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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.
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The elbow joint complex consists of a hinge joint between the humerus of the arm and the ulna of the forearm plus a secondary hinge joint between the radius of the forearm and the humerus, both of which are constrained to uniaxial flexion-extension motion (see planes and axes of movement). A third joint occurs between the bones of the forearm: the proximal radioulnar joint, which is often considered to be part of the elbow joint because it is contained within the same articular capsule. The radioulnar joint allows pronation-supination of the forearm, which enables the hand to assume a pronated or supinated position at any elbow flexion angle.
Upper limb
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
The elbow joint allows flexion and extension as well as making up the proximal part of the radioulnar joint, which permits pronation and supination of the forearm. The brachial artery passes immediately in front of the joint, while the ulnar nerve passes lateral to the medial epicondyle, immediately behind it.
Dorsal dry needling to the pronator quadratus muscle is a safe and valid technique: A cadaveric study
Published in Physiotherapy Theory and Practice, 2023
Albert Pérez-Bellmunt, Carlos López-de-Celis, Jacobo Rodríguez-Sanz, César Hidalgo-García, Joseph M. Donnelly, Simón A Cedeño-Bermúdez, César Fernández-de-las-Peñas
The pronator quadratus (PQ) is a deep flat muscle covering the distal ends of the ulna and radius anteriorly. It originates from the anterior surface of the distal ulna and inserts onto the distal aspect of the anterior surface of the radius proximal to the wrist (Standring, 2016). This muscle is an important pronator of the forearm and also contributes to stability of the distal radio-ulnar joint. Therefore, due to its function, this muscle is susceptible to repetitive overload that may lead to development of myofascial pain. In fact, patients with TrPs in the PQ clinically report difficulty in using scissors for cutting heavy cloth, handling tools while gardening, or using tools that require stability and a forceful grasp. Similarly, injuries in the lower portion of the forearm, e.g., distal radius fracture, could also affect the PQ muscle (Donnelly, 2019). Interestingly, the pain referral pattern from the PQ muscle was not described by Simons, Travell, and Simons (1999). The pain referral pattern from the PQ was described by Hwang, Kang, and Kim (2005) in an experimentally induced pain model. These authors reported that PQ muscle referred pain pattern spreads both proximally and distally along the medial aspect of the forearm mimicking ulnar or median nerve sensory distributions (Hwang, Kang, and Kim, 2005).
Incidence of distal ulna fractures in a Swedish county: 74/100,000 person-years, most of them treated non-operatively
Published in Acta Orthopaedica, 2020
Maria Moloney, Simon Farnebo, Lars Adolfsson
Fractures of the distal ulna may result in incongruence and instability of the distal radioulnar joint (DRUJ), which may result in chronic pain or limited forearm rotation (Kvernmo 2014). Fractures of the distal ulna most often accompany a distal radius fracture and in the majority of cases they affect the ulnar styloid process, while fractures of the ulnar head and/or neck are less common (Ring et al. 2004). Distal radius fractures and concomitant fractures of the distal radius and ulna are commonly caused by a fall from standing height on an outstretched arm with extended wrist. Isolated ulna fractures on the other hand are most often caused by a direct trauma to the ulnar border of the wrist (Richards and Deal 2014). Among patients with a Colles fracture, excluding ulnar styloid fractures, 5.6% have a concomitant fracture of the distal ulna (Biyani et al. 1995). Internal fixation of these fractures is typically difficult (Ring et al. 2004) as the distal fragment in most cases is small, consisting to a large extent of metaphysis and has a 270° articular surface.
Non-union of the ulnar styloid process in children is common but long-term morbidity is rare: a population-based study with mean 11 years (9–15) follow-up
Published in Acta Orthopaedica, 2019
Linda Korhonen, Sarita Victorzon, Willy Serlo, Juha-Jaakko Sinikumpu
There are several potential complications in USP non-union. The triangular fibrocartilage complex (TFCC) and anatomic bone congruity are the main factors contributing to the stability of the distal radioulnar joint (DRUJ) (Kazemian et al. 2011) and even minor changes in ulnar length can change the axial loads on the TFCC (Bae and Waters 2006). Growth arrest resulting from distal radius fracture appears as ulnar lengthening (ulna plus) (Schuurman et al. 2001, Waters et al. 2002). Respectively, ulnar shortening is a result of growth arrest of ulna and it may result in TFCC degeneration and rupture (Nelson et al. 1984). Thus, one of the most disabling complications after distal radius fracture is instability in DRUJ (Daneshvar et al. 2014, Gogna et al. 2014). In addition, chronic ulnar sided wrist pain (Yuan et al. 2017) and higher Disabilities of the Arm, Shoulder and Hand (DASH) scoring have been reported; nevertheless, they are still slight enough to fall outside clinical importance in short-term follow-up (Kazemian et al. 2011, Kramer et al. 2013, Wijffels et al. 2014, Mulders et al. 2018).