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Forearm, Elbow, and Humerus Radiography
Published in Russell L. Wilson, Chiropractic Radiography and Quality Assurance Handbook, 2020
The view will provide a clear view of the radial head and capitellum. It should be the first view taken when a radial head fracture is suspected. A view for the coronoid process can be taken with the tube angled toward the brachial crease and the elbow flexed less than 80°.
Posterior elbow dislocation
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
Reduction techniques: Sit the patient upright with the affected elbow held in 90° of flexion and hypersupination of the forearm. Apply posterior stabilizing force to the affected forearm, while simultaneously applying downward traction to the volar surface of the proximal forearm along the long axis of the humerus. This is followed by traction along the axis of the forearm to bring the coronoid process distal to the humerus. Flexion at the elbow with longitudinal traction and pressure on the volar aspect of the forearm are maintained to complete the reduction.Place the patient in prone position with the affected forearm dangling over the examination table. Grasp the wrist and apply traction along the long axis of the forearm. Continue to apply traction until muscle relaxation is achieved, usually within 10 minutes. Grasp the olecranon with the thumb and forefinger, then guide it into position just distal to the humerus.
Biomechanics and Joint Replacement of the Shoulder and Elbow
Published in Manoj Ramachandran, Tom Nunn, Basic Orthopaedic Sciences, 2018
Mark Falworth, Prakash Jayakumar, Simon Lambert
The largest joint reaction forces in the elbow are due to posteriorly directed forces caused by extensor and flexor musculature at the distal humerus. The major osseous constraint and articular contribution to elbow stability resisting posterior displacement is the coronoid process. A minimum of 50% of the coronoid process is required to maintain ulnohumeral stability. Bony deficiency of 50% will lead to a significant loss of stability, especially in full extension. An intact radial head enhances resistance to posterior displacement in the presence of a deficient coronoid.
Efficacy of immediate physiotherapy after surgical release of zygomatico-coronoid ankylosis in a young child: A case report
Published in Physiotherapy Theory and Practice, 2022
Krzysztof Dowgierd, Anna Lipowicz, Małgorzata Kulesa-Mrowiecka, Wojciech Wolański, Paweł Linek, Andrzej Myśliwiec
A second surgical bone fusion release procedure at age 37 months was performed in the same hospital where the first surgery was performed and was performed by the same maxillary surgeon. Before the procedure, a CT scan was obtained again, during which the recurrence of fusion of the coronoid process with the zygomatic arch and massive scarring was diagnosed on the same side of the mandible. A re-ankylotic fibro-osseous block connecting the hypoplastic shaft and ramus of the mandible with the zygomatic arch in the location of the previous scar limiting the jaw opening to 3 mm was reached using the intraoral access under general anesthesia. Then, using surgical chisels and a saw, a piece of the ankylotic block (part of the mandibular shank) was cut out to release the mandible and to allow the jaw to open up to about 30 mm. Due to the close location of the 37 tooth bud in the area of ankylosis, the decision was made to extract it. The osteotomy of a larger area of the apical part of the coronoid process was performed to such a degree that the risk of recurrence of bone fusion was minimized. After an analysis of the changes that had occurred since the previous surgery and due to insignificant damage to the joint, the surgeon decided to leave the head of the mandible.
Stress distribution is susceptible to the angle of the osteotomy in the high oblique sagittal osteotomy (HOSO): biomechanical evaluation using finite element analyses
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Herrera-Vizcaíno Carlos, Baselga Lahoz Marta, Pelliccioni Monrroy Orlando, Udeabor E Samuel, Robert Sader, Lukas Benedikt Seifert
The results of the setback mobilizations (−2.5 mm to −5.5 mm) show comparable values in the reported tensions of the A probes with respect to those obtained in the advancement. However, there is no significant correlation (p-value> 0.05). The results obtained from probe B show a high correlation to the OA parameter (R2> 0.9), slightly less than in the case of advance mobilizations. The results of this probe show greater dispersion of the tension as the OA increases and are statistically significant (p-value <10-8). The reported values of probe C show an increase in tension at intermediate angles, while at extreme values, this result remains stable. However, the results are not statistically significant (p-value> 0.05). Finally, probes D and E, corresponding to the anterior and posterior regions of the coronoid process, show stable values and a low dependence on the parameter of the OA. The resulting contact surface between bone segments (Figure 7) varies depending on the OA, increasing 44.67% from 45° to 70° and decreasing to 22.05% when the angle is reduced to 30°.
Isolated complete ulnar collateral ligament tear of the elbow in a gymnast: does it need surgery?
Published in The Physician and Sportsmedicine, 2019
Justin M. Dubin, Jorge L. Rojas, Amrut U. Borade, Filippo Familiari, Edward G. McFarland
Imaging of suspected UCL tears should begin with conventional radiographs to rule out fractures of the distal humerus, medial epicondyle, medial epicodylar physeal fracture or UCL avulsion fractures from the sublime tubercle [32,33]. In assessing radiographs for elbow dislocation, coronoid process tip fractures are commonly seen because of a mechanism in which the trochlea impacts the coronoid process tip during dislocation [34,35]. This patient’s radiograph showed no signs of coronoid process fracture of the ulna. While stress radiographs have been advocated by some authors [36], our experience has been that in the acute phase they are impractical and in the chronic phase it is difficult to get the radiographs in similar orientations for comparison purposes.