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Ned Tijdschr Geneeskd 2018 Nov 2;162. Epub 2018 Nov 2.

UMC Utrecht, afd. Heelkunde.

Only 1% of all tendon injuries affect the triceps tendon, making triceps ruptures very rare. An acute rupture can therefore easily be missed due to a low degree of suspicion. A palpable gap, inability to flex the elbow against resistance and a positive modified Thompson test are indicative for a complete triceps tendon rupture. Read More

Rev Med Suisse 2018 Dec;14(631):2264-2267

Service de chirurgie orthopédique et traumatologique, Département de l'appareil locomoteur, CHUV, 1011 Lausanne.

Olecranon fractures represent 5 % of all adult fractures. Management is most often surgical. Conservative treatment is recommended for non-displaced fractures or patients who would be poor surgical candidates. Read More

Orthopedics 2018 Nov 26:1-7. Epub 2018 Nov 26.

Hardware-related complications can occur when plate fixation is used to stabilize osteoporotic fractures involving the olecranon. The use of an additional nonlocking screw, placed retrograde into the proximal fracture segment, may improve stability under load. The purpose of this study was to conduct a biomechanical comparison of olecranon repair constructs with and without this additional retrograde screw. Read More

J Orthop Sci 2018 Nov 4;23(6):948-952. Epub 2018 Jul 4.

Department of Orthopaedic Surgery, Hokkaido University, Sapporo, Japan. Electronic address:

Background: Long-term pitching activities change the stress distribution across the elbow joint surface in living subjects, however the influence of the different strength of stress on the stress distribution patterns remain unclear. The aims of this study were to evaluate the distribution of subchondral bone density across the elbow joint in different levels of pitchers, and to reveal the influence of the strength of stress on the elbow joint surface under long-term loading conditions of baseball pitching.

Methods: The current analysis was performed using computed tomography (CT) image data obtained from the throwing side elbow of 12 nonthrowing athletes (controls), 15 college baseball pitchers (college group) and 13 professional baseball pitchers (professional group). Read More

CEN Case Rep 2018 Nov 12. Epub 2018 Nov 12.

Division of Nephrology, Hypertension and Renal Transplantation, Department of Medicine, University of Florida, P.O. Box 100224, Gainesville, FL, 32610, USA.

Injury 2018 Nov;49 Suppl 3:S84-S93

Shoulder and Elbow Unit, IRCCS Istituto Ortopedico Rizzoli, Via G.C. Pupilli 1, Bologna, Italy.

Introduction: Only few case series of capitellar and trochlear fractures have been reported. Some of them assume that the presence of a posterior comminution (type B according to Dubberley classification) can represent a negative risk factor for treatment and prognosis respect to the type A cases (without posterior comminution). Nevertheless, how this parameter impacts the treatment and the prognosis has never been quantified before. Read More

Sports Med Arthrosc Rev 2018 Dec;26(4):181-184

Andrews Sports Medicine, Birmingham, AL.

Injuries and disorders of the elbow in athletes are common especially among throwing athletes. Common injuries encountered in the throwing athlete include ulnar collateral ligament injuries, ulnar neuritis, capitellar osteochondritis dissecans, valgus extension overload with posterior olecranon impingement, olecranon stress fracture, and loose bodies. A thorough knowledge of both the functional anatomy as well as throwing biomechanics are required to properly diagnosis and treat these problems. Read More

Zhongguo Gu Shang 2018 Oct;31(10):976-982

Department of Orthpaedics, Chengdu 363 Hospital of Sichuan, Chengdu 610041, Sichuan, China;

Distal humerus type C fracture is a rare and complicated intra-articular injury. Non-surgical treatment is difficult to achieve accurately reduction and reconstruction of articular surface, while open reduction and internal fixation is the best treatment option. Olecranon osteotomy could provide adequate surgical exposure, and is the most commonly used surgical method, but complications such as non-union osteotomy, internal fixation failure occurred. Read More

Cureus 2018 Aug 14;10(8):e3141. Epub 2018 Aug 14.

Orthopedic Surgery, New England Baptist Hospital, Boston, USA.

Introduction Damage to the posterior interosseous nerve (PIN) is a known complication when using a cortical button during distal biceps tendon repair. Prior studies show that the trajectory of the drill through the biceps tuberosity can affect the distance from the PIN. We develop a mathematical model to predict the location of the tuberosity based on a palpable bony landmark and patient demographic factors. Read More

J Shoulder Elbow Surg 2018 Nov;27(11):e344-e347

Department of Orthopaedics, Tokai University School of Medicine, Isehara, Japan.

Anat Rec (Hoboken) 2018 Oct 12. Epub 2018 Oct 12.

Function, Evolution and Anatomy Research Laboratory, School of Environmental and Rural Science, University of New England, Armidale, New South Wales, Australia.

The evolution of extraordinarily large size among Sauropoda was associated with a number of biomechanical adaptations. Changes in muscle moment arms undoubtedly accompanied these adaptations, but since muscles rarely fossilize, our ability to understand them has been restricted. Here, we use three-dimensional (3D) musculoskeletal modeling to reconstruct and quantitatively assess leverage of forelimb muscles in the transition from the narrow-gauge stance of basal sauropods to a wide-gauge stance in titanosaurs. Read More

Unfallchirurg 2018 Nov;121(11):911-922

Schwerpunkt für Unfall‑, Hand- und Ellenbogenchirurgie, Universitätsklinik zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.

Olecranon fractures represent a common elbow injury and they are usually treated operatively. Depending on fracture morphology conservative therapy can be considered in geriatric patients. When surgical treatment is performed the anatomical features of the proximal ulna have to be taken into consideration. Read More

J Cutan Pathol 2018 Oct 12. Epub 2018 Oct 12.

Department of Dermatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Acquired perforating calcific collagenosis (APCC), which is characterized by the calcification of dermal collagen fibers with subsequent transepidermal elimination and perforation, is an extremely rare entity. Thus far, it has only been reported in a patient with direct contact exposure to calcium chloride. Here, we report a unique case of APCC occurring in a drug addict admitted for rhabdomyolysis. Read More

Trauma Case Rep 2018 Oct 29;17:14-17. Epub 2018 Sep 29.

Department of Orthopaedics, Penn State College of Medicine, Hershey, PA, USA.

A long arm cast with the elbow extended is a useful but often forgotten technique to manage some pediatric fractures. Specifically, proximal forearm fractures of both the radius and ulna, olecranon fractures, flexion-type supracondylar fractures and type II Monteggia fractures are well managed in this manner. Although some of these fractures are seen infrequently, timely diagnosis and treatment are essential to prevent complications. Read More

PeerJ 2018 2;6:e5595. Epub 2018 Oct 2.

Institute of Paleobiology, Polish Academy of Sciences, Warsaw, Poland.

Aetosaurs are armored basal archosaurs that played a significant role in land ecosystems during the Late Triassic (237-201 Ma). The polish species Sulej, 2010 described from the Krasiejów locality (southern Poland) is one of the oldest known representatives of the group. Abundant and well-preserved material, including partially articulated specimens, allows a detailed description of the forelimbs in this species. Read More

Orthop J Sports Med 2018 Oct 8;6(10):2325967118799262. Epub 2018 Oct 8.

Rothman Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Background: Stress fractures of the elbow are rare in throwing athletes and present a challenge from both a management and rehabilitation perspective. Although the incidence of stress fractures of the elbow is increasing, there is a lack of data in the literature focused on throwers.

Purpose: To evaluate studies regarding the management and outcomes of stress fractures of the elbow in throwing athletes. Read More

Curr Sports Med Rep 2018 Oct;17(10):335-337

Department of Orthopaedic Surgery, University of Alabama Birmingham, Birmingham, AL.

Am J Orthop (Belle Mead NJ) 2018 Sep;47(9)

Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY.

The ulnar nerve is most commonly compressed at the elbow in the cubital tunnel. Conservative and operative treatments have been applied for cubital tunnel syndrome. Surgical management options include decompression, medial epicondylectomy, and various anterior transposition techniques. Read More

J Child Orthop 2018 Oct;12(5):497-501

Children's Healthcare of Atlanta, Atlanta, Georgia, USA.

Purpose: Open reduction and internal fixation with a tension band construct is the standard treatment for displaced transverse intra-articular olecranon fractures. The purpose of this study is to describe the outcomes of tension band fixation of olecranon fractures in children, specifically assessing the need for revision fixation and hardware removal.

Methods: Patients less than 18 years of age diagnosed with a displaced transverse intra-articular olecranon fracture and treated with tension band fixation between 2008 and 2017 were retrospectively enrolled. Read More

Arthrosc Tech 2018 Sep 6;7(9):e893-e898. Epub 2018 Aug 6.

Department of Upper Limb Surgery and Trauma, Flinders Medical Centre, Flinders University, Bedford Park, Adelaide, Australia.

Olecranon spur is a common underlying clinical problem in patients with inflammatory conditions such as triceps tendonitis, olecranon bursitis, and gout. It is often managed conservatively. Conventionally, symptomatic olecranon spurs that have failed conservative management are excised along with the overlying bursa using an open technique. Read More

Acta Chir Orthop Traumatol Cech 2018 ;85(4):271-275

Klinika dětské chirurgie, ortopedie a traumatologie, Fakultní nemocnice Brno.

PURPOSE OF THE STUDY Olecranon fractures in skeletally immature patients are rather rare and represent up to 7% of elbow skeletal injuries. Although the majority of olecranon fractures is constituted by undisplaced fractures treated conservatively with good outcomes, a few of them require surgery. The aim of the study was to compare two different approaches of surgical treatment - the open reduction with tension band wiring - cerclage (ORCe) and the closed reduction and percutaneous pinning (CRPP). Read More

Case Rep Infect Dis 2018 4;2018:5353085. Epub 2018 Sep 4.

Assistant Professor, Wingate University School of Pharmacy, 805 6th Avenue West, Suite 200, Hendersonville, NC 28739, USA.

A livestock farmer with a history of arthropathy presented with unilateral olecranon bursal swelling and tenderness. Multiple wound and intraoperative cultures revealed growth of , a Gram-positive coccobacillus, with symptom resolution following appropriate antimicrobial therapy. To our knowledge, this is the first case report of olecranon bursitis caused by this organism. Read More

JBJS Essent Surg Tech 2018 Jun 9;8(2):e14. Epub 2018 May 9.

Department of Orthopaedic Surgery, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona.

Background: The olecranon osteotomy-facilitated elbow release (OFER) is a safe and effective method for releasing severe posttraumatic elbow contractures. The OFER procedure is easier, faster, and relatively less invasive, and appears to offer superior outcomes, compared with more traditional techniques.

Description: An olecranon osteotomy provides a trapdoor through which the surgeon will have circumferential access to the joint and will be able to address all intrinsic and extrinsic causes of contracture. Read More

JBJS Essent Surg Tech 2018 Jun 11;8(2):e10. Epub 2018 Apr 11.

Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Supracondylar humeral fractures are the most common elbow fractures in children requiring operative intervention. They are classified according to the Gartland system as nondisplaced (type I), displaced with hinging and the posterior cortex intact (type II), and completely displaced (type III). The standard treatment for type-II and III fractures is closed reduction and percutaneous pinning. Read More

JBJS Essent Surg Tech 2018 Mar 14;8(1):e8. Epub 2018 Mar 14.

Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.

Background: Capitellar osteochondritis dissecans (OCD) is a focal injury of the articular cartilage involving separation of a segment of cartilage from the subchondral bone that is infrequently encountered in the dominant-side elbow of adolescent throwing athletes. The literature suggests that patients may achieve better short and mid-term results when treated with certain types of surgical procedures. Selection of the appropriate surgical method should be based on the International Cartilage Repair Society (ICRS) OCD classification system. Read More

JBJS Essent Surg Tech 2018 Mar 14;8(1):e4. Epub 2018 Feb 14.

AZ Monica, University Hospital Antwerp, Antwerp, Belgium.

Although triceps tendon ruptures can result from a traumatic incident, chronic overuse causing degenerative changes to the insertion and leading to a complete or partial rupture is more common. In our practice, we have found that anabolic steroid abuse by weightlifters is the most common predisposing factor. The initial diagnosis is often missed. Read More

JBJS Essent Surg Tech 2018 Mar 10;8(1):e1. Epub 2018 Jan 10.

Mayo Clinic, Rochester, Minnesota.

Fractures of the olecranon are sometimes difficult to treat. The steps for operative plate fixation of olecranon fractures consist of (1) a dorsal incision, (2) exposure using full-thickness flaps, (3) removal of hematoma from the fracture site, (4) fracture reduction, (5) provisional fixation, (6) plate application, (7) proximal fixation, (8) distal fixation, and (9) layered wound closure. Although this is generally a straightforward procedure, several specific steps may make fixation easier and improve outcomes. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 10;32(10):1321-1325

Center of Upper Limb Injury, Henan Provincial Luoyang Orthopedic-Traumatological Hospital & Henan Provincial Orthopedic Hospital, Luoyang Henan, 471002, P.R.China.

Objective: To compare the effectiveness between paratricipital approach and chevron olecranon V osteotomy approach for the treatment of type C3 (AO/OTA) distal humeral fractures and investigate the details of operation.

Methods: Between April 2010 and September 2016, 36 type C3 (AO/OTA) distal humeral fractures were treated with open reduction and bicolumnar orthogonal locking plating fixation by paratricipital approach and chevron olecranon V osteotomy approach respectively. The patients were divided into 2 groups by approach, there were 17 cases in paratricipital group (group A) and the bicolumns and distal humeral joint surface were exposed by traction of triceps and olecranon, and the distal humeral joint surface of the 19 cases in chevron olecranon V osteotomy group (group B) were exposed by osteotomy of the olecranon and reversing of triceps. Read More

Injury 2018 Nov 30;49(11):2058-2060. Epub 2018 Aug 30.

Department of Trauma and Orthopaedics, Aintree University Hospital Longmoor Ln, Liverpool, Merseyside, L9 7AL, United Kingdom.

Aim: To determine whether there is a correlation between the length of forearm to the distal interphalangeal joint (DIPJ) of the little finger and length of antegrade intramedullary (IM) femoral nails in adults.

Study Design And Methods: Measurements from the tip of the olecranon to the DIPJ of the ipsilateral upper limb was taken in 30 patients undergoing antegrade IM femoral nails. The length of the IM nails inserted was determined by intra-operative measurements using a guide wire. Read More

Radiologe 2018 Nov;58(11):976-984

Klinik und Poliklinik für Chirurgie, Abteilung für Unfall‑, Hand- & Wiederherstellungschirurgie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland.

Diagnosis and treatment of injuries to the elbow joint place high demands on the treating physicians. The complex anatomy of the elbow joint enables a wide range of movement and complex functions in everyday and professional life. These must be restored in the event of injury. Read More

Orthopade 2018 Sep 7. Epub 2018 Sep 7.

Arcus Sportklinik, Rastatter Str. 17-19, 75179, Pforzheim, Deutschland.

Background: Arthroscopic and open debridement arthroplasty for elbow arthrosis produce excellent results. Resection of the tip of the olecranon and coronoid, as well as debridement of the associated fossae, is frequently described as sufficient for restoring range of motion and reducing pain.

Objectives: The purpose of this study was to demonstrate that medial and lateral osteophytes of the olecranon and the coronoid usually mark the first bony contact and may, therefore, restrict range of motion. Read More

J Orthop Traumatol 2018 Sep 6;19(1):16. Epub 2018 Sep 6.

Orthotrauma Research Center, University of Amsterdam Orthopaedic Residency Program (PGY 4), Amsterdam, The Netherlands.

Unfortunately, after publication of this article [1], it was noticed that the author J. Carel Goslings was tagged incorrectly during the production process. This resulted in the PubMed display of the author name as 'J Carel Goslings'. Read More

Surg Radiol Anat 2018 Dec 6;40(12):1371-1377. Epub 2018 Sep 6.

School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa.

Introduction: The supratrochlear aperture (STA) is the opening observed in the septum that separates the olecranon from the coronoid fossae. Numerous studies have shown that there is considerable variation in the occurrence of this feature within and among populations.

Materials And Methods: Cadavers (n = 43) were assessed for the presence of the STA by means of X-ray. Read More

J Plast Surg Hand Surg 2018 Sep 4:1-5. Epub 2018 Sep 4.

a Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery , University of Regensburg , Regensburg , Germany.

Wound healing problems following acute and chronic olecranon bursitis can result in problematic tissue defects around the elbow. These defects often require a regional flap or a free flap for durable tissue coverage. The aim of this study was to assess clinical outcome the lateral arm flap (LAF) used to cover tissue defects caused by chronic olecranon bursitis. Read More

Case Rep Orthop 2018 5;2018:7602096. Epub 2018 Aug 5.

Orthopedic Surgery, Department of Surgery, 5400 Boul Gouin O, Hôpital du Sacré-Cœur de Montréal, Montréal, QC, Canada H4J 1C5.

Introduction: Quadriceps tendon ruptures (QTR) frequently occur in patients with end-stage renal failure, while triceps brachii tendon ruptures (TTR) are less common. This is the first properly documented report of a simultaneous ipsilateral traumatic rupture of both of these tendons.

Case Report: A 50-year-old patient, on hemodialysis for end-stage renal failure, fell on his right side. Read More

Knee Surg Sports Traumatol Arthrosc 2018 Aug 23. Epub 2018 Aug 23.

Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, 1105 AZ, Amsterdam, The Netherlands.

Purpose: Knowledge of ulnar nerve position is of utmost importance to avoid iatrogenic injury in elbow arthroscopy. The aim of this study was to determine how accurate surgeons are in locating the ulnar nerve after fluid extravasation has already occurred, and basing their localization solely on palpation of anatomical landmarks.

Methods: Seven cadaveric elbows were used and seven experienced surgeons in elbow arthroscopy participated. Read More

Case Rep Orthop 2018 24;2018:1901235. Epub 2018 Jul 24.

Department of Orthopaedic Surgery, Seikeikai Hospital, 1-1-1 Minamiyasuicho, Sakai-ku, Sakai, Osaka 590-0064, Japan.

A 24-year-old right-handed man suffered right olecranon and lateral epicondylar fracture from high energy trauma. Fixation of olecranon was performed by a previous doctor. Three months after operation, he presented with limited range of motion (ROM) of the right elbow caused by malunion of the lateral epicondylar fracture and subluxation of the radiohumeral joint. Read More

Proc Inst Mech Eng H 2018 Oct 24;232(10):1025-1029. Epub 2018 Aug 24.

3 Department of Mechanical Engineering, Faculty of Engineering, KTO Karatay University, Konya, Turkey.

Supracondylar humerus fractures are common fractures around the elbow. Open fractures, comminuted metaphyseal fractures and also fractures with bone loss may need to be treated with external fixators. The aim of this study is to compare two different external fixators, tubular external fixators and polymethyl methacrylate with K wires external fixators, with regard to stiffness and stability for metaphyseal-diaphyseal osteotomies of distal humerus close to the joint. Read More

Ann R Coll Surg Engl 2018 Aug 16:1-2. Epub 2018 Aug 16.

Trauma and Orthopaedics, Kings College Hospital , London , UK.

Malays Orthop J 2018 Jul;12(2):65-67

Department of Orthopaedics, SME Tata Consultancy Services, Mumbai, India.

We present an unusual case of five months old neglected anterior dislocation of the right elbow joint in a 19-year old man. The patient had been initially treated by a traditional bone setter, but the elbow remained unreduced. He presented to us with pain, deformity and limited range of motion of his right elbow joint. Read More

J Hand Surg Am 2018 Aug 10. Epub 2018 Aug 10.

Department of Orthopaedic Surgery, University of Arizona College of Medicine, Phoenix, AZ.

Purpose: Currently, there is no consensus on the optimal treatment for scaphoid nonunion with avascular necrosis (AVN). Various techniques, often involving vascularized corticocancellous bone grafting, have been proposed. The authors hypothesized that similar outcomes might be possible with volar plate fixation augmented with autogenous pure cancellous graft. Read More

J Med Biol Eng 2018 26;38(4):618-624. Epub 2017 Sep 26.

2Department of Automation, Biomechanics and Mechatronics, Lodz University of Technology, 1/15 Stefanowski St., 90-924 Lodz, Poland.

Radial head fractures are becoming a major public health problem and are an increasingly important target for both clinical and mechanical researchers. In this work, comparative biomechanical analyses of the stress-strain state of a healthy elbow joint and elbow joints with radial head compression from 2 to 5 mm due to injury are performed. Three-dimensional models of the elbow joint with cartilage surfaces and ligaments were constructed based on the results of computed tomography. Read More

J Orthop Trauma 2018 Nov;32(11):e445-e450

Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, RI.

Objectives: To determine if mean ultimate strength or failure mechanism differed between comminuted olecranon fractures created at the proximal 25% or 50% of the trochlear notch and fixed with precontoured posterior locking plates (PLPs).

Methods: Comminuted osteotomies were created in 10 matched pairs of cadaveric upper extremities at either the proximal 25% or 50% of the trochlear notch after quantitative computed tomography scans were performed to evaluate bone mineral density. Variable-angle olecranon PLPs were fixed to the specimens. Read More

World J Orthop 2018 Jul 18;9(7):100-104. Epub 2018 Jul 18.

Department of Orthopaedic Surgery and Traumatology, Habib Bourguiba University Hospital, Sfax 3000, Tunisia.

Anterior transolecranon dislocation of the elbow is rarely observed in children, reported in only a small series. The present case involves an anterior transolecranon dislocation of the left elbow joint in a 7-year-old child, which was surgically treated. Two attempts of closed reduction failed because the radial head had buttonholed via the joint capsule. Read More

Bone Joint J 2018 08;100-B(8):1066-1073

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Aims: The aim of this study was to report the mid-term clinical outcome of cemented unlinked J-alumina ceramic elbow (JACE) arthroplasties when used in patients with rheumatoid arthritis (RA).

Patients And Methods: We retrospectively reviewed 87 elbows, in 75 patients with RA, which was replaced using a cemented JACE total elbow arthroplasty (TEA) between August 2003 and December 2012, with a follow-up of 96%. There were 72 women and three men, with a mean age of 62 years (35 to 79). Read More

J Clin Microbiol 2018 Aug 26;56(8). Epub 2018 Jul 26.

Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA

J Clin Microbiol 2018 Aug 26;56(8). Epub 2018 Jul 26.

Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA