Evaluation of functional outcome and patient satisfaction after arthroscopic elbow arthrolysis

Arthroscopic arthrolysis is indicated for stiffness and pain caused by intrinsic stiffness and early arthritis of the elbow joint. Previous studies have demonstrated the benefits in relieving pain and improving motion, but none have reported the specific functional recovery. To understand the functional outcome and patient satisfaction, 26 patients were reviewed at a mean follow-up of 25 months. All were manual workers or strength athletes. Pre- and post-operative evaluation included the Elbow Functional Assessment score, patient satisfaction and return to work and sports. Function improved significantly in 87% and the overall Elbow Functional Assessment score raised from a preoperative 48 to a postoperative 84. Arthroscopic arthrolysis not only improved pain and the range of motion, but also restored the elbow function and returned patients to their desired level of activity

Posterolateral Elbow Dislocation with Ipsilateral Fractures of Head and Distal End Radius

Elbow dislocation associated with ipsilateral fracture head and distal end radius is a rare pattern of Injury, although it is common for elbow dislocation and radius fractures to occur separately. We report a case of 35 year-old male who had a posterolateral elbow dislocation with ipsilateral fractures of head and distal end radius that underwent closed reduction and POP application and outcome is excellent with 9 months of follow-up

Changes in circle area after gravity compensation training in chronic stroke patients

After a stroke, many people experience difficulties to selectively activate muscles. As a result many patients move the affected arm in stereotypical patterns. Shoulder abduction is often accompanied by elbow flexion, reducing the ability to extend the elbow. This involuntary coupling reduces the patient's active range of motion. Gravity compensation reduces the activation level of shoulder abductors which limits the amount of coupled elbow flexion. As a result, stroke patients can instantaneously increase their active range of motion [1]. The objective of the present study is to examine whether training in a gravity compensated environment can also lead to an increased range of motion in an unsupported environment. Parts of this work have been presented at EMBC2009, Minneapolis, USA

Management of Elbow Dislocations in the National Football League.

Background: Although much literature exists regarding the treatment and management of elbow dislocations in the general population, little information is available regarding management in the athletic population. Furthermore, no literature is available regarding the postinjury treatment and timing of return to play in the contact or professional athlete. Purpose: To review the clinical course of elbow dislocations in professional football players and determine the timing of return to full participation. Study Design: Case series; Level of evidence, 4. Methods: All National Football League (NFL) athletes with elbow dislocations from 2000 through 2011 who returned to play during the season were identified from the NFL Injury Surveillance System (NFL ISS). Roster position, player activity, use of external bracing, and clinical course were reviewed. Mean number of days lost until full return to play was determined for players with elbow dislocations who returned in the same season. Results: From 2000 to 2011, a total of 62 elbow dislocations out of 35,324 injuries were recorded (0.17%); 40 (64.5%) dislocations occurred in defensive players, 12 (19.4%) were in offensive players; and 10 (16.1%) were during special teams play. Over half of the injuries (33/62, 53.2%) were sustained while tackling, and 4 (6.5%) patients required surgery. A total of 47 (75.8%) players who sustained this injury were able to return in the same season. For this group, the mean number of days lost in players treated conservatively (45/47) was 25.1 days (median, 23.0 days; range, 0.0-118 days), while that for players treated operatively (2/47) was 46.5 days (median, 46.5 days; range, 29-64 days). Mean return to play based on player position was 25.8 days for defensive players (n = 28; median, 21.5 days; range, 3.0-118 days), 24.1 days for offensive players (n = 11; median, 19 days; range, 2.0-59 days), and 25.6 days for special teams players (n = 8; median, 25.5 days; range, 0-44 days). Conclusion: Elbow dislocations comprise less than a half of a percent of all injuries sustained in the NFL. Most injuries occur during the act of tackling, with the majority of injured athletes playing a defensive position. Players treated nonoperatively missed a mean of 25.1 days, whereas those managed operatively missed a mean of 46.5 days

Fatigue and Recovery from Dynamic Contractions in Men and Women Differ for Arm and Leg Muscles

Introduction: Whether there is a gender difference in fatigue and recovery from maximal velocity fatiguing contractions and across muscles is not understood. Methods: Sixteen men and 19 women performed 90 isotonic contractions at maximal voluntary shortening velocity (maximal velocity concentric contractions, MVCC) with the elbow flexor and knee extensor muscles (separate days) at a load equivalent to 20% maximal voluntary isometric contraction (MVIC). Results: Power (from MVCCs) decreased similarly for men and women for both muscles (P \u3e 0.05). Men and women had similar declines in MVIC of elbow flexors, but men had greater reductions in knee extensor MVIC force and MVIC electromyogram activity than women (P \u3c 0.05). The decline in MVIC and power was greater, and force recovery was slower for the elbow flexors compared with knee extensors. Conclusions: The gender difference in muscle fatigue often observed during isometric tasks was diminished during fast dynamic contractions for upper and lower limb muscles

Visual estimation of joint angles at the elbow

The aim of this study was to assess the accuracy of visual estimation of elbow joint angles. A total of 116observers (93 doctors and 23 physiotherapists) were shown 21 digital images of two arms in predeWned degrees of elbow Xexion on two separate occasions. They estimated the angle of Xexion to the nearest 5°. Only 70.8% of estimates were within +5°, although intra-observer agreement was good among all groups tested (ICC range 0.963-0.983). Orthopaedic consultants and registrars were equivalent and statistically better at estimating the angles compared to senior house officers and physiotherapists (P < 0.001). Compared to the angles of 85 and 90°, all other angles were signifcantly less likely to be estimated to within +5° (P < 0.001). In conclusion, visual estimation of joint angles at the elbow may not be desirable in cases where accurate serial assessment is required for clinical decision making. The use of a goniometer by an agreed standardized protocol is advised

Aging and Muscle Fatigability in the Upper Extremity

Aging is accompanied by reductions in strength and contraction velocity, and increased fatigability of limb muscles during high-velocity dynamic contractions. These age-related changes affect functional tasks and are well described for the lower limb, with less known about the upper limb muscles. The aims of the thesis were to compare in young and old men and women: (1) maximal torque and power of the elbow flexor muscles across a range of isokinetic velocities, and (2) the neural (supraspinal) and muscular mechanisms of fatigue induced by high-velocity dynamic contractions of the elbow flexor muscles. 28 young (23.2 ± 2.6 years) men (n = 14) and women (n = 14) and 33 (72.6 ± 5.6 years) old men (n = 18) and women (n = 15) with the elbow flexor muscles performed: (1) maximal isokinetic contractions at 15 velocities to assess strength and power (0-450°/s), and (2) a dynamic fatiguing task involving 80 fast, maximal-effort contractions with a load equivalent to 20% of maximal voluntary isometric torque (MVIC). Before and after the fatiguing task the following were assessed: voluntary activation using motor cortical stimulation as a measure of supraspinal fatigue, and contractile properties evoked with electrical stimulation as a measure of muscular mechanisms. The elbow flexor muscles of the old adults were weaker and less powerful than young adults across all the velocities assessed (P\u3c0.01), although voluntary activation was similar between the age groups (P\u3e0.05). Some young and old adults were not able attain higher contraction velocities, primarily driven by the women. Old adults were more fatigable than young adults (P\u3c0.001, 15% difference) with now sex differences (P\u3e0.05). Old adults exhibited a larger reduction in voluntary activation (P=0.036, 7.5% age difference) and greater increase in relaxation in the old adults (55%) than the young (36%) following the fatiguing task. The elbow flexor muscles of old men and women were weaker and less powerful than young, but this was not due to differences in voluntary activation. The greater fatigability of elbow flexor muscles in the old adults however, was due to both supraspinal mechanisms and slowing of the muscle that occurs with aging

Dysplastic elbow diseases in dogs

Elbow dysplasia (ED) is a term used to describe the most common causes of elbow lameness. The term refers to ununited anconeal process (UAP), fragmented coronoid process (FCP), osteochondritis dissecans (OCD) and elbow incongruity, according to the International Elbow Working Group (IEWG). All conditions are polygenetic and multifactorial diseases that often occur in young, popular breeds. Elbow incongruity has been suggested as a causative factor in most of these pathologies. The aim of this review was to describe the etiology and clinical appearance on radiography, computed tomography (CT) and arthroscopy, together with their treatment options and prognosis.Elleboogdysplasie is een term die de meest voorkomende oorzaken van elleboogmanken groepeert. Volgens de International Elbow Working Group (IEWG) omvat deze groep losse processus anconeus (LPA), losse processus coronoideus (LPC), osteochondritis dissecans (OCD) en elleboogincongruentie. Iedere aandoening is polygenetisch en multifactorieel en komt vaak voor bij jonge, populaire hondenrassen. Elleboogincongruentie wordt bovendien genoemd als een oorzakelijke factor bij de meeste van deze aandoeningen. Het doel van dit artikel is een overzicht te geven van de etiologie, van het klinisch beeld op radiografie, computer tomografie (CT) en artroscopie, en van de behandelingsopties en de prognose na de behandeling van de verschillende aandoeningen

Evaluating elbow osteoarthritis within the prehistoric Tiwanaku state using generalized estimating equations (GEE).

OBJECTIVES:Studies of osteoarthritis (OA) in human skeletal remains can come with scalar problems. If OA measurement is noted as present or absent in one joint, like the elbow, results may not identify specific articular pathology data and the sample size may be insufficient to address research questions. If calculated on a per data point basis (i.e., each articular surface within a joint), results may prove too data heavy to comprehensively understand arthritic changes, or one individual with multiple positive scores may skew results and violate the data independence required for statistical tests. The objective of this article is to show that the statistical methodology Generalized Estimating Equations (GEE) can solve scalar issues in bioarchaeological studies. MATERIALS AND METHODS:Using GEE, a population-averaged statistical model, 1,195 adults from the core and one colony of the prehistoric Tiwanaku state (AD 500-1,100) were evaluated bilaterally for OA on the seven articular surfaces of the elbow joint. RESULTS:GEE linked the articular surfaces within each individual specimen, permitting the largest possible unbiased dataset, and showed significant differences between core and colony Tiwanaku peoples in the overall elbow joint, while also pinpointing specific articular surfaces with OA. Data groupings by sex and age at death also demonstrated significant variation. A pattern of elbow rotation noted for core Tiwanaku people may indicate a specific pattern of movement. DISCUSSION:GEE is effective and should be encouraged in bioarchaeological studies as a way to address scalar issues and to retain all pathology information

Looped and Perforated Elbow Pipes in Northeast Texas

Todd presented a general chronology for the presence of aboriginal-manufactured clay elbow pipes in Northeast Texas Caddo sites. Most of the pipe types have an extensive range in time; however, this may be true for thong elbow pipes. This paper looks further at the time range for; and the variety, of thong pipes. Jackson refers to elbow pipes that have a hole between the keel and the bowl as thong pipes. A string appears to have been run through the holes. He refers to the two types of pipes as handled and holed, but I use the terms looped and perforated. Perino mentions that the perforation in the pipe\u27s keel may have been so that a cord could be fastened to the stem, similar to some French and Native American micmac pipes