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History taking and clinical examination in musculoskeletal disease
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Bones. The three palpation landmarks are the medial and lateral epicondyles and the apex of the olecranon. These form an equilateral triangle when the elbow is flexed to 90°. The radial head is palpated with the examiner's thumb while the other hand pronates and supinates the forearm. On the medial side, palpate the medial epicondyle. Posteriorly, palpate the olecranon fossa.
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
There may be minimal or moderate displacement of the medial epicondylar apophysis (Figure 7.14). In severe injury, the medial epicondyle may become trapped in the elbow joint. It is easy to mistake the medial epicondyle within the joint for the capitellum.
Upper limb
Published in David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings, McMinn’s Concise Human Anatomy, 2017
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings
The elbow joint is a hinge joint with muscles arranged appropriately to allow its movement. Which statement below most accurately describes muscle location and action at this important joint?Attaching to the medial epicondyle, this muscle attaches to the distal radius and is involved in flexion.Attaching to the supercondylar ridge laterally, this muscle attaches tothe distal radius and is involved in flexion.Attaching to the distal humerus posteriorly, this muscle attaches to the coronoid process of the ulna and is involved in flexion.Attaching to the mid shaft of the humerus, this muscle with two heads passes distally to attach to the radial tuberosity and is involved in flexion.Attaching to the lateral epicondyle and the supinator crest of the ulna and passing distally to the posterior aspect of the mid-shaft to the ulna, this muscle is involved in supination.
Effect of the medial collateral ligament and the lateral ulnar collateral ligament injury on elbow stability: a finite element analysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Fang Wang, Shuoqi Jia, Mingxin Li, Kui Pan, Jianguo Zhang, Yubo Fan
The anatomical orientation and stress distribution of all ligaments in the intact state was shown in Figure 5. The aMCL and the pMCL originated at the anteroinferior medial epicondyle of humerus. The aMCL inserted in the anteromedial olecranon of ulna and the pMCL inserts in the posteromedial side of ulna olecranon. The tMCL originated and inserted on ulna (Figure 5A). The LUCL originated in the lateral epicondyle of humerus and inserted on posterolateral side of ulna (Figure 5B) (Karbach and Elfar 2017). The stress distribution of all ligaments in four injury conditions was shown in Figure 6. The stress distribution of ligaments both in intact state and injury conditions was similar. The stress of the aMCL and the pMCL mainly distributed at their initial position that was medial epicondyle of humerus during the flexion in all conditions (Figures 5C and 6). The aMCL was taut during the entire flexion and a slight bending deformation was occurred at 90°. However, other ligaments were taut without deformation. The stress of tMCL was mainly distributed at the origination and insertion points (Floris et al. 1998; Tarassoli et al. 2017). The stress of LUCL was distributed throughout the ligament, but the peak stress also located at the insertion that the attachment point on the ulna (Figure 7).
Validation of a finite element model with six-year-old child anatomical characteristics as specified in Euro NCAP Pedestrian Human Model Certification (TB024)
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Haiyan Li, Kun Li, Yongqiang Huang, Wenle Lv, Shihai Cui, Lijuan He, Jesse Shijie Ruan, Chunxiang Wang
The initial posture of six-year-old pedestrian human model (named walking posture for distinguishing the standing posture) is specified in TB024 (as Table 3) and the reference axis is defined in Appendix A of the certification (Figure 2(a)). In TB024, the femur reference axis is defined as the connection between the centre of the nodes of the acetabulum and the midpoint between Epicondylus femoralis medialis and Epicondylus femoralis lateralis. The humerus reference axis is defined as the connection between the midpoint of the most laterodorsal point of the Angulus Acromialis and the most ventral point of processus coracoideus and the midpoint of the most caudal-lateral point on lateral epicondyle and the most caudal-medial point on medial epicondyle. For example, when adjusting the right knee, the elements of ligaments, skin and muscles of the responding joints are deleted, and the angles are adjusted in Hypermesh software; then the elements are remeshed by using common nodes (the flow is showed in Figure 2(b-f)). In the process of model adjustment, the joint angles of the 6YO pedestrian standing posture model are adjusted by rotating parts around the joint rotation center so that they are consistent with the Euro NCAP 6YO pedestrian posture model and within the allowable tolerance range. In TB024, the HBM shall be fitted a pair of shoes. Therefore, a pair of shoes are created under the HBM with a sole thickness of 25 mm and a weight of 1000 g.
Contralateral C7 transfer via both ulnar nerve and medial antebrachial cutaneous nerve to repair total brachial plexus avulsion: a preliminary report
Published in British Journal of Neurosurgery, 2019
Shulin Li, Yu Cao, Youlai Zhang, Junjian Jiang, Yudong Gu, Lei Xu
The MACN is considered an alternative to nerve grafting, especially in brachial plexus reconstruction, providing a long length of nerve with minimal donor site morbidity. The MACN is found to arise from the medial cord or the lower trunk, carrying fibers from C8 and T1, and running toward the distal region until penetration with the deep fascia 10 cm above the medial epicondyle. It was found to divide into two branches in the distal arm, an anterior, and a posterior. Both were found to provide the sensory supply of the medial aspect of the forearm, the olecranon, and the deep fascia overlying the medial epicondyle and cubital tunnel.12 The MACN was found to be easily isolated and transferred to the contralateral side together with the ulnar nerve in the surgical procedure of the first stage of cC7 transfer, without leaving extra deficit nor significantly increasing operative time. The average length of the MACN was found to be 18.64 cm from intraoperative observations, and was sufficient to transfer to the contralateral side for tension-free repair. The small gap between the two turning points was found to increase the possibility of completing the second stage through the same incision.