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.
A to Z Entries
Clare E. Milner in Functional Anatomy for Sport and Exercise, 2019
The ankle and foot form a complex region containing many joints, which provide flexibility and enable the foot to adapt to its environment. Athletes with chronic ankle instability often protect their ankle with rigid ankle braces that limit the amount of supination. The bones of the foot and ankle are at risk of stress fracture, particularly in runners and military recruits. Key bones are the leg bones – the tibia and fibula – which form the proximal part of the ankle joint, and the foot bones – the talus and the calcaneus. The ankle and foot form a complex structure containing many bones and joints, which provide flexibility and enable the foot to adapt to its environment. The forearm is a unique structure because the two bones within it, the ulna and radius, are able to move from their normal side-by-side position to a crossed position.
Upper limb
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings in McMinn’s Concise Human Anatomy, 2017
The upper limb accounts for 5" of the body weight. The movements of the clavicle and scapula, humerus, radius, ulna and wrist have one collective purpose - to put the hand into the desired position for whatever it is required to do. Since the limb is essentially suspended from the trunk of the body mainly by muscles and not by a large joint, it has great freedom of movement. The stability of the shoulder depends on its surrounding muscles and not on its bony structure. As a result, it is the most mobile joint in the body and the most frequently dislocated. The tendon of the long head of biceps runs over the top of the head of the humerus within the joint cavity and passes out of the joint capsule, surrounded by a tubular sleeve of synovial membrane to lie in the intertubercular groove of the humerus.
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
Background and purpose — Fractures of the distal ulna can occur in isolation or in conjunction with a distal radius fracture. They may result in incongruence and instability of the distal radioulnar joint. We investigated the incidence of distal ulna fractures, whether any fracture types were more common, and the methods of treatment used. Patients and methods — Data were collected from patients 18 years or older, treated for a fracture of the distal ulna in Östergötland, Sweden, during 2010–2012. Patients were identified in the patient registry. The fractures were classified according to the AO comprehensive classification of fractures. Results — The incidence of distal ulna fractures was 74/100,000 person-years. The most common fracture type was that of the ulnar styloid Q1 (79%), followed by the ulnar neck Q2 (11%). Rarest was ulna head fracture, type Q4 (1%). Incidental findings were a mean age of 63 years (SD 18), a concomitant distal radius fracture in 92% of the patients and that 79% were caused by falling from standing height. Internal fixation was performed in 30% of the Q2–Q6 fractures. This indicates that most were considered stable without internal fixation or stable after fixation of a concomitant radius fracture. Interpretation — Our results show that fractures of the distal ulna are not very common, and some fracture types are even rare. There seem to be no consensus on treatment.
Modified Sauvé-Kapandji procedure for rheumatoid wrists: A long-term study with a minimum follow-up of 5 years
Published in Modern Rheumatology, 2014
Akira Kawabata, Takeshi Egi, Hideki Tsuboi, Eiji Takeuchi, Satoru Fujita, Kazuhiro Masada, Kenrin Shi
Objectives. We performed a modified Sauvé-Kapandji procedure for treating disorders of distal radioulnar joint in patients with rheumatoid arthritis (RA). This procedure involves resecting the distal part of the ulna, rotating the resected portion by 90° and fixating it with the distal part of the radius for shelf plasty. The purpose of this study was to examine the clinical and radiographic outcomes of this procedure with more than 5 years’ follow-up. Methods. We studied 32 wrists of 27 RA patients with the mean follow-up of 93.1 months after operation. Pain, grip strength and range of motion of the wrist were examined clinically, while two indices for evaluation of ulnar and palmar translation of the carpus, carpal translation index and palmar carpal subluxation ratio were calculated on radiographs. Results. The wrist pain reduced in all cases. Range of motion increased significantly regarding pronation and supination but decreased significantly regarding flexion. Change in grip power was not significant. No significant differences were recognized between radiographic indices, suggesting carpal alignment was maintained well throughout the follow-up period. Conclusions. We think this procedure could be applied for distal radioulnar joint disorders in RA patients with promising clinical as well as radiographic outcomes over a long period.
Idiopathic distal radioulnar synostosis
Published in Journal of Plastic Surgery and Hand Surgery, 2014
Yaron Shoham, Reuven Gurfinkel, Amiram Sagi
Radioulnar synostosis is rare, and exists in two forms: congenital and post-traumatic. The congenital form presents only in the proximal forearm, and the post-traumatic form may present anywhere along the radius and ulna. The only known aetiology for distal radioulnar synostosis is post-traumatic. We present a rare case of distal radioulnar synostosis with no previous history of trauma.