E ORIGINAL ARTICLE Elbow dislocation and articular fracture of the distal humerus
|
|
- Elisabeth Hopkins
- 5 years ago
- Views:
Transcription
1 Shoulder & Elbow. ISSN E ORIGINAL ARTICLE Elbow dislocation and articular fracture of the distal humerus Thierry G. Guitton,AndrewD.Duckworth, Margaret M. McQueen, Peter Kloen &DavidRing Harvard Medical School, Orthopedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA, USA Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, UK Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands Received Received 7 June 2009; accepted 23 December 2009 Keywords Capitellum, distal humerus, dislocations, elbow, fracture, trochlea Conflicts of Interest The authors did not receive any outside funding or grants in support of their research fororduringthepreparationofthiswork. Correspondence David Ring, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114, USA. Tel.: Fax: dring@partners.org DOI: /j x ABSTRACT Background The present report describes subluxation and dislocation of the elbow with articular fracture of the distal humerus and injury to the medial collateral ligament, a type of elbow fracture-dislocation about which little is available in the literature. Methods Twenty-two patients with subluxation or dislocation of the elbow (with injury to the medial collateral ligament) anda fracture of the distal humerusarticular surface(capitellum/trochlea) were identified. Seventeen patients had a minimum of 12 months follow-up and eight patients returned for a long-term follow-up at a median of 36 months (range 12 months to 154 months) after injury. Results Nine patients had one or more subsequent surgeries. Seven patients had surgery to address complications and two had a planned implant removal. The final median arc of elbow flexion was 120 (range 100 to 145 ) and the median arc of forearm rotation was 175 (range 150 to 180 ). The median Broberg and Morrey score was 88 points (range 63 points to 100 points) and the median Disabilities of the Arm Shoulder and Hand score was 9 points (range 1 point to 43 points). Discussion Some elbow dislocations and subluxations are associated with osteochondral fractures of the distal humeral articular surface. INTRODUCTION The definition of an elbow fracture-dislocation has been expressed as either a dislocation of the elbow with fracture of the radial head [1] or a dislocation of the elbow with intra-articular fracture [2,3]; however, reports of elbow dislocation or subluxation with associated fracture of the distal humerus are uncommon in adults [4 6] where fractures of the proximal radius and ulna are emphasized [7 9]. In children, dislocation of the elbow is most frequently associated with fracture of the medial or lateral epicondyle [10]. Very little mention has been made of dislocation or subluxation of the elbow associated with intra-articular fracture of the distal humerus in either age group [11,12]. We describe 22 adult patients with subluxation or dislocation of the elbow and articular fracture of the distal humerus (capitellum/trochlea) with injury to the medial collateral ligament documented by direct operative inspection or valgus stress testing with the aim of highlighting this variation of traumatic elbow instability. MATERIALS AND METHODS Inclusion and exclusion criteria (Tables 1 and 2) All fractures at one of our institutions were entered into a prospective database organized according to the AO Comprehensive Classification of Fractures [13] between 1974 and Among Table 1 Patients Institution 1 4 Institution 2 13 Institution 3 5 Total 22 Table 2 Patient details RSFU 8 Dead 4 Opt. out 3 Refused 1 Lost to FU 6 Total 22 Included RSFU 8 NO RSFU >12 FU 9 Total 17 RSFU, Research specific follow-up; NO RSFU >12 FU, no research specific follow-up but >12 months follow-up available in medical record. 264 adult patients with a fracture of the distal humerus, four had an associated elbow dislocation or subluxation. N Journal Compilation 2010 British Elbow and Shoulder Society. Shoulder & Elbow , pp
2 (a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) Figure 1: Legend on next page. 112 Journal Compilation 2010 British Elbow and Shoulder Society. Shoulder & Elbow , pp
3 At a second institution, between 1997 and 2007, two surgeons treated an additional 13 patients with articular fractures of the distal humerus with additional dislocation or subluxation, many of whom had been referred from other institutions. At the third institution, one surgeon treated an additional five patients with articular fractures of the distal humerus with additional dislocation or subluxation. At all three institutions, we defined a dislocation as either complete loss of apposition of the articular surfaces of the humerus and the ulna, or substantial subluxation necessitating injury to the medial collateral ligament with confirmation of ligament injury by stress examination after fracture fixation in the operating room or after closed reduction in the three patients treated non-operatively. Eighteen patients were treated operatively and four patients were treated non-operatively. Two patients had an ipsilateral minimally displaced radial head fracture, one patient had an additional distal radius fracture and one patient had an ipsilateral metacarpal phalangeal joint fracture. The medical records were reviewed retrospectively and patients were invited to return for a comprehensive long-term follow-up under a protocol approved by each Institutional Review Board. Four patients were dead, one patient became paraplegic and refused further investigation, three patients opted out and six patients could not be contacted. The four patients that were deceased at the time of the study had a median age of 70 years (range 25 years to 80 years) at the time of injury. Eight patients underwent a research specific comprehensive long-term evaluation performed by independent observers. Among the 14 patients who did not return for a study-specific long-term evaluation, nine had adequate records a minimum of 12 months after surgery and were evaluated based upon data from the medical record alone. Therefore, a total of 17 patients were included in the study: nine that had adequate records a minimum of 12 months after surgery and eight patients with a comprehensive long-term evaluation. The median interval between injury and final evaluation was 36 months (range 12 months to 154 months). Classification The distal humerus fractures were classified based on radiographs taken immediately after injury and intra-operative findings according the classifications of Ring et al. [11] and Dubberley et al. [14] (Fig. 1). According to the classification of capitellum/trochlea fractures used by Ring et al. [11] (Fig. 2), there was one Type 1 (i.e. single fragment involving the capitellum and lateral portion of the trochleaonly), threetype 2 (i.e. Type 1 fracture also involving the lateral epicondyle), five Type 3 (i.e. Type 2 fracture also involving the posterior part from the metaphyseal bone of the lateral column), four Type 4 (i.e. Type 3 fracture also involving a fracture of the posterior trochlea) and four Type 5 (i.e. Type 4 fracture also involving a fracture of the medial epicondyle) fractures. According to the classification of Dubberley et al. [14], four patients had Type 1A fractures (i.e. involving the capitellum and a small portion of lateral trochlea without involvement of the posterior aspect of the distal humerus), one Type 1B (i.e. similar to 1A with posterior fracture/impaction), five Type 2B (i.e. more extensive involvement of the lateral trochlea with posterior fracture), two Type 3A (i.e. fractures of both the capitellum and the trochlea as separate fragments) and five Type 3B (i.e. more extensive involvement of the trochlea with more than one fragment and with posterior fracture) (Table 1). All patients had subluxation or dislocation of the elbow in addition to their distal humerus fracture. Patients Among the 17 patients with at least 1 year of follow-up, there were six men and 11 women with a median age of 50 years (range 21 years to 80 years) at the time of surgery. Six patients were known to be employed at the time of injury: one was a homemaker and five were retired. From five patients the occupation was unknown. Open reduction and internal fixation was performed in 13 patients a median of 1 day (range 0 day to 7 days) after injury. Operative technique At least six different surgeons participated in the care of these fractures and no standard protocols were used. Thirteen patients were treated operatively with open reduction and internal fixation and three patients were treated non-operatively. All three patients treated non-operatively underwent immediate reduction and then cast immobilization for 10 days to 14 days. One patient was treated operatively but the fracture fragments were excised. A lateral skin incision was used in eight patients, a posterior incision in five patients and one fracture was addressed through an Fig. 1 A 31-year-old man sustained a left injury with complex fracture of the capitellum, trochlea and lateral epicondyle, and subluxation consistent with injury to the medial collateral ligament dislocation when skiing (Patient 1). (A, B) Anteroposterior and lateral radiographs and (C) computed tomography, including three-dimensional reconstructions, demonstrated a complex articular fracture involving the capitellum, the anterior portion of the lateral trochlea, part of the lateral column posterior to the capitellum, and the lateral epicondyle. (D) Operative treatment revealed numerous small osteochondral fragments. The larger articular fragments were repaired and the smaller fragments were discarded or used as bone graft. (E, F) Anteroposterior and lateral radiographs taken a few weeks after surgery show fixation with a combination of countersunk headless variable pitch screws and small threaded Kirschner wires. The lateral epicondyle was repaired with a tension band wire engaging the soft tissue attachments. After fixation ofthe fracture,valgusstress confirmedinjuryto the medialcollateralligament,but it was not repaired. (G, H) Seven months after the operation, anteroposterior and lateral radiographs detected avascular necrosis and non-union of some of the capitellar fragments with loose hardware. He returned to the operating room for removal of loose wires and ununited fragments and repeat fixation of the lateral epicondyle. (I, J) Anteroposterior and lateral radiographs taken at the final evaluation 24 months after the injury demonstrated stable concentric reduction of the ulnohumeral joint with a stable non-union (possibly a fibrous non-union) of the lateral epicondyle, and no signs of progressive arthritis. (K, L) He regained near full flexion and extension, worked as a musician and remained active in sports. Journal Compilation 2010 British Elbow and Shoulder Society. Shoulder & Elbow , pp
4 (a) (b) (c) (d) (e) Fig. 2 A 28-year-old man sustained a very high-energy open elbow dislocation in a motorcycle crash. (A, B) Anteroposterior and lateral radiographs demonstrate an extensive anteromedial wound (Gustilo Type III B) and a very complex fracture of the distal humerus involving the articular surface and the medial and lateral epicondyles, but not the columns of the distal humerus. The fracture fragments are dislocated from the ulnohumeral joint. Operative exploration disclosed fracture of the lateral epicondyle and avulsion of the medial collateral ligament origin. (C, D) Anteroposterior andlateral radiographs demonstrate open reduction and internal fixation after two initial debridements. Extensive heterotopic ossification is present one month after injury. (E) Lateral radiograph 2 years after debridement of infection, there was a bony ankylosis asa result of the heterotopic ossification. 114 Journal Compilation 2010 British Elbow and Shoulder Society. Shoulder & Elbow , pp
5 extension of an open wound. An olecranon osteotomy was used in a single patient. Internal fixation was performed with 3.5 mm or 2.7 mm screws in two fractures, Kirschner wires alone in two fractures and plate and screws (3.5 mm) in eight fractures (one with additional use of tension band wiring for the lateral epicondyle, one with an additional kirschner wire). Screws (3.5 mm) and Kirschner wires were used in one case. The olecranon osteotomy was secured with figure-of-eight tension band wiring. Twelve elbows were immobilized for a median of 14 days (range 4 days to 30 days). Three patients started elbow exercises the first day after surgery. Postoperative management was not clearly documented for two patients. For all patients, active assisted range of motion exercises were initiated at the time the splint was discontinued. Evaluation All of the patients were evaluated according to the system of Broberg and Morrey [1]. The eight patients that returned for a long-term study-specific evaluation were also evaluated according the Disabilities of the Arm Shoulder and Hand (DASH) [15,16] questionnaire to measure upper extremity specific disability, which runs from 0 representing no disability to 100 representing maximum disability. The range of elbow motion was measured using a hand-held goniometer. Anteroposterior and lateral radiographs of the involved elbow were evaluated for arthrosis by an independent observer according to the system of Broberg and Morrey: Grade 0, no arthrosis; Grade 1, slight joint-space narrowing with minimum osteophyte formation;grade2,moderatejoint-spacenarrowingwithmoderate osteophyte formation; and Grade 3, severe degenerative change with gross destruction of the joint [1]. RESULTS Subsequent procedures Among the cohort of 17 patients, 10 patients (59%) had one or more subsequent surgeries. Eight patients had surgery to address complications and one had a planned implant removal. Implant removal was routine at one institution during the study period but was not recommended when the implants were buried in bone. Complications (Table 3) Four patients had postoperative instability. One had subluxation immediately after surgery and did not correct with exercises. In another patient, subluxation was noted 5 days after surgery and treated with closed reduction under anaesthesia and cast immobilization. This patient developed complete bony ankylosis with heterotopic ossification that was resected 3 months after the initial injury. In the third patient, loss of fixation of the fracture and dislocation of the elbow led to an elbow arthrodesis. This fracture was counted as a failure and otherwise excluded from the final analysis of motion and function. A fourth patient had a second elbow fracture-dislocation that involved the radial head rather than the distal humerus and led to problems of recurrent instability. Table 3 Patient complications and additional procedures Patient Complication 1 Postoperative instability, bony ankylosis with HO 2 Postoperative instability 3 Planned ROM 4 5 Postoperative instability, second elbow fracture-dislocation radial head 6 7 Infection, superficial cellulitis 8 9 Infection, ORIF olecranon osteotomy non-union 10 Osteonecrosis of the capitellum, non-union of the lateral epicondyle, ROM + repeat fixation Infection, elbow stiffness and HO, ROM Osteonecrosis of the capitellum, non-union of the lateral epicondyle, ROM + repeat fixation Postoperative instability, arthrodesis 17 Infection, resection arthroplasty, HO arthrodesis HO, Heterotopic Ossification; DOI, date of injury; ROM, removal of osteosynthesis material; ORIF, open reduction internal fixation. The index surgery was complicated by infection in four patients: one was a superficial cellulitis treated with oral antibiotics and the other three were deep infections that were treated with one or more surgeries for debridement followed by parenteral antibiotics. Amongthesepatients,onealsohadasubsequentsurgeryforelbow stiffness and heterotopic ossification, another had open reduction internal fixation of an olecranon osteotomy non-union 4 months after the initial surgery, one had eventual implant removal and one had resection arthroplasty as part of the debridement and was left with an arthrodesis from extensive heterotopic ossification. Two patients had osteonecrosis of the capitellum, non-union of the lateral epicondyle, and migration of implants treated with removal of the loose bone and implants and repeat fixation of the lateral epicondyle 7 months and 10 months after the initial injury respectively. Final outcomes (Table 4) Six patients had excellent (40%), five had good (33%) and four had fair (27%) results out of 15 on the Broberg and Morrey rating. Among the eight patients that returned for a research specific follow-up, the median DASH score was nine points (range 1 point to 43 points). Nine elbows (60%) out of 15 had radiographic signs of arthrosis: rated Grade 1 in four elbows (45%), Grade 2 in three elbows (33%) and Grade 3 in two elbows (22%) at final follow-up. One patient had crepitation with elbow motion and none of the patients had symptoms or signs of ulnar neuropathy. DISCUSSION Dislocations of the elbow that are not associated with intraarticular fractures are best treated with early active range of Journal Compilation 2010 British Elbow and Shoulder Society. Shoulder & Elbow , pp
6 Table 4 Patient results Pt Sex FU Age FU Flex Ext FE arc Pro Sup SP arc B&M score B&M outcome DASH Arth score 1 F Excellent F Excellent 3 3 F Good 0 4 F Good 0 5 M Good 1 6 F Excellent F Fair F Fair M Fair 1 10 M Excellent F Excellent M Good 3 13 F Fair M Good 0 15 F Excellent 0 16 F M 2 30 Total Min Max FU, Follow up (years); Flex, flexion; Ext, extension; FE arc, flexion extension arc; Pron, pronation; Sup, supination; SP arc, supination pronation arc; B&M score, Broberg and Morrey score; B&M outcome, Broberg and Morrey outcome; DASH, Disabilities of Arm Shoulder and Hand Qeustionnaire; Arth, arthrosis rating. motion [17,18]. When at least one of the articular or osseous components that contributes to this inherent stability of the elbow is disrupted, the risks of instability, malalignment and arthrosis are increased [19,20]. Elbow fracture-dislocations involving the distal humerus are uncommon in adults and are usually considered to involve an avulsion fracture of the medial epicondyle, most likely an alternative to the usual ligament avulsion from the epicondyle. Dislocation or subluxation of the elbow with articular fracture of the distal humerus is rarely discussed [5,12]. The limitations of the present study include its retrospective design and therefore its heavy reliance on medical records, including the availability of only nine of 22 patients for comprehensive long-term evaluation. However, given the relative infrequency of theseinjuries, wefeelthatitisusefultopointoutthatdistalhumerus fractures can be associated with collateral ligament injuries and elbow dislocation or subluxation, as well as to obtain an idea of how these fractures perform within the first year of treatment. All of our patients had a complex lateral articular and lateral epicondyle fractures. The complex fracture of the anterolateral articular surface may represent an alternative to fracture of the radial head [i.e. an alternative lateral column (radiocapitellar) failure]. The fracture of the lateral epicondyle represents an alternative to lateral collateral ligament avulsion from the lateral epicondyle. The medial collateral ligament was also injured in every patient. The part of the injury that is more troublesome and distinctive from fracture-dislocations involving the radial head is that the fracture of the capitellum includes the lateral lip of the trochlea. This lateral lip is a critical part of the ulnohumeral articulation. Failure to adequately restore this lip may compromise the stability, function and durability of the elbow, particularly in the absence of radiocapitellar contact. This is in contrast to a fracture-dislocation of the elbow with associated fracture of the radial head, in which resection of the radial head is consistent with good short-term results [20], although the affect of radial head resection on the long term durability of the elbow has been questioned [21]. Two of our patients had an extremely complex injury that included both fracture and dislocation of the articular surface and both fracture and ligament avulsion from the epicondyles. This is most likely just an extremely high energy version of an articular fracture-dislocation involving thedistalhumerus. Thecombination of an open,contaminated wound and devitalized articular fractures proved devastating in one patient, although we have had success retaining devascularized articular fragments with open fracture of the distal humerus and would still consider this the best option in a young, active patient. When the lateral lip of the trochlea, the capitellum and the lateral collateral ligament/lateral epicondyle can be repaired, stability is usually restored without the need to repair the medial collateral ligament.if the capitellum cannot be repaired, the surgeon should probably consider repairing the medial collateral ligament. The decision to immobilizetheelbowafter operation is based upon the complexity of the articular fracture and the relatively tenuous fixation; there were no concerns about elbow stability after the repairs. As long as the lateral lip of the trochlea is restored and the fixation of the capitellum holds long enough for the capsuloligamentous structures to heal, the elbow will be stable, even if the capitellum 116 Journal Compilation 2010 British Elbow and Shoulder Society. Shoulder & Elbow , pp
7 ultimately fails to heal or there is osteonecrosis, as occurred in two patients. Some elbow dislocations and subluxations are associated with osteochondral fractures of the distal humeral articular surface. Restoration of the articulation of the trochlea and the trochlear notch is paramount, although radiocapitellar articulation and restoration of the lateral collateral ligament are also helpful. The injured medial collateral ligament will heal if the elbow remains concentrically reduced [11] and does not routinely need repair. These are complex injuries with a high rate of recurrent dislocation or subluxation (four of 17; 23%) and complications. It is our hope that increased awareness of these injuries and their pitfalls will contribute to improved outcomes. References 1. Broberg MA, Morrey BF. Results of delayed excision of the radial head after fracture. J Bone Joint Surg Am 1986; 68: Broberg MA, Morrey BF. Resultsoftreatmentoffracture-dislocations of the elbow. Clin Orthop Relat Res 1987; 216: Josefsson PO, Johnell O, GentzCF. Long-term sequelae of simple dislocation of the elbow. J Bone Joint Surg Am 1984; 66: McKee MD, Jupiter JB, Bamberger HB. Coronal shear fractures of the distal end of the humerus. J Bone Joint Surg Am 1996; 78: Inoue G, Horii E. Combined shear fractures of the trochlea and capitellum associated with anterior fracture-dislocation of the elbow. J Orthop Trauma 1992; 6: Jupiter JB, Barnes KA, Goodman LJ, Saldana AE. Multiplane fracture of the distal humerus. J Orthop Trauma 1993; 7: An KN, Moorey BF. Biomechanics of the elbow. In: Morrey BF, ed. The elbow and its disorders. Philadelphia: WB Saunders, 1993: Morrey BF. Anatomy of the elbow joint. In: Morrey BF, ed. The elbow and its disorders. Philadelphia: WB Saunders, 1993: Morrey BF, An KN. Functional anatomy of the ligaments of the elbow. Clin Orthop 1985; 201: Rasool MN. Dislocations of the elbow in children. J Bone Joint Surg Br 2004; 86: Ring D, Jupiter JB, Gulotta L. Articular fractures of the distal part of the humerus. J Bone Joint Surg Am 2003; 85-A: GuittonTG, Doornberg JN, Raaymakers EL, Ring D, KloenP. Fractures of the capitellum and trochlea. J Bone Joint Surg Am 2009; 91: Müller ME, Nazarian S, Koch P, Chatzker J. The comprehensive classification of fractures of long bones. Berlin: Springer-Verlag, Dubberley JH, Faber KJ, Macdermid JC, Patterson SD, King GJ. Outcome after open reduction and internal fixation of capitellar and trochlear fractures. J Bone Joint Surg Am 2006; 88: Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 1996; 29: Veehof MM, Sleegers EJ, van Veldhoven NH, Schuurman AH, van Meeteren NL. Psychometric qualities of the Dutch language version of the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH-DLV). JHandTher2002; 15: Mehlhoff TL, NoblePC, Bennett JB, Tullos HS. Simple dislocation of the elbow in the adult. Results after closed treatment. J Bone Joint Surg Am 1988; 70: Protzman RR. Dislocation of the elbow joint. J Bone Joint Surg Am 1978; 60: Josefsson PO, Gentz CF, Johnell O, Wendeberg B. Dislocations of the elbow and intraarticular fractures. Clin Orthop 1989; 246: Broberg MA, Morrey BF. Resultsoftreatmentoffracture-dislocations of the elbow. Clin Orthop 1987; 216: Sanchez-Sotelo J, Romanillos O, Garay EG. Resultsof acuteexcision of the radial head in elbow radial head fracture-dislocations. JOrthop Trauma 2000; 14: Journal Compilation 2010 British Elbow and Shoulder Society. Shoulder & Elbow , pp
Recurrent subluxation or dislocation after surgical
)263( COPYRIGHT 2017 BY THE ARCHIVES OF BONE AND JOINT SURGERY CASE REPORT Persistent Medial Subluxation of the Ulna with Radiotrochlear Articulation Amir R. Kachooei, MD; David Ring, MD, PhD Research
More informationE ORIGINAL ARTICLE Low extra-articular (transcondylar) fractures of the distal humerus
Shoulder & Elbow. ISSN 1758-5732 E ORIGINAL ARTICLE Low extra-articular (transcondylar) fractures of the distal humerus Alexander A. Weening, Kim M. Brouwer, Margaritha Adams & David Ring Orthopaedic Hand
More informationMANAGEMENT OF INTRAARTICULAR FRACTURES OF ELBOW JOINT. By Dr B. Anudeep M. S. orthopaedics Final yr pg
MANAGEMENT OF INTRAARTICULAR FRACTURES OF ELBOW JOINT By Dr B. Anudeep M. S. orthopaedics Final yr pg INTRAARTICULAR FRACTURES Intercondyar fracture Elbow dislocation Capitellum # Trochlea # Radial head
More informationRehabilitation after Total Elbow Arthroplasty
Rehabilitation after Total Elbow Arthroplasty Total Elbow Atrthroplasty Total elbow arthroplasty (TEA) Replacement of the ulnohumeral articulation with a prosthetic device. Goal of TEA is to provide pain
More informationNearly all of these fractures are displaced, given the paucity of soft tissue attachments.
CAPITELLAR FRACTURE Vasu Pai Nearly all of these fractures are displaced, given the paucity of soft tissue attachments. Nonsurgical management is fraught with complications including chronic pain, mechanical
More informationCase Report Combined Isolated Laugier s Fracture and Distal Radial Fracture: Management and Literature Review on the Mechanism of Injury
Case Reports in Orthopedics Volume 2016, Article ID 7631425, 6 pages http://dx.doi.org/10.1155/2016/7631425 Case Report Combined Isolated Laugier s Fracture and Distal Radial Fracture: Management and Literature
More informationMEDIAL EPICONDYLE FRACTURES
MEDIAL EPICONDYLE FRACTURES Demographic 20% of elbow fractures 60% of which are associated with elbow dislocation. 75% in boys between 6-12 years 20% of elbow dislocation with ME fracture, the ME is incarcerated
More informationThe Journal of the Korean Society of Fractures Vol.11, No.3, July, 1998
The Journal of the Korean Society of Fractures Vol11, No3, July, 1998 Department of Orthopaedic Surgery, College of Medicine, Gyeong-Sang National Univeristy, Chinju, Korea Post-traumatic elbow stiffness
More informationCitation for published version (APA): Bruinsma, W. E. (2014). Classification and management of shoulder and elbow trauma.
UvA-DARE (Digital Academic Repository) Classification and management of shoulder and elbow trauma Bruinsma, W.E. Link to publication Citation for published version (APA): Bruinsma, W. E. (2014). Classification
More informationCase Report Intra-Articular Osteotomy for Distal Humerus Malunion
Volume 2009, Article ID 631306, 4 pages doi:10.1155/2009/631306 Case Report Intra-Articular Osteotomy for Distal Humerus Malunion RenéK.Marti 1 and Job Doornberg 2 1 Department of Orthopaedic Surgery,
More informationFractures and dislocations around elbow in adult
Lec: 3 Fractures and dislocations around elbow in adult These include fractures of distal humerus, fracture of the capitulum, fracture of the radial head, fracture of the olecranon & dislocation of the
More informationPosterolateral elbow dislocation with entrapment of the medial epicondyle in children: a case report Juan Rodríguez Martín* and Juan Pretell Mazzini
Open Access Case report Posterolateral elbow dislocation with entrapment of the medial epicondyle in children: a case report Juan Rodríguez Martín* and Juan Pretell Mazzini Address: Department of Orthopaedic
More informationElbow dislocations represent 10% to 25% of all injuries. Elbow Fracture-Dislocations. The Role of Hinged External Fixation
33 Elbow Fracture-Dislocations The Role of Hinged External Fixation Nader Paksima, D.O., M.P.H., and Anand Panchal, B.S. Abstract Fracture-dislocations of the elbow remain a complex problem in orthopaedics.
More informationCoronal Shear Fractures of the Distal End of the Humerus*
Copyright 1996 by The Journal of Bone and Joint Surgery, Incorporated Coronal Shear Fractures of the Distal End of the Humerus* BY MICHAEL D. McKEE, M.D., F.R.C.S.(C)t, JESSE B. JUPITER, M.D4, BOSTON,
More informationAn isolated capitellum fracture of the humerus in adult: A rare case report
Case Report of the humerus in adult: A rare case report RP Shah Kalawar, P Chaudhary, R Maharjan, SF Afaque Department of Orthopaedics B.P. Koirala Institute of Health Sciences, Dharan, Nepal Abstract
More informationCase Presentation: Comminuted Fractures of the Proximal Ulna 11/28/2017. Disclosures. Surgical Strategy. Implant Choice. Melvin P.
Current Solutions in Orthopaedic Trauma Case Presentation: Comminuted Fracture of the Proximal Ulna Melvin P. Rosenwasser, MD Robert E. Carroll Professor of Surgery of the Hand Chief, Orthopaedic Hand
More informationELBOW ARTHROSCOPY WHERE ARE WE NOW?
ELBOW ARTHROSCOPY WHERE ARE WE NOW? Christian Veillette M.D., M.Sc., FRCSC Assistant Professor, University of Toronto Shoulder & Elbow Reconstructive Surgery Toronto Western Hospital @ University Health
More informationTerrible triad of the elbow
Terrible triad of the elbow Vasu Pai ? Terrible triad of the elbow" Posterior dislocation of the elbow + Fractures of the radial head + Fracture of coronoid process Uncommon injury 5% of dislocation Problems
More informationTraumatic Elbow Instability
Traumatic Elbow Instability David Ring MD PhD Updated April 2016 Simple Elbow Dislocation No associated fractures Complete or near complete capuloligamentous injury Extensive muscle injury Nearly always
More informationAnterior Elbow Capsulodesis
7(1):72 76, 2006 m R E V I E W m Anterior Elbow Capsulodesis Donald H. Lee, MD, Douglas R. Weikert, and Jeffry T. Watson Department of Orthopaedic Surgery Vanderbilt Orthopaedic Institute Nashville, TN
More informationSurgical approach to posterior dislocation of the elbow combined with radial head and coronoid fractures (terrible triad): report of 19 cases
SHAFA ORTHOPEDIC JOURNAL, Original Article Surgical approach to posterior dislocation of the elbow combined with radial head and coronoid fractures (terrible triad): report of 19 cases Kaveh Gharanizadeh
More informationUnstable elbow dislocations: a case report of a new surgical technique
SICOT J 2016, 2, 15 Ó The Authors, published by EDP Sciences, 2016 DOI: 10.1051/sicotj/2016010 Available online at: www.sicot-j.org CASE REPORT OPEN ACCESS Unstable elbow dislocations: a case report of
More informationTERRIBLE TRIAD OF THE ELBOW: EVALUATION OF SURGICAL TREATMENT
ORIGINAL ARTICLE TERRIBLE TRIAD OF THE ELBOW: EVALUATION OF SURGICAL TREATMENT Leandro Cardoso Gomide 1, Dagoberto de Oliveira Campos 2, José Maria Ribeiro de Sá 1, Marcelo Rangel Pamfílio de Sousa 1,
More informationElbow Fractures ORIF VS Arthroplasty
Elbow Fractures ORIF VS Arthroplasty Oke Anakwenze, M.D. Olympus Orthopedics No disclosures Disclosures Distal humerus fractures 0.5-0.7% of all fractures 30% of all elbow fractures Bimodal etiology Young
More informationSlide 1. Slide 2. Slide 3. The Thrower s Elbow: When to Operate. Medial Elbow Pain in the Athlete. Goal of This Talk
Slide 1 The Thrower s Elbow: When to Operate Luke S. Oh, MD Massachusetts General Hospital Team Physician, Boston Red Sox Team Physician, New England Revolution Consultant, Harvard University Athletics
More informationRadial - Head Fractures. Christophe Spormann Endoclinic Zürich
Radial - Head Fractures Christophe Spormann Endoclinic Zürich Elbow Func6on > 90% Ac6vi6es of daily living : 100 Flexion Extension : 130-30 Pro Supina9on : 50-0 - 50 Extension deficit beeer tolerated than
More informationInt J Clin Exp Med 2015;8(8): /ISSN: /IJCEM Guoqing Zha, Xiaofeng Niu, Weiguang Yu, Liangbao Xiao
Int J Clin Exp Med 2015;8(8):14214-14220 www.ijcem.com /ISSN:1940-5901/IJCEM0011204 Case Report Severe injury of bilateral elbow joints with unilateral terrible triad of the elbow and unilateral suspected
More informationFunctional Anatomy of the Elbow
Functional Anatomy of the Elbow Orthopedic Institute Daryl C. Osbahr, M.D. Chief of Sports Medicine, Orlando Health Chief Medical Officer, Orlando City Soccer Club Orthopedic Consultant, Washington Nationals
More informationArthroscopic Treatment of Posttraumatic
Arthroscopic Treatment of Posttraumatic Elbow Pain and Stiffness* Laura A. Timmerman, MD, and James R. Andrews, MD From the American Sports Medicine Institute, Birmingham, Alabama ABSTRACT Nineteen consecutive
More informationHumeral Capitellar Fractures Fixation with Herbert Screws
ORIGINAL ARTICLE SAJJAD HUSSAIN, ASAD ALI, M. TAHIR YUSUF, R. M. IRFAN SIDDIQUE ABSTRACT Background: Capitellar fractures are quite rare injury and often missed primarily. Different treatment options are
More informationDebridement arthroplasty for osteoarthritis of the elbow (Outerbridge-Kashiwagi procedure)
Acta Orthop. Belg., 2004, 70, 306-310 ORIGINAL STUDIES Debridement arthroplasty for osteoarthritis of the elbow (Outerbridge-Kashiwagi procedure) Bart VINGERHOEDS, Ilse DEGREEF, Luc DE SMET From the University
More informationFractures of the Distal Humerus
Fractures of the Distal Humerus Functional Anatomy Hinged joint with single axis of rotation (trochlear axis) Trochlea is center point with a lateral and medial column distal humeral triangle Functional
More informationBipolar Radial Head System
Bipolar Radial Head System Katalyst Surgical Technique DESCRIPTION The Katalyst Telescoping Bipolar Radial Head implant restores the support and bearing surface of the radial head in the face of fracture,
More informationRadial Head Fractures Save or Replace?
Radial Head Fractures Save or Replace? Current Solutions in Orthopedic Trauma Sepember 19, 2015 Jorge L. Orbay MD. Disclosure Skeletal Dynamics Elbow Joint Ulno-Humeral and Radio-Capitellar The key joint
More informationThe posterior Monteggia lesion with associated ulnohumeral instability
The posterior Monteggia lesion with associated ulnohumeral instability E. J. Strauss, N. C. Tejwani, C. F. Preston, K. A. Egol From the New York Universty Hospital for Joint Diseases, New York, New York,
More informationA Patient s Guide to Adult Olecranon (Elbow) Fractures
A Patient s Guide to Adult Olecranon (Elbow) Fractures 2350 Royal Boulevard Suite 200 Elgin, IL 60123 Phone: 847.931.5300 Fax: 847.931.9072 1 DISCLAIMER: The information in this booklet is compiled from
More informationDISTAL HUMERUS FRACTURES WHAT I HAVE LEARNED DISTAL HUMERUS FRACTURES WHAT I HAVE LEARNED 63 YO WOMAN CT FIXABLE OSTEOTOMY NOT NEEDED
AMERICAN SHOULDER AND ELBOW SURGEONS ORTHOPAEDIC TRAUMA ASSOCIATION SPECIALTY DAY SAN DIEGO, MARCH 2017 Graham JW King MD, MSc, FRCSC 63 YO WOMAN CT FIXABLE OSTEOTOMY NOT NEEDED 64 YO WOMAN FALL OF LADDER
More informationElbow Elbow Anatomy. Flexion extension. Pronation Supination. Anatomy. Anatomy. Romina Astifidis, MS., PT., CHT
Elbow Elbow Anatomy Romina Astifidis, MS., PT., CHT Curtis National Hand Center Baltimore, MD October 6-8, 2017 Link between the arm and forearm to position the hand in space Not just a hinge Elbow = 70%
More informationRelocation of the radial head with minimal invasive approach using the Ilizarov technique in neglected Monteggia fracture
2016; 2(2): 13-20 ISSN: 2395-1958 IJOS 2016; 2(2): 13-20 2016 IJOS www.orthopaper.com Received: 01-09-2015 Accepted: 02-03-2016 Dr. Nishant Chaudhari Postgraduate resident in orthopaedics, Surat Municipal
More informationCase Report Intra-Articular Entrapment of the Medial Epicondyle following a Traumatic Fracture Dislocation of the Elbow in an Adult
Hindawi Case Reports in Orthopedics Volume 2018, Article ID 5401634, 6 pages https://doi.org/10.1155/2018/5401634 Case Report Intra-Articular Entrapment of the Medial Epicondyle following a Traumatic Fracture
More informationOutcome of surgically treated displaced medial epicondyle fracture of humerus in children: A prospective study
2017; 3(3): 287-291 ISSN: 2395-1958 IJOS 2017; 3(3): 287-291 2017 IJOS www.orthopaper.com Received: 08-05-2017 Accepted: 10-06-2017 Sahu RL M.S. Orthopaedics, Professor, Dr. Nadeem Ahmad Outcome of surgically
More informationInspection. Physical Examination of the Elbow. Anterior Elbow 2/14/2017. Inspection. Carrying angle. Lateral dimple. Physical Exam of the Elbow
of the Elbow Anthony A. Romeo, MD Professor, Department of Orthopedics Head, Section of Shoulder and Elbow Surgery Rush University President-Elect, American Shoulder Elbow Surgeons Team Physician, Chicago
More informationA Patient s Guide to Adult Radial Head (Elbow) Fractures
A Patient s Guide to Adult Radial Head (Elbow) Fractures 2321 Coronado Idaho Falls, ID 83404 Phone: 208-227-1100 jpond@summitortho.net 1 DISCLAIMER: The information in this booklet is compiled from a variety
More informationSurgical Care at the District Hospital. EMERGENCY & ESSENTIAL SURGICAL CARE
Surgical Care at the District Hospital 1 18 Orthopedic Trauma Key Points 2 18.1 Upper Extremity Injuries Clavicle Fractures Diagnose fractures from the history and by physical examination Treat with a
More informationFracture of the radial head is the most common
5 points on Surgical Management of Radial Head Fractures Robert W. Wysocki, M, and Mark S. ohen, M Fracture of the radial head is the most common skeletal injury in the adult elbow. Most radial head fractures
More informationTerrible Triad: Tricks for Dealing with the Unstable Elbow
Terrible Triad: Tricks for Dealing with the Unstable Elbow Mark A. Mighell, MD Kaitlyn N. Christmas, BS Disclosure Paid Consultation Research Support Speakers Bureau Paid Consultation Speakers Bureau The
More information1 Humeral fractures 1.13 l Distal humeral fractures Treatment with a splint
1 Executive Editor: Chris Colton Authors: Mariusz Bonczar, Daniel Rikli, David Ring 1 Humeral fractures 1.13 l Distal humeral fractures Treatment with a splint Indication All 13-A type fractures, excluding
More informationPediatric Fractures. Objectives. Epiphyseal Complex. Anatomy and Physiology. Ligaments. Bony matrix
1 Pediatric Fractures Nicholas White, MD Assistant Professor of Pediatrics Eastern Virginia Medical School Attending, Pediatric Emergency Department Children s Hospital of The King s Daughters Objectives
More informationReview Article Primary and Posttraumatic Arthritis of the Elbow
Arthritis Volume 2013, Article ID 473259, 6 pages http://dx.doi.org/10.1155/2013/473259 Review Article Primary and Posttraumatic Arthritis of the Elbow Debdut Biswas, Robert W. Wysocki, and Mark S. Cohen
More informationElbow, forearm injuries. K. Fekete
Elbow, forearm injuries K. Fekete 1. Outline: Fractures of the elbow Dislocation of the elbow Fractures of the forearm Special injuries 2. ANATOMY 3. Lennard Funk Anatomical reminder Three joints: Humero-ulnar
More informationOther Elbow Concerns in Overhead Athletes
Other Elbow Concerns in Overhead Athletes John A. Steubs, M.D. Team Physician, Minnesota Twins TRIA Orthopaedic Center Disclosures None relevant to this presentation. Other Elbow Problems Valgus extension
More informationAnterior Olecranon Fracture-Dislocations of the Elbow in Children A Report of Four Cases Guitton, T.G.; Albers, R.G.H.; Ring, D.
UvA-DARE (Digital Academic Repository) Anterior Olecranon Fracture-Dislocations of the Elbow in Children A Report of Four Cases Guitton, T.G.; Albers, R.G.H.; Ring, D. Published in: The journal of bone
More informationA prospective study of surgical management of distal end humerus fractures in adults
2016; 2(4): 223-229 ISSN: 2395-1958 IJOS 2016; 2(4): 223-229 2016 IJOS www.orthopaper.com Received: 06-08-2016 Accepted: 07-09-2016 Dayanand BB Associate Professor, Shri BM Patil Medical College Hospital
More informationPosteromedial approach to the distal humerus for fracture fixation
Acta Orthop. Belg., 2006, 72, 395-399 ORIGINAL STUDY Posteromedial approach to the distal humerus for fracture fixation Cédric LAPORTE, Maurice THIONGO, Dominique JEGOU From the General Hospital of Meaux,
More informationWhat happens to the elbow joint after fractured radial head excision? Clinical and radiographic study at a mean 15-year follow-up
J Orthopaed Traumatol (2006) 7:126 130 DOI 10.1007/s10195-006-0135-8 ORIGINAL C. Faldini S. Pagkrati G. Grandi V. Digennaro G. Lauretani O. Faldini S. Giannini What happens to the elbow joint after fractured
More informationIntegra. Katalyst Bipolar Radial Head System SURGICAL TECHNIQUE
Integra Katalyst Bipolar Radial Head System SURGICAL TECHNIQUE Surgical Technique As the manufacturer of this device, Integra does not practice medicine and does not recommend this or any other surgical
More informationScholars Journal of Medical Case Reports
DOI: 10.21276/sjmcr Scholars Journal of Medical Case Reports Sch J Med Case Rep 2017; 5(4):272-276 Scholars Academic and Scientific Publishers (SAS Publishers) (An International Publisher for Academic
More informationDistal Humerus Fractures: How should they be fixed?
Distal Humerus Fractures: How should they be fixed? Dr. Emil Schemitsch, MD, FRCS(C) Richard Ivey Professor and Chairman, Department of Surgery, Western University Chief of Surgery London Health Sciences
More informationClinical Results of Surgically Treated Medial Humeral Epicondylar Apophyseal Avulsion Injury in Children and Adolescent
Clinical Results of Surgically Treated Medial Humeral Epicondylar Apophyseal Avulsion Injury in Children and Adolescent Ruban Raj Joshi, a,c Gabriel David Sundararaj b,c Original Research Article ABSTRACT:
More informationTREATMENT OF NONUNION OF OLECRANON FRACTURES
TREATMENT OF NONUNION OF OLECRANON FRACTURES PANAYIOTIS J. PAPAGELOPOULOS, BERNARD F. MORREY From the Mayo Clinic and Mayo Foundation, Rochester, USA We report the results in 24 consecutive patients treated
More informationRadial head fractures; ORIF radial head; radial head arthroplasty; coronoid process fracture; ligament repair Elbow Anatomy Spectrum of injuries
Radial head fractures; ORIF radial head; radial head arthroplasty; coronoid process fracture; ligament repair This information aims to help you understand your condition and gain maximum benefit from your
More informationProximal radioulnar translocation associated with elbow dislocation and radial neck fracture in child: a case report and review of literature
DOI 10.1007/s00402-013-1820-8 TRAUMA SURGERY Proximal radioulnar translocation associated with elbow dislocation and radial neck fracture in child: a case report and review of literature Hong Kee Yoon
More informationLong-term sequel of posterolateral rotatory instability of the elbow: a case report
CASE REPORT Open Access Long-term sequel of posterolateral rotatory instability of the elbow: a case report Chun-Ying Cheng * Abstract The natural course of untreated posterior lateral rotatory instability
More informationI (and/or my co-authors) have something to disclose.
Elbow Anatomy And Biomechanics Nikhil N Verma, MD Director, Division of Sports Medicine Professor, Department of Orthopedics Rush University Medical Center Team Physician, Chicago White Sox and Bulls I
More informationElbow Anatomy, Growth and Physical Exam. Donna M. Pacicca, MD Section of Sports Medicine Division of Orthopaedic Surgery Children s Mercy Hospital
Elbow Anatomy, Growth and Physical Exam Donna M. Pacicca, MD Section of Sports Medicine Division of Orthopaedic Surgery Children s Mercy Hospital Contributing Factors to Elbow Injury The elbow is affected
More informationFracture-dislocations of the elbow are complex injuries
Bulletin of the NYU Hospital for Joint Diseases 2007;65(4):263-70 263 Fracture-Dislocation of the Elbow Functional Outcome Following Treatment with a Standardized Protocol Kenneth A. Egol, M.D., Igor Immerman,
More informationAdam J. Seidl, MD Assistant Professor University of Colorado School of Medicine Shoulder & Elbow Surgery Division of Sports Medicine and Shoulder
Adam J. Seidl, MD Assistant Professor University of Colorado School of Medicine Shoulder & Elbow Surgery Division of Sports Medicine and Shoulder Surgery Division of Hand, Wrist, and Elbow Surgery Anatomy
More informationPediatric Elbow Radiology. Seema Awatramani, MD Friday, April 5, 2018 ACOEP Spring Seminar
Pediatric Elbow Radiology Seema Awatramani, MD Friday, April 5, 2018 ACOEP Spring Seminar Disclosure I have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or
More informationOrthopedics in Motion Tristan Hartzell, MD January 27, 2016
Orthopedics in Motion 2016 Tristan Hartzell, MD January 27, 2016 Humerus fractures Proximal Shaft Distal Objectives 1) Understand the anatomy 2) Epidemiology and mechanisms of injury 3) Types of fractures
More informationThe Elbow Scanning Protocol
The Elbow Scanning Protocol Diagnostic Imaging of the Elbow: Introduction The elbow maybe considered as consisting of four quadrants, anterior, medial, lateral and posterior. Ultrasound would normally
More information1/19/2018. Winter injuries to the shoulder and elbow. Highgate Private Hospital (Whittington Health NHS Trust)
Winter injuries to the shoulder and elbow Omar Haddo Consultant Orthopaedic Surgeon, Shoulder, Elbow, Hand & Wrist Specialist MBBS, BmedSci, FRCS(Orth) Highgate Private Hospital (Whittington Health NHS
More informationJoseph L. Laratta Richard S. Yoon Matthew A. Frank Kenneth Koury Derek J. Donegan Frank A. Liporace
J Orthopaed Traumatol (2014) 15:63 67 DOI 10.1007/s10195-013-0239-x CASE REPORT Divergent elbow dislocation with radial shaft fracture, distal ulnar deformation, and distal radioulnar joint instability:
More informationBiomechanics of Two Reconstruction Techniques for Elbow Ulnar Collateral Ligament Insufficiency
Biomechanics of Two Reconstruction Techniques for Elbow Ulnar Collateral Ligament Insufficiency Justin E. Chronister, MD 1, Randal P. Morris, BS 2, Clark R. Andersen, MS 2, J. Michael Bennett, MD 3, Thomas
More informationOCCUPATIONAL INJURIES OF THE ELBOW
PLEASE STAND BY WEBINAR WILL BEGIN AT 12:00 PM PST FOR AUDIO: CALL 866-740-1260 / ACCESS CODE: 764-4915# JAMES VAN DEN BOGAERDE, MD OCCUPATIONAL INJURIES OF THE ELBOW Conflict of Interest Disclosure I,
More informationFractures of the shoulder girdle, elbow and fractures of the humerus. H. Sithebe 2012
Fractures of the shoulder girdle, elbow and fractures of the humerus H. Sithebe 2012 Fractures of the Clavicle (mid-shaft). Fractures of the clavicle Fractures of the clavicle Treatment- conservative.
More informationTrauma. Open reduction and internal fixation of comminuted fractures of the radial head using low-profile mini-plates
Trauma Open reduction and internal fixation of comminuted fractures of the radial head using low-profile mini-plates M. Ikeda, Y. Yamashina, M. Kamimoto, Y. Oka From Tokai University Oiso Hospital, Kanagawa,
More informationTraumatic injuries of the paediatric elbow: A pictorial review
Traumatic injuries of the paediatric elbow: A pictorial review Poster No.: C-750 Congress: ECR 2009 Type: Educational Exhibit Topic: Pediatric Authors: A. M. Veitch, J. Harington, K. Franklin ; Plymouth/UK,
More informationthe radial collateral ligament, the lateral ulnar collateral ligament, and the annular ligament 13
1823 COPYRIGHT 2001 BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED Ligamentous Stabilizers Against Posterolateral Rotatory Instability of the Elbow BY CYNTHIA E. DUNNING, PHD, ZANE D.S. ZARZOUR,
More informationLCP Proximal Radius Plates 2.4. Plates for radial head rim and for radial head neck address individual fracture patterns of the proximal radius.
Technique Guide LCP Proximal Radius Plates 2.4. Plates for radial head rim and for radial head neck address individual fracture patterns of the proximal radius. Table of Contents Introduction LCP Proximal
More informationFracture and Dislocation of the Carpus ( 1-Jan-1985 )
In: Textbook of Small Animal Orthopaedics, C. D. Newton and D. M. Nunamaker (Eds.) Publisher: International Veterinary Information Service (www.ivis.org), Ithaca, New York, USA. Fracture and Dislocation
More informationCase Report Surgical Treatment of Posttraumatic Radioulnar Synostosis
Case Reports in Orthopedics Volume 2016, Article ID 5956304, 4 pages http://dx.doi.org/10.1155/2016/5956304 Case Report Surgical Treatment of Posttraumatic Radioulnar Synostosis S. Pfanner, P. Bigazzi,
More informationManagement of Chronic Elbow Pain
Mr. Nashat Siddiqui Consultant Upper Limb Orthopaedic Surgeon Management of Chronic Elbow Pain Patients presenting with elbow pain can pose a diagnostic challenge, especially if there is no obvious recent
More informationElbow Injuries in Young Athletes!
Elbow Injuries in Young Athletes! Andrew Martin DO, MBA, CAQSM! Director Sports Medicine Campbell University! Head Team Physician, Associate Professor Sports Medicine Disclosures None based on the content
More informationEarly Elbow Motion Protocol Ligament Repair of the elbow
499 Blossom Hill Rd, San Jose, Ca 95123 Tel: 408-268-8536 Fax: 408-268-8727 www.handsoncaretherapy.com Early Elbow Motion Protocol Ligament Repair of the elbow EARLY MOTION PROTOCOL 1-3 DAYS POST OP LIGAMENT
More informationSurgical Complications
Surgical Complications Complications are common even with ideal management. Recently, Bashyal performed a retrospective review of 622 patients treated for supracondylar fractures and evaluated the complications
More informationThe study of distal ¼ diaphyseal extra articular fractures of humerus treated with antegrade intramedullary interlocking nailing
2018; 4(4): 46-50 ISSN: 2395-1958 IJOS 2018; 4(4): 46-50 2018 IJOS www.orthopaper.com Received: 01-08-2018 Accepted: 03-09-2018 Dr. Ankur Parikh Orthopaedics, Jehangir Hospital, Sassoon road, Pune, Dr.
More informationKudo type-5 total elbow arthroplasty in mutilating rheumatoid arthritis
Upper limb Kudo type-5 total elbow arthroplasty in mutilating rheumatoid arthritis A 5- TO 11-YEAR FOLLOW-UP T. Mori, H. Kudo, K. Iwano, T. Juji From the National Hospital Organization Sagamihara Hospital,
More informationCommon Elbow Problems
Common Elbow Problems Duncan Ferguson FRACS Knee and Shoulder Specialist Elbow Instability Common 10-25% of elbow injuries Median age 30 yrs Most simple dislocations are stable after reduction recurrence
More informationFunctional Outcome of Hahn-Steinthal Fracture Capitellum Fixed with Kirschner-wires Via Posterolateral Approach
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2016/502 Functional Outcome of Hahn-Steinthal Fracture Capitellum Fixed with Kirschner-wires Via Posterolateral Approach
More informationElbow. Chapter 2 LISTEN. Mechanism of Injury (If Applicable) Pain
Chapter 2 Elbow LISTEN Mechanism of Injury (If Applicable) Patient usually remembers their position at the time of injury Certain mechanisms of injury result in characteristic patterns Fall on outstretched
More informationUpper Extremity Fractures
Upper Extremity Fractures Ranie Whatley, RN,FNP-C David W. Gray, MD Skeletal Trauma 10 to 15 % of all Childhood Injuries Physeal (Growth Plate) Injuries are ~ 15% of all Skeletal Injuries Orthopaedic Assessment
More informationUpper limb fractures. Mithun Nambiar Orthopaedic Resident Royal Melbourne Hospital
Upper limb fractures Mithun Nambiar Orthopaedic Resident Royal Melbourne Hospital http://janeaustensworld.files.wordpress.com/2010/10/17_skeleton.jpg Principles of fracture management Restoration of anatomy
More informationTechnique Guide. 2.4 mm Variable Angle LCP Distal Radius System. For fragment-specific fracture fixation with variable angle locking technology.
Technique Guide 2.4 mm Variable Angle LCP Distal Radius System. For fragment-specific fracture fixation with variable angle locking technology. Table of Contents Introduction 2.4 mm Variable Angle LCP
More informationKATALYST. Bipolar Radial Head System. Surgical Technique. orthopedics. KATALYST English. PRODUCTS FOR SALE IN EUROPE, MIDDLE-EAST and AFRICA ONLY
KATALYST Bipolar Radial Head System KATALYST English Surgical Technique orthopedics UPPER extremity PRODUCTS FOR SALE IN EUROPE, MIDDLE-EAST and AFRICA ONLY KATALYST Introduction Description The Katalyst
More informationShoulder and Elbow ORTHOPAEDIC SYPMPOSIUM APRIL 8, 2017 DANIEL DOTY MD
Shoulder and Elbow ORTHOPAEDIC SYPMPOSIUM APRIL 8, 2017 DANIEL DOTY MD Shoulder Articulations Glenohumeral Joint 2/3 total arc of motion Shallow Ball and Socket Joint Allows for excellent ROM Requires
More informationTreatment of malunited fractures of the ankle
Treatment of malunited fractures of the ankle A LONG-TERM FOLLOW-UP OF RECONSTRUCTIVE SURGERY I. I. Reidsma, P. A. Nolte, R. K. Marti, E. L. F. B. Raaymakers From Academic Medical Center, Amsterdam, Netherlands
More informationTHE ELBOW. The elbow is a commonly injured joint in both children and adults.
ABC of Emergency Radiology FIG i-lateral radiograph of elbow and line THE ELBOW D A Nicholson, P A Driscoll The elbow is a commonly injured joint in both children and adults. Interpretation of elbow radiographs
More informationAnatomical Considerations Regarding the Posterior Interosseous Nerve During Posterolateral Approaches to the Proximal Part of the Radius *
Anatomical Considerations Regarding the Posterior Interosseous Nerve During Posterolateral Approaches to the Proximal Part of the Radius * BY THOMAS DILIBERTI, M.D., MICHAEL J. BOTTE, M.D., AND REID A.
More information