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Upper limb
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Radius– head (articulates with capitulum of humerus and radial notch of ulna)– radial tuberosity (attaches tendon from biceps brachii)– styloid process (more distal to styloid process of ulna)– articulates with scaphoid and lunate distally
Upper Limb
Published in Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden, Human Sectional Anatomy, 2017
Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden
The epicondyles have developed to provide attachment of the common extensor (lateral epicondyle) and flexor (medial epicondyle) muscle groups. Inflammation of the extensor origin on the lateral epicondyle (22) is known as ‘tennis elbow’. This section provides an excellent view of the superior radio-ulnar joint between the head of the radius (11) and the radial notch of the ulna (18). It communicates freely with the elbow joint. Together with the inferior radio-ulnar joint, it allows the movements of pronation and supination of the forearm, which are unique to the primate upper limb.
Terrible Triad Injury
Published in Raymond Anakwe, Scott Middleton, Trauma Vivas for the FRCS (Tr & Orth), 2017
Raymond Anakwe , Scott Middleton
I would then prepare and place a radial head replacement, taking care not to ‘overstuff’ the joint. I would confirm appropriate sizing of the radial head implant using trial implants radiographically and under direct vision: The ulnohumeral joint should be even radiographically; lateral gapping suggests an overstuffed joint. Under direct vision, the diameter of the implant should be matched to the size of the resected fragments and the prosthesis should sit so that it articulates with the radial notch and capitellum. Gapping of the coronoid away from the trochlea suggests overstuffing.
Reconstruction of a malignant soft tissue tumor around the elbow joint using a frozen autograft treated with liquid nitrogen, in combination with a free anterolateral thigh flap: A report of two cases
Published in Case Reports in Plastic Surgery and Hand Surgery, 2018
Akihiro Hirakawa, Akihito Nagano, Shingo Komura, Daichi Ishimaru, Kenji Kawashima, Haruhiko Akiyama
A 76-year-old woman visited her previous doctor with a six-month history of two tumors in her elbow. An excision biopsy was performed, with a diagnosis of fibrosarcoma confirmed through pathological examination. The patient was referred to our hospital for further assessment and treatment. On physical examination, two masses (2 × 2 cm in size) were identified on the lateral aspect of the right elbow (Figure 5), with the scar of a previous surgery between the two masses. The ROM of the elbow was within normal limits. No abnormal findings were identified on plain radiographs. On Gd-DTPA-enhanced T1WI, contrast enhancement was observed in the tumors and the fascia and subcutaneous tissue surrounding the lesions, which was considered as residual tumor tissue (Figure 6). The location of the skin incision and the level of resection were defined in the same manner as in Case 1. The tumor was excised en bloc (Figure 7a). Briefly, the wrist and finger extensor, supinator, anconeus, and triceps brachii were resected. One third of the lateral portion of the distal humerus and radial head were also resected using a bone saw. With the exception of the radial articular capsule attached to the humerus, the fascia of the wrist and finger extensor with its insertion and the tendon of the triceps brachii with its insertion, all other soft tissues and the tumor were dissected from the bone sections. The excised bone portion was frozen in liquid nitrogen in the same manner as in Case 1 (Figure 7b) and then reconstructed in situ using a locking plate (LCP Distal Humerus Plate: DePuy Synthes) and headless compression screw (3.5 mm HCS: DePuy Synthes). The triceps brachii, augmented with the Leeds-Keio ligament, was reattached to the olecranon and the radial articular capsule was reattached to the radial notch using a suture anchor (Corkscrew, Mini Corkscrew: Arthrex, Naples, FL). The wrist and finger extensor were repaired by using a polyethylene terephthalate suture (ETHIBOND®: Ethicon Inc.) (Figure 7c). The soft tissue defect was reconstructed with a free, 27 × 18 cm, ALT flap (Figure 7d). Arterial revascularization was performed end-to-end to the deep brachial artery. Venous anastomosis was done end-to-end to the vena comitans of the deep brachial artery and the basilic vein. The affected limb was elevated postoperatively and the elbow was immobilized for 14 days. Subsequently, ROM exercise was initiated in the same manner as in Case 1. Filling of the host-graft junction gap was observed 7 months after the operation. At the 1-year follow-up, elbow ROM was −35° extension and 130° flexion. Bone union was achieved (Figure 8a,b), and a complete and stable coverage of the defect was obtained (Figure 8c,d). Local recurrence of the tumor was not detected.