Elbow and Forearm
David C. Berry, Michael G. Miller, Leisha M. Berry in Athletic & Orthopedic Injury Assessment, 2017
This chapter examines the clinical evaluation and management of 16 elbow pathologies, using a combination of on-field and off-field scenarios presented in a variety of settings with a diverse patient population. The elbow pathologies presented are a mixture of acute and chronic conditions. Although we have tried to identify many of the common conditions frequently seen by athletic training students, we also believe in exposing students to rare and/or unusual cases they may run across during their careers. Finally, some of the cases presented have intentionally been written with inappropriate actions, procedures, treatments, or general mismanagement of the case by the clinician. The elbow and forearm, which together serve as a link between the upper arm and shoulder and the wrist and hand, are composed of the distal humerus, radius, and ulna. Together these structures form four separate joint articulations, three at the elbow complex and one at the wrist.
The paralysed elbow
Benjamin Joseph, Selvadurai Nayagam, Randall Loder, Ian Torode in Paediatric Orthopaedics, 2016
Paralysis of the elbow is commonly seen in children with obstetric brachial plexus palsy and in children with multiple congenital contractures (MCC). In obstetric palsy, the elbow flexors, the elbow extensors or both the flexors and extensors may be paralysed. In MCC, generally either the flexors or the extensors are paralysed. In MCC, flexion deformity of the elbow may be seen when the triceps is paralysed, while an extension deformity may occur when the biceps is paralysed. In children in whom the wrist and hand flexors are of normal power, a simple option for restoring active elbow flexion is to transfer the common flexor origin from the medial epicondyle proximally onto the humeral shaft. The long head of the triceps alone can be transferred to restore the power of elbow flexion. This part of the triceps has a separate neurovascular pedicle and it can be separated from the other two heads fairly easily.
Forearm, Elbow, and Humerus Radiography
Russell L. Wilson in Chiropractic Radiography and Quality Assurance Handbook, 2020
Sponges can be used under the wrist to get the forearm parallel to the film for both views. Proximal injuries are generally associated with elbow trauma; the ulna and radius can be fractured mid-shaft; and distal injuries are considered as wrist injuries. A direct blow to the dorsum of the forearm can fracture the ulna and dislocate the radius. The axial view of the elbow will provide a more detailed look at the soft tissues immediately around the olecranon and olecranon fossa. Regular rare-earth cassette Anatomical Top to Bottom: slightly less than film size, or to include elbow and wrist; Side to Side: soft tissue of forearm. Fine (extremity) cassette Anatomical Top to Bottom: slightly less than film size; Side to Side: soft tissue of elbow. If the patient is not able to straighten arm fully, a view with the humerus parallel to film and one with the forearm parallel to film should be taken.
The stiff elbow: How I do it
Published in Acta Orthopaedica Scandinavica, 1996
Contracture of the elbow is a common complication of fractures, dislocations, burns, etc., around the elbow. The stiff or contracted elbow is defined as an elbow with a reduction in extension greater than 30 degrees, and/or a flexion less than 120 degrees. Although supination and pronation are often reduced as well, this will not be considered further as contracture of the elbow is not related to forearm rotation. Stiffness of the elbow impairs hand function, because this is highly dependent on elbow extension and flexion and forearm rotation. A 50% reduction of elbow motion can reduce the upper extremity function by almost 80%. Surgery of the posttraumatic stiff elbow is a challenging and demanding procedure. During recent years a more aggressive approach to the treatment of chronic contractures around the elbow joint in combination with more specific surgical techniques and an advanced postoperative rehabilitation have improved the final outcome. The purpose of my article is to define a reasonable and specific approach for the clinician in the surgical management of the posttraumatic stiff elbow, based on a review of the literature and my personal experience.
Risk factors for shoulder and elbow pain in youth baseball players
Published in The Physician and Sportsmedicine, 2017
Tetsuya Matsuura, Toshiyuki Iwame, Naoto Suzue, Kokichi Arisawa, Koichi Sairyo
ABSTRACT Objectives: This study sought to quantify the 1-year cumulative incidence of shoulder and elbow pain among youth baseball players and identify risk factors associated with the occurrence of shoulder and elbow pain. Methods: In total, 900 youth baseball players (aged 7–11 years) were enrolled in a 1-year prospective follow-up study. One year later, the players were asked whether they had experienced episodes of shoulder or elbow pain and the following risk factors for such pain were investigated: age, position, length of baseball experience, training hours per week, and history of shoulder or elbow pain. Data for the groups with and without shoulder or elbow pain were analyzed using multivariate logistic regression models. Results: Episodes of shoulder pain were reported by 18.3% of players and episodes of elbow pain were reported by 35.2% of players. Multivariate analysis showed that shoulder pain was associated with pitcher position, catcher position, longer training hours per week, and history of shoulder and elbow pain, and that elbow pain was associated with age, pitcher position, catcher position, longer training hours per week, and history of elbow pain. Length of baseball experience was not associated with shoulder or elbow pain. Conclusion: History of elbow pain, pitcher position, catcher position, and longer training hours per week were associated with both types of pain. History of shoulder pain was associated with shoulder pain but not elbow pain. Age was associated with elbow pain but not shoulder pain.
Elbow kinematics during overground manual wheelchair propulsion in individuals with tetraplegia
Published in Disability and Rehabilitation: Assistive Technology, 2011
Anna M. Goins, Kerri Morgan, Christina L. Stephens, Jack R. Engsberg
Purpose. The purpose of this study was to describe horizontal and vertical translation of the elbow and elbow angle in two planes and three speeds during manual wheelchair overground propulsion in individuals with tetraplegia. Methods. Seven individuals with tetraplegia who used manual wheelchairs wheeled overground at three different speeds were recruited for the study. Video motion capture methods quantified their movements. Video data were tracked and used to calculate variables describing three-dimensional elbow translation and angular orientation. Repeated measures ANOVA were used to determine effects of speed on elbow translation and elbow angle. Paired t-tests were used to evaluate left to right differences. Results. Right elbow anterior-posterior translation was found to be significantly different during slow and fast and slow and normal speeds. Vertical and medial-lateral translation of the right elbow was significantly different between slow and fast speeds. No significant effects for speed during left elbow movement or side-to-side movement were found. No significant effects were found for elbow angle across speeds or from side-to-side. Three patterns of elbow movement emerged for anterior-posterior and medial-lateral translation and for elbow angle. Conclusions. Results indicated that elbow translation was related to propulsion speed. Work involving this population is needed for further understanding of upper extremity kinematic patterns.