertia on dominant upper limb joint moments during tennis serve.

    Directory of Open Access Journals (Sweden)

    Isabelle Rogowski

    Full Text Available This study examined the effect of the polar moment of inertia of a tennis racket on upper limb loading in the serve. Eight amateur competition tennis players performed two sets of 10 serves using two rackets identical in mass, position of center of mass and moments of inertia other than the polar moment of inertia (0.00152 vs 0.00197 kg.m2. An eight-camera motion analysis system collected the 3D trajectories of 16 markers, located on the thorax, upper limbs and racket, from which shoulder, elbow and wrist net joint moments and powers were computed using inverse dynamics. During the cocking phase, increased racket polar moment of inertia was associated with significant increases in the peak shoulder extension and abduction moments, as well the peak elbow extension, valgus and supination moments. During the forward swing phase, peak wrist extension and radial deviation moments significantly increased with polar moment of inertia. During the follow-through phase, the peak shoulder adduction, elbow pronation and wrist external rotation moments displayed a significant inverse relationship with polar moment of inertia. During the forward swing, the magnitudes of negative joint power at the elbow and wrist were significantly larger when players served using the racket with a higher polar moment of inertia. Although a larger polar of inertia allows players to better tolerate off-center impacts, it also appears to place additional loads on the upper extremity when serving and may therefore increase injury risk in tennis players.

  18. Left Ventricular Assist Devices

    Directory of Open Access Journals (Sweden)

    Khuansiri Narajeenron

    2017-04-01

    Full Text Available Audience: The audience for this classic team-based learning (cTBL session is emergency medicine residents, faculty, and students; although this topic is applicable to internal medicine and family medicine residents. Introduction: A left ventricular assist device (LVAD is a mechanical circulatory support device that can be placed in critically-ill patients who have poor left ventricular function. After LVAD implantation, patients have improved quality of life.1 The number of LVAD patients worldwide continues to rise. Left-ventricular assist device patients may present to the emergency department (ED with severe, life-threatening conditions. It is essential that emergency physicians have a good understanding of LVADs and their complications. Objectives: Upon completion of this cTBL module, the learner will be able to: 1 Properly assess LVAD patients’ circulatory status; 2 appropriately resuscitate LVAD patients; 3 identify common LVAD complications; 4 evaluate and appropriately manage patients with LVAD malfunctions. Method: The method for this didactic session is cTBL.

  19. Distribution of Platelet-rich Plasma after Ultrasound-Guided Injection for Chronic Elbow Tendinopathies

    Directory of Open Access Journals (Sweden)

    Gi-Young Park, Dong Rak Kwon, Hee Kyung Cho, Jinyoung Park, Jung Hyun Park

    2017-03-01

    Full Text Available Characteristics of the spreads of platelet-rich plasma (PRP are not widely known despite commonly use. This study aims to evaluate whether PRP stays within the injected area by using ultrasonography, to improve understanding of the spreads of intratendinous injected PRP. Thirty-nine patients (15 males, 24 females; mean age, 49.3 years, who had symptoms on their elbows (> 6 months and diagnosed as lateral (25 elbows or medial (14 elbows tendinopathies of elbow, were included. The severity of tendon pathology was assessed by ultrasonography as tear or no tear. Immediately after ultrasound-guided PRP injection, ultrasound images were evaluated to assess the area of PRP distribution, which was defined as the presence of fluid or microbubbles. Ultrasound revealed that 13 elbows had tendon tear and 26 had no tear, respectively. Post-injection ultrasound confirmed the injected PRP was within the tendon in all cases. The mean distance of distribution from the injection site was 12.6 mm (5.0–26.0 mm. There was no difference in the distance of PRP distribution between tendon tear and no tear. Injected PRP spread to soft tissue outside the tendon in 20 of 39 cases. Intra-articular extension of PRP was observed in 5 cases. Although PRP remained intratendinous after the injection in all cases, some portion tended to spread outside from the injection site in a short space of time. Postinjection ultrasonographic imaging has a value for observing the spreading patterns of intratendinous PRP injection.

  20. Reliability and Effectiveness of Smartphone Technology for the Diagnosis and Treatment Planning of Pediatric Elbow Trauma.

    Science.gov (United States)

    Paryavi, Ebrahim; Schwartz, Brandon S; Meyer, Carissa L; Herman, Martin J; Abzug, Joshua M

    2016-01-01

    Mobile imaging, such as viewing radiographs as text messages, is increasingly prevalent in clinical settings. The purpose of this study was to determine whether remote diagnosis of pediatric elbow fractures using smartphone technology is reliable. In addition, this study aimed to determine whether the assessment regarding the decision for operative treatment is affected by evaluation of images on a mobile device as opposed to standard picture archiving and communication system (PACS). Standard anteroposterior and lateral radiographs of 50 pediatric elbow trauma cases were evaluated by 2 fellowship-trained pediatric orthopaedic surgeons and 2 senior orthopaedic residents. Raters were asked to classify the case as any of 6 diagnoses: supracondylar humerus, lateral condyle, medial epicondyle, radial neck fracture, positive posterior fat pad sign, or normal pediatric elbow. Raters were asked to choose operative or conservative treatment. After 1 week, photographs of the same images were taken from a standardized distance from a computer monitor with an iPhone 5 camera and transmitted by multimedia messaging to each rater. The same questions were again posed to raters. Interobserver and intraobserver reliabilities were calculated by Cohen κ-statistics with bootstrapped 95% confidence intervals. Intraobserver reliability of classification of injuries on PACS compared with smartphone images was excellent, with an overall κ of 0.91. Treatment decision also demonstrated excellent intraobserver reliability (PACS vs. smartphones) with a κ of 0.86 for all raters. Diagnosis of pediatric elbow injuries can be made equally reliably based on either PACS or transmitted multimedia messaging images taken with an iPhone camera from a computer screen and viewed on a smartphone. Treatment decisions can also be made reliably based on either image modality. Using smartphones to transmit and display radiographs, which is common in current clinical practice, is effective and reliable for

  1. Clinical evaluation of a new, above-elbow, body-powered prosthetic arm: a final report.

    Science.gov (United States)

    Cupo, M E; Sheredos, S J

    1998-10-01

    The AdVAntage Arm is an above-elbow (AE) body-powered arm designed to improve upon, and overcome, some of the major limitations of conventional prostheses. It is the result of research and development (R&D) accomplished at the Center for Engineering Design (CED), University of Utah and Sarcos Research Corporation (SRC), Salt Lake City, UT. The AdVAntage Arm was developed to provide the following main features: lightweight, independent elbow and terminal device (TD) control, and a cable recovery system for full TD actuation at any elbow position. The Department of Veterans Affairs (VA) Rehab R&D Service's Technology Transfer Section (TTS), with collaboration from the VA National Prosthetic and Sensory Aids Service (PSAS), managed a multi-center clinical evaluation of the precommercial AdVAntage Arm (the Arm). The purpose was to objectively assess and affirm the Arm's functional advantages, reliability, clinical application, and commercial readiness. Eleven VA prosthetic services served as evaluation sites with a total of 16 subjects with amputation (14 unilateral and 2 bilateral). Fifteen prosthetists provided their comments. Overall, the results demonstrated that the Arm could be fit for use by persons with transhumeral, and even with forequarter, amputation. Once the learning curve was overcome, the majority of subjects reported that the Arm offered several functional advantages over their conventional prosthesis. Its overall light weight, separation of elbow and TD function, and cable recovery system allowed opening and closure of the TD at any elbow position; resulting in a more fluid manner of use and allowing subjects to perform more activities from waist level and above (especially in the outstretched and overhead positions). At the conclusion of clinical trials, 10 subjects elected to keep the Arm for continued use. The manufacturer is committed to the commercial marketing and technical support of the arm. Based upon the clinical findings, the AdVAntage Arm

  2. Muscle releases to improve passive motion and relieve pain in patients with spastic hemiplegia and elbow flexion contractures.

    Science.gov (United States)

    Namdari, Surena; Horneff, J Gabe; Baldwin, Keith; Keenan, Mary Ann

    2012-10-01

    Patients with spastic hemiplegia after upper motor neuron (UMN) injury can develop elbow contractures. This study evaluated outcomes of elbow releases in treating spastic elbow flexion contractures in hemiplegic patients. Adults with spastic hemiplegia due to UMN injury who underwent elbow releases (brachialis, brachioradialis, and biceps muscles) were included. Nonoperative treatment was unsuccessful in all patients. Patients complained of difficulty with passive functions. Passive range of motion (ROM), pain relief, Modified Ashworth spasticity score, and complications were evaluated preoperatively and postoperatively. There were 8 men and 21 women with an average age of 52.4 years (range, 24.1-81.4 years). Seventeen patients had pain preoperatively. Postoperative follow-up was a mean of 1.7 years (range, 1-4.5 years). Preoperatively, patients lacked a mean of 78° of passive elbow extension compared with 17° postoperatively (P .05). Releases of the brachialis, brachioradialis, and biceps muscles can be an effective means of pain relief, improved passive ROM, and decreased spasticity in patients with elbow flexion deformity after UMN injury. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  3. ADOLESCENT CHONDROLYSIS OF THE mp JOINT*

    African Journals Online (AJOL)

    1971-02-20

    Feb 20, 1971 ... 10 mm in one hour. The latex-fixation test was negative. When he was last seen on 28 July 1968 the left hip was painless and virtually motionless, but he could walk a mile using crutches with a swing-through gait. Radiographs showed a much reduced joint space, increased sclerosis in the acetabular roof ...

  4. Assessing joint space and condylar position in the people with normal function of temporomandibular joint with cone-beam computed tomography

    Directory of Open Access Journals (Sweden)

    Zahra Dalili

    2012-01-01

    Conclusion: The assessment of joint spaces in right and left sides should be done independently. Overall, the measured joint spaces except Sjs are not different in two sexes. The data from this study could be a useful and comparable reference for the clinical assessment of condylar position in patients with normal functional joints.

  5. Liquid-metal flow through a thin-walled elbow in a plane perpendicular to a uniform magnetic field

    International Nuclear Information System (INIS)

    Walker, J.S.

    1986-04-01

    This paper presents analytical solutions for the liquid-metal flow through two straight pipes connected by a smooth elbow with the same inside radius. The pipes and the elbow lie in a plane which is perpendicular to a uniform, applied magnetic field. The strength of the magnetic field is assumed to be sufficiently strong that inertial and viscous effects are negligible. This assumption is appropriate for the liquid-lithium flow in the blanket of a magnetic confinement fusion reactor, such as a tokamak. The pipes and the elbow have thin metal walls

  6. Left Ventricular Pseudoaneurysm Perceived as a Left Lung Mass

    Directory of Open Access Journals (Sweden)

    Ugur Gocen

    2013-02-01

    Full Text Available Left ventricular pseudo-aneurysm is a rare complication of aneurysmectomy. We present a case of surgically-treated left ventricular pseudo-aneurysm which was diagnosed three years after coronary artery bypass grafting and left ventricular aneurysmectomy. The presenting symptoms, diagnostic evaluation and surgical repair are described. [Cukurova Med J 2013; 38(1.000: 123-125

  7. Reliability of Tubular Joints

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard; Thoft-Christensen, Palle

    In this paper the preliminary results obtained by tests on tubular joints are presented. The joints are T-joints and the loading is static. It is the intention in continuation of these tests to perform tests on other types of joints (e.g. Y-joints) and also with dynamic loading. The purpose of th...

  8. Joint Involvement in Primary Sjögren’s Syndrome: An Ultrasound “Target Area Approach to Arthritis”

    Directory of Open Access Journals (Sweden)

    Luis M. Amezcua-Guerra

    2013-01-01

    Full Text Available Objective. To characterize the ultrasound (US pattern of joint involvement in primary Sjögren’s syndrome (pSS. Methods. Seventeen patients with pSS, 18 with secondary Sjögren’s syndrome (sSS, and 17 healthy controls underwent US examinations of various articular regions. Synovitis (synovial hypertrophy/joint effusion, power Doppler (PD signals, and erosions were assessed. Results. In patients with pSS, synovitis was found in the metacarpophalangeal joints (MCP, 76%, wrists (76%, and knees (76%, while the proximal interphalangeal joints, elbows, and ankles were mostly unscathed. Intra-articular PD signals were occasionally detected in wrists (12%, elbows (6%, and knees (6%. Erosions were evident in the wrists of three (18% patients with pSS, one of these also having anti-cyclic citrullinated peptide (anti-CCP antibodies. While US synovitis does not discriminate between sSS and pSS, demonstration of bone erosions in the 2nd MCP joints showed 28.8% sensitivity and 100% specificity for diagnosing sSS; in comparison, these figures were 72.2 and 94.1% for circulating anti-CCP antibodies. Conclusions. In pSS, the pattern of joint involvement by US is polyarticular, bilateral, and symmetrical. Synovitis is the US sign most commonly found in patients with pSS, especially in MCP joints, wrists, and knees, and bone erosions also may occur.

  9. 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.

  10. Human Joint Articulation and Motion-Resistive Properties

    Science.gov (United States)

    1987-04-01

    HUMAN HUMERO -ELBOW COMPLEX... 83 5.1 Introduction . . . . . . . . . . . . . . . . .. . 83 5.2 Determination of the Humero -elbow Complex Sinus...Biomechanical Properties of the Human Humero -Elbow Complex . . . . . . . 93 6. CONCLUDING REMARKS. . . . . . . . . . . . . ........ . . . 103 APPENDIX A...sinus for subject No. 1 . . . . . . . . . . . . 89 5.5 Raw data and the functional expansions of the humero -elbow complex sinus for subject No. 2

  11. Upper limb joint motion of two different user groups during manual wheelchair propulsion

    Science.gov (United States)

    Hwang, Seonhong; Kim, Seunghyeon; Son, Jongsang; Lee, Jinbok; Kim, Youngho

    2013-02-01

    Manual wheelchair users have a high risk of injury to the upper extremities. Recent studies have focused on kinematic and kinetic analyses of manual wheelchair propulsion in order to understand the physical demands on wheelchair users. The purpose of this study was to investigate upper limb joint motion by using a motion capture system and a dynamometer with two different groups of wheelchair users propelling their wheelchairs at different speeds under different load conditions. The variations in the contact time, release time, and linear velocity of the experienced group were all larger than they were in the novice group. The propulsion angles of the experienced users were larger than those of the novices under all conditions. The variances in the propulsion force (both radial and tangential) of the experienced users were larger than those of the novices. The shoulder joint moment had the largest variance with the conditions, followed by the wrist joint moment and the elbow joint moment. The variance of the maximum shoulder joint moment was over four times the variance of the maximum wrist joint moment and eight times the maximum elbow joint moment. The maximum joint moments increased significantly as the speed and load increased in both groups. Quick and significant manipulation ability based on environmental changes is considered an important factor in efficient propulsion. This efficiency was confirmed from the propulsion power results. Sophisticated strategies for efficient manual wheelchair propulsion could be understood by observation of the physical responses of each upper limb joint to changes in load and speed. We expect that the findings of this study will be utilized for designing a rehabilitation program to reduce injuries.

  12. Joint Instability and Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Darryl Blalock

    2015-01-01

    Full Text Available Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA. Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA.

  13. Joint Advanced Warfighting School

    National Research Council Canada - National Science Library

    Davis, Jon

    2003-01-01

    When the United States employs military power, it does so as a joint force. The cornerstone for effective joint force employment remains Service competency, but truly effective Service warfighters must think, plan and fight jointly...

  14. Neuropathic arthropathy progressing with multiple joint involvement in the upper extremity due to syringomyelia and type I Arnold-Chiari malformation.

    Science.gov (United States)

    Nacir, Baris; Arslan Cebeci, S; Cetinkaya, E; Karagoz, A; Erdem, H R

    2010-05-01

    Neuropathic arthropathy (NA), known as Charcot neuroarthropathy, is a chronic, degenerative arthropathy and is associated with decreased sensory innervation. Numerous causes of this arthropathy have been described. Neuropathic joint, although first described by Charcot in tabes dorsalis in 1868, has subsequently been observed in a variety of conditions including syringomyelia, diabetes mellitus and peripheral nerve disorders. Syringomyelia is characterized by slow progression. The shoulders and elbows are the most frequently involved joints in syringomyelia. Involvement of the hand is a quite rarely seen in the cases of NA caused by syringomyelia. In this article, we reported a case of NA secondary to syringomyelia. The characteristics of this presented case is the presence of Arnold-Chiari malformation accompanying with syringomyelia and involvement of the shoulder, elbow and hand (multiple joint involvement).

  15. Position of arm and forearm, and elbow flexion during performance of the sculling technique: Technical recommendation versus actual performance

    Directory of Open Access Journals (Sweden)

    Lara Elena Gomes

    2014-03-01

    Full Text Available Sculling motion is a swimming technique executed in a vertical position with the head above the water's surface and, based on the technical recommendation, should be performed maintaining an elbow flexion angle of 90°, arms kept stationary while the forearms move. In order to verify if this recommendation is indeed realistic, the aim of this study was to describe the elbow flexion angle ant its angular velocity, linear speed and range of motion of the shoulder, elbow and wrist during the sculling motion. Data were calculated using three-dimensional kinematic process from underwater video images of ten athletes of synchronized swimming. The results indicate that the arm is relatively stationary and the forearm moves, which agrees with the technical recommendation. However, the elbow flexes and extends, which contradicts the technical recommendation. These findings should be considered when this action is practiced, especially in synchronized swimming, in which sculling motion is a fundamental technique.

  16. Intra-articular elastofibroma of the shoulder joint

    International Nuclear Information System (INIS)

    Bae, Sang-Jin; Shin, Myung Jin; Kim, Sung Moon; Cho, Kyung-Ja

    2002-01-01

    A 19-year-old man presented with an elastofibroma in his left shoulder joint. The patient had had limitation of motion in his left arm for 3 years, especially when rotating internally. Radiography of his left shoulder showed bone erosion in the neck of the humerus. On MR imaging, a soft tissue mass was noted in the shoulder joint eroding bone. The mass showed similar signal intensity to that of surrounding muscles on T1- and T2-weighted images. At surgery, a soft, encapsulated mass was found attached to the subscapularis muscle. It was pathologically confirmed as an elastofibroma. This unusual manifestation of an elastofibroma is discussed. (orig.)

  17. Why Dora Left

    DEFF Research Database (Denmark)

    Gammelgård, Judy

    2017-01-01

    The question of why Dora left her treatment before it was brought to a satisfactory end and the equally important question of why Freud chose to publish this problematic and fragmentary story have both been dealt with at great length by Freud’s successors. Dora has been read by analysts, literary...... critics, and not least by feminists. The aim of this paper is to point out the position Freud took toward his patient. Dora stands out as the one case among Freud’s 5 great case stories that has a female protagonist, and reading the case it becomes clear that Freud stumbled because of an unresolved...... problem toward femininity, both Dora’s and his own. In Dora, it is argued, Freud took a new stance toward the object of his investigation, speaking from the position of the master. Freud presents himself as the one who knows, in great contrast to the position he takes when unraveling the dream. Here he...

  18. Saving a Child’s Elbow Joint: A Novel Reconstruction for a Tumour of the Distal Humerus

    Directory of Open Access Journals (Sweden)

    Calogero Graci

    2015-01-01

    Full Text Available Reconstruction after wide resection of a malignant bone tumor can be obtained using several techniques such as the use of prostheses, allograft, autograft, or combined procedure. We describe a 12-year-old girl with parosteal osteosarcoma of the distal right humerus treated by en bloc resection, intraoperative extracorporeal irradiation, and implantation. We inserted a nonvascularised fibular autograft through the middle of irradiated graft to obtain a greater stability. We have not recorded any complication associated with this technique such as nonunion, pathological fracture, infection, and bone necrosis and we obtained an excellent functional result. 10 years after surgery, the patient had no recurrence. Extracorporeal irradiation and reimplantation is a valid and inexpensive technique for the treatment of bone tumors when there is reasonable residual bone stock. With this procedure we have a precise fit being the patient’s own bone. In this way we avoid all the problems related to the adaptation of the shape and size.

  19. The modal analysis of a pipe elbow with realistic boundary conditions

    International Nuclear Information System (INIS)

    Carneiro, J.O.; Melo, F.J.Q. de; Rodrigues, J.F.D.; Lopes, H.; Teixeira, V.

    2005-01-01

    A vibration analysis for the determination of the natural frequencies and the associated eigenmodes of a pipe elbow with end-flanges or tangent terminations was performed. A numerical investigation of this problem was achieved with a semi-analytic definition finite ring element and a commercial finite element code. To assess the accuracy of the numerical solution for the elbow vibration, an experimental modal analysis was performed on a curved and on a straight pipe. The responses were processed by a data acquisition system which performs a fast Fourier transform on the time histories to convert them from a time to frequency domain, these leading to the extraction of natural frequencies and mode shapes associated with the test-specimen. The results were compared with the corresponding ones from the numerical approach and discussion about the results completes the paper

  20. Ultrasonographic Characteristics of the Common Extensor Tendon of the Elbow in Asymptomatic Individuals

    DEFF Research Database (Denmark)

    Krogh, Thøger Persson; Fredberg, Ulrich; Ammitzbøl, Christian

    2017-01-01

    BACKGROUND: Ultrasonography (US) of the common extensor tendon (CET) of the elbow is often part of the assessment of patients with lateral epicondylitis. This US assessment is currently based on general tendinopathy references and not well-defined US entities. PURPOSE: To describe CET thickness......, color Doppler activity, and bony spurs on US in asymptomatic volunteers and to investigate the influence of sex, age, height, body mass index (BMI), weight, and elbow dominance on the measurements. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Tendon thickness, color Doppler...... activity, and bony spurs of the CET were measured sonographically in 264 adults (50% women) aged 20 to 96 years. Two different tendon-thickness measuring techniques were applied, labeled the "plateau measure" and the "1-cm measure." Color Doppler activity was based on a 0 to 4 rating scale (negative...

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  2. [Treatment of the complex intraarticular fracture of the distal humerus with the latitude elbow prosthesis].

    Science.gov (United States)

    Burkhart, Klaus Josef; Müller, Lars Peter; Schwarz, Christina; Mattyasovszky, Stefan Georg; Rommens, Pol Maria

    2010-07-01

    Therapy of comminuted intraarticular distal humerus fractures in elderly patients with primary total elbow arthroplasty to achieve stable and painless function. Use of "third-generation" elbow prosthesis with the following options:--linked total elbow arthroplasty,--unlinked total elbow arthroplasty,--either with or without radial head replacement,--hemiarthroplasty. Comminuted intraarticular distal humerus fractures with poor bone quality, in which stable osteosynthesis is impossible. Failure of internal fixation without the technical possibility of revision osteosynthesis. Posttraumatic osteoarthritis or rheumatoid arthritis. Open fractures (Gustilo-Anderson type II or III) or contaminated wounds should not initially be treated with total elbow arthroplasty. Prosthetic replacement may be considered after consolidation of the soft tissue. Low compliance, high functional demands. Paralysis of the biceps muscle. Supine positioning of the patient. Surgical approach after Bryan-Morrey. Anterior transposition of the ulnar nerve. Preparation of the insertion of the triceps at the distal humerus, capsule and proximal ulna. Reflection of the triceps in continuity with the ulnar periosteum and the forearm fascia. Attempt at reconstruction of the epicondyles to achieve ligamentary stability and to implant an unlinked prosthesis. If this is technically not possible, the prosthesis is linked at the end of the operation. Removal of the distal humerus fragments. Determination of the prosthesis size. Detection of the extension-flexion axis. Opening of the humeral intramedullary canal. Determination of the offset. Preparation of the humeral prosthesis repository. Placement of the trial prosthesis. Potential implantation of a hemiprosthesis, if radial head, proximal ulna and ligaments are unaffected. Otherwise preparation of the ulnar prosthesis repository. If the radial head is unaffected, it can be preserved. Otherwise it has to be resected and preferably replaced. Placement of

  3. Gadopentetate-dimeglumine-enhanced MR imaging of osteonecrosis and osteochondritis dissecans of the elbow: initial experience

    International Nuclear Information System (INIS)

    Peiss, J.; Adam, G.; Casser, R.; Urhahn, R.; Guenther, R.W.

    1995-01-01

    Magnetic resonance imaging (MRI) was performed on seven patients with aseptic osteonecrosis (n=4) and osteochondritis dissecans (OCD; n=3) of the elbow. Precontrast MRI was superior to plain radiographs, which did not show any abnormality in three cases of osteonecrosis. On gadopentetate-dimeglumine-enhanced T1-weighted images, which were obtained in three patients with osteonecrosis and three patients with OCD, all cases of osteonecrosis demonstrated homogeneous enhancement of the lesions. All cases of OCD were diagnosed on plain radiographs. On MRI one showed significant enhancement of the loose body. In another case an incompletely enhancing loose body was surrounded by a diffusely enhancing region. In the third patient only a small marginal enhancement of the defect was observed. Our results suggest that MRI can improve the accuracy in diagnosis of aseptic osteonecrosis of the elbow. The use of gadopentetate dimeglumine allows the viability of the lesions or the loose bodies to be demonstrated and reparative tissue to be detected. (orig.)

  4. Why Are the Right and Left Hemisphere Conceptual Representations Different?

    Directory of Open Access Journals (Sweden)

    Guido Gainotti

    2014-01-01

    Full Text Available The present survey develops a previous position paper, in which I suggested that the multimodal semantic impairment observed in advanced stages of semantic dementia is due to the joint disruption of pictorial and verbal representations, subtended by the right and left anterior temporal lobes, rather than to the loss of a unitary, amodal semantic system. The main goals of the present review are (a to survey a larger set of data, in order to confirm the differences in conceptual representations at the level of the right and left hemispheres, (b to examine if language-mediated information plays a greater role in left hemisphere semantic knowledge than sensory-motor information in right hemisphere conceptual knowledge, and (c to discuss the models that could explain both the differences in conceptual representations at the hemispheric level and the prevalence of the left hemisphere language-mediated semantic knowledge over the right hemisphere perceptually based conceptual representations.

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

    OpenAIRE

    Vanamali B Seetharamaiah; Amrit Gantaguru; Sunil Basavarajanna

    2017-01-01

    Background: Lateral elbow pain is common with a population prevalence of 1%?3%. The study was a comparative trial to validate the efficacy of single injection of platelet-rich plasma (PRP) for tennis elbow as compared with single injections of triamcinolone and placebo (normal saline) over a short term period. Materials and Methods: Comparative trial with 3- and 6-month followup evaluated with visual analog scale (VAS) and facial pain scale (FPS). Our study included a total of eighty patients...

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

    Science.gov (United States)

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

    2016-02-01

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

  7. Prophylactic Radiotherapy to Prevent the Recurrence of Heterotopic Ossification after Surgical Intervention of the Elbow

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hak Jae; Kim, Jin Ho; Kim, Kyu Bo; Choi, Ja Young; Chung, Moon Sang; Kim, Il Han [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2007-12-15

    Purpose: Heterotopic ossification is a well-known postoperative and post-traumatic complication of the elbow. We reviewed the treatment outcome for the use of low-dose radiation after surgical intervention of the elbow to prevent recurrence of heterotopic ossification (HO). Materials and Methods: Forty-five patients with HO underwent surgical intervention and postoperative radiotherapy of the elbow. The median age of the patients was 29 years (16{approx}75 years), and 27 of the patients were men and 18 were women. The occurrence of HO was mainly due to surgery after fracture (24/45) and traumatic injury (21/45). Limitation of the range of motion (ROM) was the most common symptom of the patients. Thirty-four patients received postoperative radiotherapy with a dose of 8 Gy in 2 fractions; 5 patients received a dose of 10 Gy in 5 fractions and 6 patients received a dose of 7 Gy in 1 fraction. Postoperative radiotherapy was given on the first two postoperative days for most of the patients. Sixteen patients were not given anti-inflammatory medication and 29 patients were given NSAIDs for 1{approx}8 months. Results: After a median follow-up period of 18 months (range 6{approx}72 months), 41 patients showed clinical improvement and two patients did not show improvement. Assessment of the ROM showed a mean improvement from 0{approx}135 .deg. to 60{approx}145 .deg. (p=0.028), and assessment of the functional outcome according to MEPI was from (15{approx}95) to (80{approx}100) (p<0.0001). Two of the 34 patients that were followed-up with radiography had mild radiological recurrence of heterotopic ossification. No complications were observed after the radiotherapy. Conclusion: These results suggested that low-dose radiation administered after surgical intervention is safe and effective to prevent the recurrence of HO in the elbow.

  8. Three dimensional printing technology and materials for treatment of elbow fractures.

    Science.gov (United States)

    Yang, Long; Grottkau, Brian; He, Zhixu; Ye, Chuan

    2017-11-01

    3D printing is a rapid prototyping technology that uses a 3D digital model to physically build an object. The aim of this study was to evaluate the peri-operative effect of 3D printing in treating complex elbow fractures and its role in physician-patient communication and determine which material is best for surgical model printing. Forty patients with elbow fractures were randomly divided into a 3D printing-assisted surgery group (n = 20) and a conventional surgery group (n = 20). Surgery duration, intra-operative blood loss, anatomic reduction rate, incidence of complications and elbow function score were compared between the two groups. The printing parameters, the advantages and the disadvantages of PLA and ABS were also compared. The independent-samples t-test was used to compare the data between groups. A questionnaire was designed for orthopaedic surgeons to evaluate the verisimilitude, the appearance of being true or real, and effectiveness of the 3D printing fracture model. Another questionnaire was designed to evaluate physician-patient communication effectiveness. The 3D group showed shorter surgical duration, lower blood loss and higher elbow function score, compared with the conventional group. PLA is an environmentally friendly material, whereas ABS produce an odour in the printing process. Curling edges occurred easily in the printing process with ABS and were observed in four of ten ABS models but in only one PLA model. The overall scores given by the surgeons about the verisimilitude and effectiveness of the 3D model were relatively high. Patient satisfaction scores for the 3D model were higher than those for the 2D imaging data during physician-patient discussions. 3D-printed models can accurately depict the anatomic characteristics of fracture sites, help surgeons determine a surgical plan and represent an effective tool for physician-patient communication. PLA is more suitable for desktop fused deposition printing in surgical modeling

  9. Intra-articular findings in symptomatic minor instability of the lateral elbow (SMILE).

    Science.gov (United States)

    Arrigoni, Paolo; Cucchi, Davide; D'Ambrosi, Riccardo; Butt, Usman; Safran, Marc R; Denard, Patrick; Randelli, Pietro

    2017-07-01

    Lateral epicondylitis is generally considered an extra-articular condition. The role of minor instability in the aetiology of lateral elbow pain has rarely been considered. The aim of this study was to evaluate the correlation of lateral ligamentous laxity with aspects of intra-articular lateral elbow pathology and investigate the role of minor instability in lateral elbow pain. Thirty-five consecutive patients aged between 20 and 60 years with recalcitrant lateral epicondylitis who had failed conservative therapy and had no previous trauma or overt instability, were included. The presence of three signs of lateral ligamentous patholaxity and five intra-articular findings were documented during arthroscopy. The relative incidence of each of these was calculated, and the correlation between patholaxity and intra-articular pathology was evaluated. At least one sign of lateral ligamentous laxity was observed in 48.6% of the studied cohort, and 85.7% demonstrated at least one intra-articular abnormal finding. Radial head ballottement was the most common sign of patholaxity (42.9%). Synovitis was the most common intra-articular aspect of pathology (77.1%), followed by lateral capitellar chondropathy (40.0%). A significant correlation was found between the presence of lateral ligamentous patholaxity signs and capitellar chondropathy (p = 0.0409), as well as anteromedial synovitis (p = 0.0408). Almost one half of patients suffering from recalcitrant lateral epicondylitis display signs of lateral ligamentous patholaxity, and over 85% demonstrate at least one intra-articular abnormality. The most frequent intra-articular findings are synovitis and lateral capitellar chondropathy, which correlate significantly with the presence of lateral ligamentous patholaxity. The fact that several patients demonstrated multiple intra-articular findings in relation to laxity provides support to a sequence of pathologic changes that may result from a symptomatic minor instability of

  10. Proprioceptive localization of the hand changes when skin stretch around the elbow is manipulated

    Directory of Open Access Journals (Sweden)

    Irene A. Kuling

    2016-10-01

    Full Text Available Cutaneous information has been shown to influence proprioceptive position sense when subjects had to judge or match the posture of their limbs. In the present study, we tested whether cutaneous information also affects proprioceptive localization of the hand when moving it to a target. In an explorative study, we manipulated the skin stretch around the elbow by attaching elastic sports tape to one side of the arm. Subjects were asked to move the unseen manipulated arm to visually presented targets. We found that the tape induced a significant shift of the end-points of these hand movements. Surprisingly, this shift corresponded with an increase in elbow extension, irrespective of the side of the arm that was taped. A control experiment showed that this cannot be explained by how the skin stretches, because the skin near the elbow stretches to a similar extent on the inside and outside of the arm when the elbow angle increases and decreases, respectively. A second control experiment reproduced and extended the results of the main experiment for tape on the inside of the arm, and showed that the asymmetry was not just a consequence of the tape originally being applied slightly differently to the outside of the arm. However, the way in which the tape was applied does appear to matter, because applying the tape in the same way to the outside of the arm as to the inside of the arm influenced different subjects quite differently, suggesting that the relationship between skin stretch and sensed limb posture is quite complex. We conclude that the way the skin is stretched during a goal-directed movement provides information that helps guide the hand towards the target.

  11. Acupuncture and moxibustion for lateral elbow pain: A systematic review of randomized controlled trials

    OpenAIRE

    Yeung, Wingfai; Chung, Kafai; Wang, Fuchun; Zhang, Shiping; Bangrazi, Sergio; Bian, Zhaoxiang; Gadau, Marcus; Liu, Hua; Zaslawski, Chris J.; Tan, Yuansheng

    2014-01-01

    Background: Acupuncture and moxibustion have widely been used to treat lateral elbow pain (LEP). A comprehensive systematic review of randomized controlled trials (RCTs) including both English and Chinese databases was conducted to assess the efficacy of acupuncture and moxibustion in the treatment of LEP.Methods: Revised STRICTA (2010) criteria were used to appraise the acupuncture procedures, the Cochrane risk of bias tool was used to assess the methodological quality of the studies. A tota...

  12. 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.

  13. Effect of radiation on preservation of convenient dish 'bowl-shape packed pig elbow'

    International Nuclear Information System (INIS)

    Wang Keqin; Chen Jingping; Li Wenge; Peng Weizheng

    2005-01-01

    The suitable parameters for radiation processing were investiqated by analyzing the microload of material and product, and radiation effect on the preservation of convenient dish 'bowl-shape packed pig elbow'. The results showed the store period of the product could be extended 2-6 month by 4.0-6.0 kGy radiation at different storage temperature. The sensory, physical and chemical index of the products met the requirement of relevant national standard of food hygiene. (authors)

  14. Studies on the behavior of part-through circumferential crack at intrados in elbows under in-plane bending moment

    International Nuclear Information System (INIS)

    Srivastava, A.; Prabhakaran, K.M.; Ghosh, A.K.

    2011-01-01

    Highlights: → Behavior of cracked elbows with part-through crack at intrados under bending moment is studied. → Some part of crack always opens and some part gets closed irrespective of mode of applied moment. → Fraction of the crack that opens basically decides the weakening effect of the cracked elbow. → Results will be useful for fracture studies and limit load estimation especially for LBB. - Abstract: This paper presents the behavior of part-through circumferential crack at intrados in elbows under in-plane bending moment. This is based on detailed non-linear (both material and geometric) finite element analysis performed on various sizes of elbows (generally used in piping industry), having different crack sizes. It is observed that some part of the crack always opens and some part gets closed irrespective of the mode of applied bending moment (opening/closing). The fraction of the crack that opens basically decides the weakening effect of the cracked elbow. It is observed that there is a threshold value of crack length and crack depth, before which no crack opening is observed under opening mode. Also as elbow becomes thinner, the threshold value of above two parameters increases. Quite interestingly, the part of crack which closes in opening mode opens under closing mode. The above mentioned study on the behavior of crack will be useful for fracture studies and limit load estimation especially when leak before break concept is to be employed.

  15. Structure- and fluid-borne acoustic power sources induced by turbulent flow in 90° piping elbows

    Science.gov (United States)

    Hambric, S. A.; Boger, D. A.; Fahnline, J. B.; Campbell, R. L.

    2010-01-01

    The structure- and fluid-borne vibro-acoustic power spectra induced by turbulent fluid flow over the walls of a continuous 90° piping elbow are computed. Although the actual power input to the piping by the wall pressure fluctuations is distributed throughout the elbow, equivalent total power inputs to various structural wavetypes (bending, torsion, axial) and fluid (plane-waves) at the inlet and discharge of the elbow are computed. The powers at the elbow “ports” are suitable inputs to wave- and statistically-based models of larger piping systems that include the elbow. Calculations for several flow and structural parameters, including pipe wall thickness, flow speed, and flow Reynolds number are shown. The power spectra are scaled on flow and structural-acoustic parameters so that levels for conditions other than those considered in the paper may be estimated, subject to geometric similarity constraints (elbow radius/pipe diameter). The approach for computing the powers (called CHAMP - combined hydroacoustic modeling programs), which links computational fluid dynamics, finite element and boundary element modeling, and efficient random analysis techniques, is general, and may be applied to other piping system components excited by turbulent fluid flow, such as U-bends and T-sections.

  16. The effect of elbow flexor fatigue on spine kinematics and muscle activation in response to sudden loading at the hands.

    Science.gov (United States)

    Zwambag, Derek P; Freeman, Nikole E; Brown, Stephen H M

    2015-04-01

    Sudden loads, originating at either the hands or the feet, can cause injury to spine structures. As muscles are primarily responsible for stabilization following a perturbation, the effect of spine muscle fatigue in this context has been well investigated. However, the effect of fatigue of arm muscles, which can help control perturbations originating at the hands, on the spine is unknown. The purpose of this study was to determine if the magnitude of spine flexion or the pre-activation, reflex amplitude, and reflex latency of spine muscles were altered by elbow flexor fatigue during a sudden loading (6.8 kg) perturbation at the hands. Elbow flexor fatigue was induced by an isometric 30% maximal elbow flexion moment until failure. Results demonstrate that spine kinematics were not altered in the presence of elbow flexor fatigue. Small magnitude differences in trunk muscle pre- and peak activation indicate that the presence of elbow flexor fatigue does not necessitate substantially greater spine muscle action under the tested conditions. Despite fatigued elbow flexors, the arm muscles were sufficiently able to control the perturbation. Interestingly, 5/14 participants demonstrated altered reflex latencies in all observed muscles that lasted up to 10 min after the fatiguing task. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Measurement of flow accelerated corrosion rate at an elbow pipe and combination effect of an upstream orifice

    International Nuclear Information System (INIS)

    Utanohara, Yoichi; Kamahori, Koichi; Nakamura, Akira; Murase, Michio

    2016-01-01

    Flow accelerated corrosion (FAC) rates at an elbow pipe with the diameter of D = 50 mm were measured by using corrosion sensors made of carbon steel. In addition, FAC rates at the elbow with an upstream orifice were measured to investigate the enhancement of FAC due to pipe geometries. The diameter ratio of the orifice was 0.5. The water temperature was 150°C, the mean cross-sectional velocity was 4.98 m/s, the dissolved oxygen concentration was under 0.2 μg/kg, and pH was nearly neutral (about 7.0) at room temperature. The FAC rate was smaller at the intrados of the elbow pipe than at other circumferential locations due to low flow velocity near the inner surface. The ratio of the maximum FAC rate at the elbow pipe to the FAC rate in the straight pipe was about 3.7 without the upstream orifice and about 15.4 with the upstream orifice. This showed that the orifice significantly affected the FAC rate at the elbow pipe because of the short distance of 2.65D between the orifice and the elbow pipe. (author)

  18. Pseudoelastic Nitinol-Based Device for Relaxation of Spastic Elbow in Stroke Patients

    Science.gov (United States)

    Viscuso, S.; Pittaccio, S.; Caimmi, M.; Gasperini, G.; Pirovano, S.; Villa, E.; Besseghini, S.; Molteni, F.

    2009-08-01

    A compliant brace (EDGES) promoting spastic elbow relaxation was designed to investigate the potentialities of pseudoelastic NiTi in orthotics. By exploiting its peculiar characteristics, EDGES could improve elbow posture without constraining movements and thus avoiding any pain to the patient. A commercial Ni50.7-Ti49.3 alloy heat treated at 400 °C 1 h + WQ was selected for this application. A prototype of EDGES was assembled with two thermoplastic shells connected by polycentric hinges. Four 2-mm-diameter NiTi bars were encastred in the upper-arm shell and let slide along tubular fixtures on the forearm. Specially designed bending tests demonstrated suitable moment-angle characteristics. Two post-stroke subjects (aged 62 and 64, mild elbow flexors spasticity) wore EDGES for 1 week, at least 10 h a day. No additional treatment was applied during this period or the following week. A great improvement (20° ± 5°) of the resting position was observed in both patients as early as 3 h after starting the treatment. Acceptability was very good. A slight decrease in spasticity was also observed in both subjects. All the effects disappeared 1 week after discontinuation. EDGES appears to be a good alternative to traditional orthoses in terms of acceptability and effectiveness in improving posture, especially whenever short-term splinting is planned.

  19. Effects of platelet-rich plasma on lateral epicondylitis of the elbow: prospective randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Evandro Pereira Palacio

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the effects of platelet-rich plasma (PRP infiltration in patients with lateral epicondylitis of the elbow, through analysis of the Disabilities of the Arm, Shoulder and Hand (DASH and Patient-Rated Tennis Elbow Evaluation (PRTEE questionnaires. METHODS: Sixty patients with lateral epicondylitis of the elbow were prospectively randomized and evaluated after receiving infiltration of three milliliters of PRP, or 0.5% neocaine, or dexamethasone. For the scoring process, the patients were asked to fill out the DASH and PRTEE questionnaires on three occasions: on the day of infiltration and 90 and 180 days afterwards. RESULTS: Around 81.7% of the patients who underwent the treatment presented some improvement of the symptoms. The statistical tests showed that there was evidence that the cure rate was unrelated to the substance applied (p = 0.62. There was also intersection between the confidence intervals of each group, thus demonstrating that the proportions of patients whose symptoms improved were similar in all the groups. CONCLUSION: At a significance level of 5%, there was no evidence that one treatment was more effective than another, when assessed using the DASH and PRTEE questionnaires.

  20. Gender-specific pattern differences of the ossification centers in the pediatric elbow

    International Nuclear Information System (INIS)

    Patel, Bijal; Reed, Martin; Patel, Shamir

    2009-01-01

    Only a limited number of studies have investigated the age ranges in which the secondary centers of the elbow appear and ossify. Knowledge of sequence, gender differences and age ranges can aid in accurate assessment of radiographs, especially in cases of injury. To determine the sequence and general age ranges in which each ossification center both appears and fuses, and also to identify differences between genders. This study included 412 sets of radiographs of children's elbows that were analyzed prospectively by a single experienced pediatric radiologist. The presence as well as state of fusion of each ossification center was noted. The ages of the children ranged from 2 months to 17 years. In girls, the radial head and medial epicondyle appeared at the same age. In boys, there was a trend towards the radial head appearing earlier than the medial epicondyle. There was no statistically significant difference between the age at which the trochlea and olecranon appeared. Our results demonstrate a statistically significant difference between genders in both appearance and fusion. All centers both appeared and fused earlier in girls, with the exception of the appearance of the capitellum. The sequence of appearance and fusion was similar between genders. Ossification centers at the elbow both appear and fuse earlier in females but the normal range in age for the times of appearance and fusion of these centers is quite wide for both sexes. (orig.)

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

    International Nuclear Information System (INIS)

    Hermann, G.; Gilbert, M.

    1988-01-01

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

  2. J simplified assessment for cracked pipes and elbows in the RSE-M code

    International Nuclear Information System (INIS)

    Delliou, P.L.; Sermage, J.-P.; Gilles, P.; Marie, S.; Kayser, Y.; Barthelet, B.

    2005-01-01

    RSE-M Code provides rules and requirements for in-service inspection of French Pressurized Water Reactor power plant components. Non mandatory guidance is given in the Code for defect assessment in a wide range of configurations: surface cracked pipes and elbows under pressure, moment and thermal loading. The Code provides influence coefficients to calculate stress intensity factors in pipes and elbows containing semi-elliptical surface defects (circumferential or longitudinal). The J assessment method is based on the reference stress concept with two options for reference loads evaluation: 'CEP elastic plastic stress' and 'CLC modified limit load'. This paper presents an overview of all the formulations and namely the case of pipe-to elbow junctions. The paper provides also a description of the very large data base of 2D and 3D J elastic-plastic finite element calculations performed to establish and validate the formulations. Finally an applicability domain of the methods is given ensuring a conservative prediction of J. (authors)

  3. Crack opening area estimates in pressurized through-wall cracked elbows under bending

    Energy Technology Data Exchange (ETDEWEB)

    Franco, C.; Gilles, P.; Pignol, M.

    1997-04-01

    One of the most important aspects in the leak-before-break approach is the estimation of the crack opening area corresponding to potential through-wall cracks at critical locations during plant operation. In order to provide a reasonable lower bound to the leak area under such loading conditions, numerous experimental and numerical programs have been developed in USA, U.K. and FRG and widely discussed in literature. This paper aims to extend these investigations on a class of pipe elbows characteristic of PWR main coolant piping. The paper is divided in three main parts. First, a new simplified estimation scheme for leakage area is described, based on the reference stress method. This approach mainly developed in U.K. and more recently in France provides a convenient way to account for the non-linear behavior of the material. Second, the method is carried out for circumferential through-wall cracks located in PWR elbows subjected to internal pressure. Finite element crack area results are presented and comparisons are made with our predictions. Finally, in the third part, the discussion is extended to elbows under combined pressure and in plane bending moment.

  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. Non-compact left ventricle/hypertrabeculated left ventricle

    International Nuclear Information System (INIS)

    Restrepo, Gustavo; Castano, Rafael; Marmol, Alejandro

    2005-01-01

    Non-compact left ventricle/hypertrabeculated left ventricle is a myocardiopatie produced by an arrest of the normal left ventricular compaction process during the early embryogenesis. It is associated to cardiac anomalies (congenital cardiopaties) as well as to extracardial conditions (neurological, facial, hematologic, cutaneous, skeletal and endocrinological anomalies). This entity is frequently unnoticed, being diagnosed only in centers with great experience in the diagnosis and treatment of myocardiopathies. Many cases of non-compact left ventricle have been initially misdiagnosed as hypertrophic myocardiopatie, endocardial fibroelastosis, dilated cardiomyopatie, restrictive cardiomyopathy and endocardial fibrosis. It is reported the case of a 74 years old man with a history of chronic arterial hypertension and diabetes mellitus, prechordial chest pain and mild dyspnoea. An echocardiogram showed signs of non-compact left ventricle with prominent trabeculations and deep inter-trabecular recesses involving left ventricular apical segment and extending to the lateral and inferior walls. Literature on this topic is reviewed

  6. Mechanical discordance between left atrium and left atrial appendage

    Directory of Open Access Journals (Sweden)

    Arash Khamooshian

    2018-01-01

    Full Text Available During standard transesophageal echocardiographic examinations in sinus rhythm (SR patients, the left atrial appendage (LAA is not routinely assessed with Doppler. Despite having a SR, it is still possible to have irregular activity in the LAA. This situation is even more important for SR patients where assessment of the left atrium is often foregone. We describe a case where we encountered this situation and briefly review how to assess the left atrium and its appendage in such a case scenario.

  7. [Left-handedness and health].

    Science.gov (United States)

    Milenković, Sanja; Belojević, Goran; Kocijancić, Radojka

    2010-01-01

    Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome), developmental disorders (autism, dislexia and sttutering) and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about "anomalous" cerebral domination, as a consequence of hormonal disbalance.

  8. Single motor unit firing behavior in the right trapezius muscle during rapid movement of right or left index finger

    DEFF Research Database (Denmark)

    Søgaard, Karen; Olsen, Henrik B; Blangsted, Anne K

    2014-01-01

    of a general multi joint motor program, while a generally increased and continuous firing rate would support the attention related muscle activation. METHOD: Twelve healthy female subjects were seated at a computer work place with elbows and forearms supported. Ten double clicks (DC) were performed with right......BACKGROUND: Computer work is associated with low level sustained activity in the trapezius muscle that may cause development of trapezius myalgia. Such a low level activity may be attention related or alternatively, be part of a general multi joint motor program providing stabilization...... of the shoulder joint as a biomechanical prerequisite for precise finger manipulation. This study examines single motor unit (MU) firing pattern in the right trapezius muscle during fast movements of ipsilateral or contralateral index finger. A modulation of the MU firing rate would support the existence...

  9. Characteristics of functional impairment in patients with long-standing rheumatoid arthritis based on range of motion of joints: Baseline data from a multicenter prospective observational cohort study to evaluate the effectiveness of joint surgery in the treat-to-target era.

    Science.gov (United States)

    Kojima, Toshihisa; Ishikawa, Hajime; Tanaka, Sakae; Haga, Nobuhiko; Nishida, Keiichiro; Yukioka, Masao; Hashimoto, Jun; Miyahara, Hisaaki; Niki, Yasuo; Kimura, Tomoatsu; Oda, Hiromi; Asai, Shuji; Funahashi, Koji; Kojima, Masayo; Ishiguro, Naoki

    2017-07-25

    To explore the characteristics of functional impairment in patients with established rheumatoid arthritis (RA) based on the range of motion (ROM) of joints in a prospective observational study of RA patients undergoing joint surgery. We collected data on demographics, Health Assessment Questionnaire Disability Index (HAQ-DI), and the ROM of large joints including the shoulder, elbow, wrist, hip, knee, and ankle. Associations between the ROM of each joint and disability in the eight HAQ-DI categories were determined using receiver operating characteristic (ROC) and logistic regression analyses. ROM cut-off values of each joint for the absence of disability in each HAQ-DI category were determined using ROC curves. A total of 460 patients were enrolled and analyzed in this study. Based on ROC analysis, the ROM of each joint was significantly associated with disability in each category. After adjusting for disease activity, age, and sex, shoulder abduction had the highest independent impact on disability in activity [cut-off: 139 degrees (OR: 5.26)], elbow flexion-extension in dressing [121 degrees (OR: 2.22)], wrist flexion-extension in reach [86 degrees (OR: 2.71)], hip flexion-extension in walking [126 degrees (OR: 3.42)], and knee flexion-extension in walking [134 degrees (OR: 2.97)]. Limited ROM of multiple joints was significantly associated with functional impairment in patients with long-standing RA. Motion in daily activity involves multiple joints, and at least two joints were independently involved in disability.

  10. Rasch analysis of the Dutch version of the Oxford elbow score

    Directory of Open Access Journals (Sweden)

    de Haan J

    2011-08-01

    Full Text Available Jeroen de Haan1, Niels Schep2, Wim Tuinebreijer2, Peter Patka2, Dennis den Hartog21Department of Surgery and Traumatology, Westfriesgasthuis, Hoorn, the Netherlands; 2Department of Surgery and Traumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the NetherlandsBackground: The Oxford elbow score (OES is a patient-rated, 12-item questionnaire that measures quality of life in relation to elbow disorders. This English questionnaire has been proven to be a reliable and valid instrument. Recently, the OES has been translated into Dutch and examined for its reliability, validity, and responsiveness in a group of Dutch patients with elbow pathology. The aim of this study was to analyze the Dutch version of the OES (OES-DV in combination with Rasch analysis or the one-parameter item response theory to examine the structure of the questionnaire.Methods: The OES-DV was administered to 103 patients (68 female, 35 male. The mean age of the patients was 44.3 ± 14.7 (range 15–75 years. Rasch analysis was performed using the Winsteps® Rasch Measurement Version 3.70.1.1 and a rating scale parameterization.Results: The person separation index, which is a measure of person reliability, was excellent (2.30. All the items of the OES had a reasonable mean square infit or outfit value between 0.6 and 1.7. The threshold of items were ordered, so the categories can function as intended. Principal component analysis of the residuals partly confirmed the multidimensionality of the English version of the OES. The OES distinguished 3.4 strata, which indicates that about three ranges can be differentiated.Conclusion: Rasch analysis of the OES-DV showed that the data fit to the stringent Rasch model. The multidimensionality of the English version of the OES was partly confirmed, and the four items of the function and three items of the pain domain were recognized as separate domains. The category rating scale of the OES-DV works well. The OES can

  11. Distinct Thalamo-Cortical Controls for Shoulder, Elbow, and Wrist during Locomotion

    Science.gov (United States)

    Beloozerova, Irina N.; Stout, Erik E.; Sirota, Mikhail G.

    2013-01-01

    Recent data from this laboratory on differential controls for the shoulder, elbow, and wrist exerted by the thalamo-cortical network during locomotion is presented, based on experiments involving chronically instrumented cats walking on a flat surface and along a horizontal ladder. The activity of the following three groups of neurons is characterized: (1) neurons of the motor cortex that project to the pyramidal tract (PTNs), (2) neurons of the ventrolateral thalamus (VL), many identified as projecting to the motor cortex (thalamo-cortical neurons, TCs), and (3) neurons of the reticular nucleus of thalamus (RE), which inhibit TCs. Neurons were grouped according to their receptive field into shoulder-, elbow-, and wrist/paw-related categories. During simple locomotion, shoulder-related PTNs were most active in the late stance and early swing, and on the ladder, often increased activity and stride-related modulation while reducing discharge duration. Elbow-related PTNs were most active during late swing/early stance and typically remained similar on the ladder. Wrist-related PTNs were most active during swing, and on the ladder often decreased activity and increased modulation while reducing discharge duration. In the VL, shoulder-related neurons were more active during the transition from swing-to-stance. Elbow-related cells tended to be more active during the transition from stance-to-swing and on the ladder often decreased their activity and increased modulation. Wrist-related neurons were more active throughout the stance phase. In the RE, shoulder-related cells had low discharge rates and depths of modulation and long periods of activity distributed evenly across the cycle. In sharp contrast, wrist/paw-related cells discharged synchronously during the end of stance and swing with short periods of high activity, high modulation, and frequent sleep-type bursting. We conclude that thalamo-cortical network processes information related to different segments of the

  12. International joint ventures

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    2001-01-01

    The article analysis problems connected with corporate joint ventures. Among others the possible conflicts between the joint venture agreement and the statutes of the companies is examined, as well as certain problems connected to the fact that the joint venture partners have created commen control...... over their joint company....

  13. Reduced joint counts misclassify patients with oligoarticular psoriatic arthritis and miss significant numbers of patients with active disease.

    Science.gov (United States)

    Coates, Laura C; FitzGerald, Oliver; Gladman, Dafna D; McHugh, Neil; Mease, Philip; Strand, Vibeke; Helliwell, Philip S

    2013-06-01

    To evaluate joint counts in patients with oligoarticular psoriatic arthritis (PsA) for their correlation with treatment decisions and to determine the proportion of patients in whom active disease was missed using reduced joint counts. The international Group for Research and Assessment of Psoriasis and Psoriatic Arthritis Composite Exercise cohort was used for this study. Oligoarthritis was defined as count (TJC) using 68 joints and a swollen joint count (SJC) using 66 joints (66/68-joint counts) were assessed. Reduced joint counts designed for use in rheumatoid arthritis (RA), including 28- and 44-joint counts, were analyzed. In addition, the following proposed joint counts for PsA were tested: the PsA-44 (which includes elbows, wrists, metacarpophalangeal joints, finger proximal interphalangeal [PIP] joints, distal interphalangeal joints, knees, and metatarsophalangeal joints) and the PsA-56 (which includes the same joints as those assessed for the PsA-44 plus ankles and toe PIP joints). Receiver operating characteristic (ROC) curve analysis was used to assess whether joint counts predict treatment changes. The proportion of patients in whom active disease was missed using reduced joint counts designed for RA was also assessed. Among 503 patients recruited to the study, 266 (53%) had oligoarthritis. ROC curve analysis revealed that no TJC or active joint count (AJC), even a 66/68-joint count, predicted treatment change (for the TJC, area under the curve [AUC] 0.57, P = 0.125; for the AJC, AUC 0.56, P = 0.159). Use of the SJC in 66 joints did predict treatment change (AUC 0.62, P = 0.006), as did the SJC using the PsA-44 and the PsA-56 (P counts designed for RA predicted treatment change. A 28-joint count designed for RA missed 21% of patients with tender joints (n = 29) and 27% of patients with swollen joints (n = 23). The PsA-44 and PsA-56 joint counts missed tender joints in 25 patients and 13 patients, respectively, and missed swollen joints in 11 patients

  14. [Case-control study on local injection of autoallergic platelet rich plasma or whole blood for the treatment of tennis elbow].

    Science.gov (United States)

    Zhao, Li-Lai; Tong, Pei-Jian; Xiao, Lu-Wei; Zhu, Qiu-Liang; Xu, Bin; Yan, Mao-Hua

    2014-11-01

    To compare therapeutic effects of local injection with autoallergic platelet rich plasma (PRP) or autoallergic whole blood (AWB) for the treatment of chronic tennis elbow. From January 2011 to January 2014, 40 patients with chronic tennis elbow were divided into 2 groups, 20 cases in each group: PRP group and AWB group. There were 20 patients in PRP group treated with local injection of autoallergic platelet rich plasma, including 5 males and 15 females, with an average age of (47.50 ± 9.86) years old; and the average course of disease was (4.67 ± 3.27) months. Among the 20 patients in AWB group treated with local injection of autoallergic whole blood, 3 patients were male and 17 patients were female, with an average age of (46.50 ± 9.96) years old;and the average course of disease was (4.53 ± 2.27) months. The elbow joint was fixed with elastic stockings after injection. All the patients were guided to do strengthening and extension exercises during the follow-up period. Visual analog scale (VAS), Mayo scores for elbow and pressure pain threshold (PPT) were used to evaluate clinical effects after injection immediately and 4,8 weeks after treatment. Results:All the patients were followed up,there were no infections and swelling occurred. The VAS, Mayo and PPT scores of patients in PRP group were improved from pre-therapy 7.22 ± 1.32, 56.71 ± 10.90 and 17.47 ± 4.62 to 2.73 ± 1.00, 91.59 ± 6.95 and 21.35 ± 4.80 respectively 8 weeks after treatment. The VAS, Mayo and PPT scores of patients in AWB group were improved from pre-therapy 7.16 ±1.27, 54.72 ± 8.36 and 17.06 ± 4.83 to 3.81 ± 1.36, 82.06 ± 7.89 and 20.12 ± 4.97 respectively 8 weeks after treatment. All the pain and functional variables including VAS, PPT, and Mayo scores were improved significantly in both groups 4 weeks after injection. On the 4th week after injection, there was no statistically significant difference in PPT between two groups; while the VAS and Mayo score of AWB group were

  15. Radial notch labralization for proximal radioulnar joint dysplasia.

    Science.gov (United States)

    Bellato, Enrico; O'Driscoll, Shawn W

    2017-07-01

    Chronic posterior subluxation or dislocation of the radial head is uncommon and difficult to treat. To restore radiocapitellar alignment, procedures such as deepening of the notch using a high-speed burr have been described, but they can result in cartilage damage. We hypothesized that a radial notch labralization using soft tissue could improve radiocapitellar tracking without violating the joint surface. A radial notch labralization was performed in 3 patients with chronic posterior subluxation of the radial head and developmental dysplasia of the radial notch in the setting of complex recurrent instability of the elbow. A soft tissue graft (typically a portion of an allograft hamstring tendon) was used to create a meniscus-like bumper posteriorly, thereby deepening the radial notch and reducing its radius of curvature. A corrective anterior opening wedge ulnar osteotomy was also performed to realign the radial head with the capitellum. At a mean follow-up of 32 months, all 3 patients were pain free and had maintained a stable joint, with a functional range of motion. Each patient gave a rating of either "Greatly Improved" or "Almost Normal" on the Summary Outcome Determination scale. Radiographs performed during the last follow-up showed improved radiocapitellar alignment. Chronic posterior subluxation or dislocation of the radial head can occur subsequent to developmental joint changes. The radial notch labralization using a soft tissue graft associated with a corrective ulnar osteotomy was successful in restoring radial head stability and avoiding cartilage damage. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  16. Modification of Spastic Stretch Reflexes at the Elbow by Flexion Synergy Expression in Individuals With Chronic Hemiparetic Stroke.

    Science.gov (United States)

    McPherson, Jacob G; Stienen, Arno H; Drogos, Justin M; Dewald, Julius P

    2018-03-01

    To systematically characterize the effect of flexion synergy expression on the manifestation of elbow flexor stretch reflexes poststroke, and to relate these findings to elbow flexor stretch reflexes in individuals without neurologic injury. Controlled cohort study. Academic medical center. Participants (N=20) included individuals with chronic hemiparetic stroke (n=10) and a convenience sample of individuals without neurologic or musculoskeletal injury (n=10). Participants with stroke were interfaced with a robotic device that precisely manipulated flexion synergy expression (by regulating shoulder abduction loading) while delivering controlled elbow extension perturbations over a wide range of velocities. This device was also used to elicit elbow flexor stretch reflexes during volitional elbow flexor activation, both in the cohort of individuals with stroke and in a control cohort. In both cases, the amplitude of volitional elbow flexor preactivation was matched to that generated involuntarily during flexion synergy expression. The amplitude of short- and long-latency stretch reflexes in the biceps brachii, assessed by electromyography, and expressed as a function of background muscle activation and stretch velocity. Increased shoulder abduction loading potentiated elbow flexor stretch reflexes via flexion synergy expression in the paretic arm. Compared with stretch reflexes in individuals without neurologic injury, paretic reflexes were larger at rest but were approximately equal to control muscles at matched levels of preactivation. Because flexion synergy expression modifies stretch reflexes in involved muscles, interventions that reduce flexion synergy expression may confer the added benefit of reducing spasticity during functional use of the arm. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Finite Element Limit Pressures for Circumferential Through-Wall Cracks in the Interface between Elbow and Pipe

    International Nuclear Information System (INIS)

    Jang, Yoon-Young; Han, Tae-Song; Huh, Nam-Su; Jeong, Jae-Uk

    2014-01-01

    Among integrity assessment method based on a fracture mechanics concept for piping system, a limit load method is one of the important way to predict a maximum load carrying capacity in the materials with high ductility in the sense that it is used to either assess directly structural integrity of pipe based on fully plastic fracture mechanics or calculate elasticplastic fracture mechanics parameters based on reference stress concept. In nuclear power plants, piping system often involves elbows welded to straight pipe. Since welded regions are vulnerable to cracking, it is important to predict an accurate limit load for pipes with a crack in the interface between elbows and attached pipes. However, although extensive works have been made for developing limit analysis methods for cracked pipes, they were mainly for straight pipes. Recently, limit moment solutions for elbow that is attached to straight pipe with a circumferential through-wall crack(TWC) in the interface were proposed, whereas limit pressure for this geometry is not suggested yet. In this context, plastic limit pressures of circumferential TWCs between elbow and straight pipe were calculated in the present study considering geometric parameters such as an elbow curvature, a pipe size and a crack length. In the present study, the FE plastic limit analyses for circumferential TWC in the interface between elbow and pipe under internal pressure were conducted based on elastic perfectly plastic assumption. Based on the present FE results, it is found that plastic limit pressures of straight pipes with circumferential TWC are not appropriate for predicting plastic limit pressures of circumferential TWC in the interface between elbow and pipe for shorter crack length

  18. Effect of Platelet-Rich Plasma (PRP) versus Autologous Whole Blood on Pain and Function Improvement in Tennis Elbow: A Randomized Clinical Trial

    OpenAIRE

    Raeissadat, Seyed Ahmad; Sedighipour, Leyla; Rayegani, Seyed Mansoor; Bahrami, Mohammad Hasan; Bayat, Masume; Rahimi, Rosa

    2014-01-01

    Background. Autologous whole blood and platelet-rich plasma (PRP) have been both suggested to treat chronic tennis elbow. The aim of the present study was to compare the effects of PRP versus autologous whole blood local injection in chronic tennis elbow. Methods. Forty patients with tennis elbow were randomly divided into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous PRP and group 2 with 2 mL of autologous blood. Tennis elbow strap, stretching, and strengthening...

  19. Prediction of fracture parameters of circumferential through-wall cracks in the interface between an elbow and a pipe under internal pressure

    International Nuclear Information System (INIS)

    Jang, Youn Young; Huh, Nam Su; Jeong, Jae Uk

    2016-01-01

    This paper provides plastic influence functions of GE/EPRI method for calculating J and Crack opening displacement (COD) of pipes with a circumferential Through-wall crack (TWC) in the interface between an elbow and a straight pipe by using 3-dimensional (3-D) elastic-plastic finite element analyses for Ramberg-Osgood (R-O) materials, in which internal pressure was considered as a loading condition. The proposed plastic influence functions are tabulated as a function of the pipe geometries, crack length and strain hardening exponent. In order to provide sufficient confidence for the proposed plastic influence functions, the estimation scheme using the proposed plastic influence functions for J and COD of cracked elbows was validated against FE results using R-O parameters for the SA312 TP316 stainless steel. Moreover, the predicted J and COD for elbows with a TWC in the interface between an elbow and a pipe by the proposed scheme were compared with those for cracked straight pipes to investigate the effect of the elbow geometries on crack behavior of elbows. One important point is that crack behaviors in the interface between an elbow and a straight pipe can be significantly different with those in straight pipes according to pipe thickness, crack length and bend radius of elbows. Thus, the proposed plastic influence functions can be useful to predict accurate J and COD for cracked elbows

  20. Acute hyperextension/valgus trauma to the elbow in top-level adult male water polo goalkeepers: a cause of osteochondritis disecans of the capitellum?

    Science.gov (United States)

    Rod, Eduard; Ivkovic, Alan; Boric, Igor; Jankovic, Sasa; Radic, Andrej; Hudetz, Damir

    2013-09-01

    We report on 2 cases of hyperextension/valgus elbow injuries in two adult male national team water polo goalkeepers. Both were healthy and had never sustained any major injuries of the elbow. Mechanism and type of injury in both of them was identical. Different medical treatment protocols of these injuries possibly have led to different outcomes, with one of them developing osteochondritis dissecans (OCD). Inadequate medical treatment of acute impact elbow injuries could lead to osteochondritis disecans of the elbow in top-level adult male water polo goalkeepers. Copyright © 2013 Elsevier Ltd. All rights reserved.