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Examination of Pediatric Elbow
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Karthick Rangasamy, Nirmal Raj Gopinathan, Pebam Sudesh
The lateral collateral ligament (Figure 6.2) includes three parts, namely the annular ligament, lateral ulnar collateral ligament, and radial collateral ligament. It provides posterolateral rotational stability and protects against varus stress on the elbow.5The lateral ulnar collateral ligament is the major stabilizer extending from the humeral lateral epicondyle to the supinator crest on the ulna.The radial collateral ligament originates from the lateral humeral epicondyle and inserts on the annular ligament.The annular ligament has its origin and insertion at the sigmoid notch of the ulna and it wraps around the radial neck. It stabilizes the proximal radioulnar joint.The accessory lateral collateral ligament begins at the annular ligament and inserts at the supinator crest on the ulna. It reinforces the annular ligament.
Surgery of the Elbow
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Alan Salih, David Butt, Deborah Higgs
The annular ligament is repaired with an absorbable suture. The common extensor origin is reattached to the lateral epicondyle with transosseous sutures. A suction drain is inserted. The deep dermal layer is approximated with absorbable sutures, then a continuous absorbable subcuticular suture with Steri-Strips to the skin. An occlusive dressing is applied, and the elbow is wrapped with wool and a crepe bandage in extension.
Injuries of the shoulder to wrist
Published in Ffion Davies, Colin E. Bruce, Kate Taylor-Robinson, Emergency Care of Minor Trauma in Children, 2017
Ffion Davies, Colin E. Bruce, Kate Taylor-Robinson
A ‘pulled’ elbow is a common injury and occurs mainly in the 1–3-year age group (range 6 months to 4 years). It is caused by a sudden longitudinal pull on the arm. This mechanism of injury causes a small tear in the distal insertion of the annular ligament, and the periosteum and the head of the radius becomes entrapped in the joint. Some children are especially prone to this, so there may be previous episodes of the same injury. The ligament tightens as the child gets older so the problem is uncommon after 3 years old.
Therapeutic Effect of Resection, Prosthetic Replacement and Open Reduction and Internal Fixation for the Treatment of Mason Type III Radial Head Fracture
Published in Journal of Investigative Surgery, 2021
Hong-Wei Chen, Jia-Liang Tian, Yong-Zhao Zhang
The prosthetic replacement group: the patient was placed in a supine position and underwent brachial plexus anesthesia or general anesthesia. A tourniquet was used to exsanguinate the forearm, and then a pneumatic tourniquet was applied. A longitudinal arc incision was made along the posterolateral elbow joint to dissect the skin and subcutaneous tissue layer by layer into the muscle space between the anconeus and the extensor carpi ulnaris. After this, the articular capsule and annular ligament were incised, and the comminuted radial head was taken out after the fractured radial head was exposed. Osteotomy of the radial head was conducted, and the type of artificial radial head was selected. Reaming was performed, and then the stub end of the radial head was filed flat and smooth, and put into the test mold. After being adjusted to the appropriate angle, the radial head was restored. Next, the flexion-extension and rotational stability of the articulation humeroradialis were checked to ensure they were in good condition. After the test mold was taken out, a suitable artificial radial head was inserted to re-inspect the flexion-extension, internal and external inversion and spin function of the articulatio humeroradialis. During surgery, the brachial cubital and brachioradial ligaments were stabilized using suture and suture anchor fixation. Instrument gauze was counted carefully and the incision was rinsed repeatedly. After the annular ligament of the radial head was repaired, a drain was inserted and sutured layer by layer. The Acumed anatomic humeral head prosthesis (Acumed, Hillsboro, OR, USA) was used in the group.
Design of a resilient ring for middle ear’s chamber stapes prosthesis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2018
Emilia Anna Kiryk, Konrad Kamieniecki, Monika Kwacz
Stapes prostheses are used for surgical treatment of otosclerosis, which is an illness affecting auditory ossicles located in the middle ear. The ossicles (malleus, incus and stapes) link the outer and inner ear and transmit sound vibrations from the tympanic membrane to the oval window (OW). The stapes footplate (SF) is suspended on a highly elastic annular ligament (AL) in the OW niche. The AL enables the stapes to vibrate and to generate a pressure wave in the perilymph fluid. Otosclerosis immobilizes the stapes due to stiffening of the AL. This leads to a decrease in stimulation of the perilymph and manifests by conductive hearing loss (CHL). Otosclerosis is the cause of almost 22% of all CHL (Potocka et al. 2010).
Otic drug delivery systems: formulation principles and recent developments
Published in Drug Development and Industrial Pharmacy, 2018
Xu Liu, Mingshuang Li, Hugh Smyth, Feng Zhang
The OW is located near the scala vestibuli and contains the footplate of the stapes and the annular ligament (Figure 1). This structure has been suggested as a secondary route for drugs to enter the perilymph of the vestibule [56]. However, it is difficult to measure the amount of drug entering the inner ear through this route [29]. Kang et al. used fluorescence technology to study and quantify the intracochlear drug delivery through the OW. They find that the fluorescently labeled bisphosphonate compound can be delivered to the apical cochlear turn via the OW in the human cochlea, and interstellar communication likely plays an important role in determining patterns of drug delivery in the inner ear [57].