Elbow trauma:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
2008
|
| Series: | Orthopedic clinics of North America
39,2 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | IX S., S. 141 - 268 zahlr. Ill., graph. Darst. |
| ISBN: | 1416058176 9781416058175 |
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Record in the Search Index
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| adam_text | CONTENTS
Preface ix
Scott P. Steinmann
Anatomy and Biomechanics of the Elbow 141
Chris D. Bryce and April D. Armstrong
The elbow is a complex, highly constrained joint that provides critical range of motion to
the upper extremity needed for performing the normal activities of daily living. The
elbow is protected by a fortress of individual static and dynamic constraints that
function together to provide stability. Knowing the identity and specific functions of
each stabilizing structure facilitates appropriate diagnosis and treatment of the acutely
injured elbow.
Acute Elbow Dislocations 155
Michael A. Kuhn and Glen Ross
The elbow is the second most commonly dislocated major joint in the adult age group
and the most commonly dislocated major joint in the pediatric population. The
mechanism of injury and resultant ligamentous disruption pattern have been
investigated and noted. Classification of elbow dislocation is well described, and allows
for appropriate treatment and rehabilitation. For stable reductions, an aggressive early
ROM protocol emphasizing active motion has been helpful for maximizing final range of
motion and minimizing extension loss. Associated injuries with elbow dislocation are
common and can result in significant morbidity if not diagnosed and treated.
Pediatric Supracondylar Fractures and Pediatric Physeal Elbow Fractures 163
M. Wade Shrader
Elbow fractures in children are extremely common, making up approximately 157, of all
fractures in pediatric patients. The unique radiographic anatomy of the pediatric elbow,
along with the potential for neurovascular compromise, often provokes anxiety in
orthopedic surgeons. A thorough understanding of the anatomy and treatment
principles makes the care for these children more straightforward, however. The distal
humerus makes up approximately 85% of all elbow fractures in children. The most
common fractures of the distal humerus in children are supracondylar humerus
fractures, lateral condyle fractures, medial epicondyle fractures, and transphyseal
humerus fractures. Each of these fractures is discussed in detail, outlining their
radiographic features, principles of treatment, and potential complications.
VOLUME 39 • NUMBER 2 • APRIL 2008 v
Current Recommendations for the Treatment of Radial Head Fractures 173
Yishai Rosenblatt, George S. Athwal, and Kenneth J. Faber
Radial head fractures are the most common type of elbow fractures. Although a
consensus has emerged that favors the nonsurgical treatment of undisplaced fractures,
controversy surrounds the treatment of displaced radial head fractures. Further research
is necessary to provide a better scientific rationale for making treatment recommenda¬
tions. Options for the treatment of displaced fractures include nonoperative manage¬
ment, fragment excision, whole head excision, open reduction and internal fixation, and
radial head arthroplasty. The purpose of this article is to review the mechanisms that
result in radial head fracture, to describe important physical findings that assist in
identifying injuries associated with radial head fractures, and to define the role of the
various interventions described for the treatment of radial head fractures.
Distal Humerus Fractures 187
J. Whitcomb Pollock, Kenneth J. Faber, and George S. Athwal
Intra-articular fractures of the distal humerus are among the most challenging fractures
to manage. Nonoperative treatment, although appropriate for some patients, often leads
to loss of motion and unsatisfactory functional outcomes. Over the last 2 decades,
enhanced operative techniques and implant designs have improved the reduction and
stability of distal humerus fractures leading to better outcomes. Careful preoperative
planning, adequate exposure, and stable fixation facilitating early mobilization are
essential to achieve successful outcomes with internal fixation.
Prosthetic Replacement for Distal Humerus Fractures 201
George S. Athwal, Thomas J. Goetz, J. Whitcomb Pollock, and Kenneth J. Faber
Primary total elbow arthroplasty is a treatment option for elderly patients with
osteopenic bone, increased comminution, and articular fragmentation. Recently, there
has been a renewed interest in distal humerus hemiarthroplasty for the treatment of
distal humerus fractures, including coronal shear fractures of the capitellum and
trochlea. This article focuses on the evaluation and management of distal humerus
fractures with prosthetic replacement.
Chronic Medial Elbow Instability 213
Sean P. Grace and Larry D. Field
Chronic medial elbow instability can be a debilitating problem for the throwing athlete.
It affects non-throwers much less commonly regarding activities of daily living.
Instability can occur as a result of repetitive microtrauma over a long period of time or as
a result of a single traumatic event. If left untreated, the resulting sequelae can lead to
chronic pain, ulnar neuritis, and inability to compete/work.
Chronic Lateral Elbow Instability 221
Emilie V. Cheung
Posterolateral rotatory instability of the elbow is the most common pattern of chronic
lateral elbow instability. The primary lesion in posterolateral rotatory instability is injury
vi CONTENTS
or attenuation of the lateral ulnar collateral ligament. Posterolateral rotatory instability is
diagnosed on the basis of careful history taking and specific physical examination
techniques. Reconstruction of the lateral ulnar collateral ligament with repair of the
surrounding soft tissue structures is recommended in patients who have symptoms of
recurrent lateral instability. Open and arthroscopic reconstruction techniques have
resulted in improvement of elbow function and satisfactory results in most patients,
although mild limitation in terminal extension of the elbow is a common finding.
Olecranon Fractures 229
Christian J.H. Veillette and Scott P. Steinmann
Approximately 10% of fractures about the adult elbow consist of fractures of the
olecranon process of the ulna and range from simple nondisplaced fractures to complex
fracture-dislocations of the elbow. Several treatment options for internal fixation have
been described, including tension-band wiring, plate fixation, intramedullary screw
fixation, and triceps advancement after fragment excision. The method of internal
fixation is chosen based primarily on fracture type. Because olecranon fractures are all
intra-articular injuries, they require anatomic or essentially normal surface reduction and
trochlear notch contour for predictable outcomes. In addition, fixation must be stable
enough to permit early mobilization to avoid significant elbow stiffness. Given the
variability in fracture patterns, the complex anatomy, and associated injuries, treating
surgeons must be familiar with multiple treatment methods and follow a systematic
surgical strategy to avoid complications and achieve reliable outcomes.
Distal Biceps Rupture 237
Augustus D. Mazzocca, Jeffrey T. Spang, and Robert A. Arciero
Recognition and treatment of distal biceps tendon ruptures is increasing, likely because
of greater clinical awareness and the greater activity and demands of the middle-aged
population. This article focuses on the proper evaluation and treatment of distal biceps
tendon ruptures with special attention focused on recently developed techniques. A
review of the recent clinical literature will accompany an overview of pertinent
biomechanical studies and an explanation of the risks and benefits of the most popular
surgical techniques for distal biceps repair.
Soft Tissue Coverage of the Elbow: A Reconstructive Algorithm 251
Mark Jensen and Steven L. Moran
Soft tissue defects can occur for various reasons, but they are primarily due to trauma,
tumor, and infection. Coverage choices may include primary closure, skin grafting, local
cutaneous flaps, fasciocutaneous transposition flaps, island fascial or fasciocutaneous
flaps, muscle or myocutaneous pedicled flaps, and microvascular free-tissue transfer.
Despite the multitude of options for coverage, the authors have found four flaps to
provide reliable coverage for most elbow deficits within their practice; these flaps are the
latissimus dorsi flap, the radial forearm flap, the anconeus flap, and the free anterior
lateral thigh flap. This article provides an overview of treatment options for elbow
coverage, with specific emphasis on the use of these four specific flaps.
Index 265
CONTENTS vii
|
| adam_txt |
CONTENTS
Preface ix
Scott P. Steinmann
Anatomy and Biomechanics of the Elbow 141
Chris D. Bryce and April D. Armstrong
The elbow is a complex, highly constrained joint that provides critical range of motion to
the upper extremity needed for performing the normal activities of daily living. The
elbow is protected by a fortress of individual static and dynamic constraints that
function together to provide stability. Knowing the identity and specific functions of
each stabilizing structure facilitates appropriate diagnosis and treatment of the acutely
injured elbow.
Acute Elbow Dislocations 155
Michael A. Kuhn and Glen Ross
The elbow is the second most commonly dislocated major joint in the adult age group
and the most commonly dislocated major joint in the pediatric population. The
mechanism of injury and resultant ligamentous disruption pattern have been
investigated and noted. Classification of elbow dislocation is well described, and allows
for appropriate treatment and rehabilitation. For stable reductions, an aggressive early
ROM protocol emphasizing active motion has been helpful for maximizing final range of
motion and minimizing extension loss. Associated injuries with elbow dislocation are
common and can result in significant morbidity if not diagnosed and treated.
Pediatric Supracondylar Fractures and Pediatric Physeal Elbow Fractures 163
M. Wade Shrader
Elbow fractures in children are extremely common, making up approximately 157, of all
fractures in pediatric patients. The unique radiographic anatomy of the pediatric elbow,
along with the potential for neurovascular compromise, often provokes anxiety in
orthopedic surgeons. A thorough understanding of the anatomy and treatment
principles makes the care for these children more straightforward, however. The distal
humerus makes up approximately 85% of all elbow fractures in children. The most
common fractures of the distal humerus in children are supracondylar humerus
fractures, lateral condyle fractures, medial epicondyle fractures, and transphyseal
humerus fractures. Each of these fractures is discussed in detail, outlining their
radiographic features, principles of treatment, and potential complications.
VOLUME 39 • NUMBER 2 • APRIL 2008 v
Current Recommendations for the Treatment of Radial Head Fractures 173
Yishai Rosenblatt, George S. Athwal, and Kenneth J. Faber
Radial head fractures are the most common type of elbow fractures. Although a
consensus has emerged that favors the nonsurgical treatment of undisplaced fractures,
controversy surrounds the treatment of displaced radial head fractures. Further research
is necessary to provide a better scientific rationale for making treatment recommenda¬
tions. Options for the treatment of displaced fractures include nonoperative manage¬
ment, fragment excision, whole head excision, open reduction and internal fixation, and
radial head arthroplasty. The purpose of this article is to review the mechanisms that
result in radial head fracture, to describe important physical findings that assist in
identifying injuries associated with radial head fractures, and to define the role of the
various interventions described for the treatment of radial head fractures.
Distal Humerus Fractures 187
J. Whitcomb Pollock, Kenneth J. Faber, and George S. Athwal
Intra-articular fractures of the distal humerus are among the most challenging fractures
to manage. Nonoperative treatment, although appropriate for some patients, often leads
to loss of motion and unsatisfactory functional outcomes. Over the last 2 decades,
enhanced operative techniques and implant designs have improved the reduction and
stability of distal humerus fractures leading to better outcomes. Careful preoperative
planning, adequate exposure, and stable fixation facilitating early mobilization are
essential to achieve successful outcomes with internal fixation.
Prosthetic Replacement for Distal Humerus Fractures 201
George S. Athwal, Thomas J. Goetz, J. Whitcomb Pollock, and Kenneth J. Faber
Primary total elbow arthroplasty is a treatment option for elderly patients with
osteopenic bone, increased comminution, and articular fragmentation. Recently, there
has been a renewed interest in distal humerus hemiarthroplasty for the treatment of
distal humerus fractures, including coronal shear fractures of the capitellum and
trochlea. This article focuses on the evaluation and management of distal humerus
fractures with prosthetic replacement.
Chronic Medial Elbow Instability 213
Sean P. Grace and Larry D. Field
Chronic medial elbow instability can be a debilitating problem for the throwing athlete.
It affects non-throwers much less commonly regarding activities of daily living.
Instability can occur as a result of repetitive microtrauma over a long period of time or as
a result of a single traumatic event. If left untreated, the resulting sequelae can lead to
chronic pain, ulnar neuritis, and inability to compete/work.
Chronic Lateral Elbow Instability 221
Emilie V. Cheung
Posterolateral rotatory instability of the elbow is the most common pattern of chronic
lateral elbow instability. The primary lesion in posterolateral rotatory instability is injury
vi CONTENTS
or attenuation of the lateral ulnar collateral ligament. Posterolateral rotatory instability is
diagnosed on the basis of careful history taking and specific physical examination
techniques. Reconstruction of the lateral ulnar collateral ligament with repair of the
surrounding soft tissue structures is recommended in patients who have symptoms of
recurrent lateral instability. Open and arthroscopic reconstruction techniques have
resulted in improvement of elbow function and satisfactory results in most patients,
although mild limitation in terminal extension of the elbow is a common finding.
Olecranon Fractures 229
Christian J.H. Veillette and Scott P. Steinmann
Approximately 10% of fractures about the adult elbow consist of fractures of the
olecranon process of the ulna and range from simple nondisplaced fractures to complex
fracture-dislocations of the elbow. Several treatment options for internal fixation have
been described, including tension-band wiring, plate fixation, intramedullary screw
fixation, and triceps advancement after fragment excision. The method of internal
fixation is chosen based primarily on fracture type. Because olecranon fractures are all
intra-articular injuries, they require anatomic or essentially normal surface reduction and
trochlear notch contour for predictable outcomes. In addition, fixation must be stable
enough to permit early mobilization to avoid significant elbow stiffness. Given the
variability in fracture patterns, the complex anatomy, and associated injuries, treating
surgeons must be familiar with multiple treatment methods and follow a systematic
surgical strategy to avoid complications and achieve reliable outcomes.
Distal Biceps Rupture 237
Augustus D. Mazzocca, Jeffrey T. Spang, and Robert A. Arciero
Recognition and treatment of distal biceps tendon ruptures is increasing, likely because
of greater clinical awareness and the greater activity and demands of the middle-aged
population. This article focuses on the proper evaluation and treatment of distal biceps
tendon ruptures with special attention focused on recently developed techniques. A
review of the recent clinical literature will accompany an overview of pertinent
biomechanical studies and an explanation of the risks and benefits of the most popular
surgical techniques for distal biceps repair.
Soft Tissue Coverage of the Elbow: A Reconstructive Algorithm 251
Mark Jensen and Steven L. Moran
Soft tissue defects can occur for various reasons, but they are primarily due to trauma,
tumor, and infection. Coverage choices may include primary closure, skin grafting, local
cutaneous flaps, fasciocutaneous transposition flaps, island fascial or fasciocutaneous
flaps, muscle or myocutaneous pedicled flaps, and microvascular free-tissue transfer.
Despite the multitude of options for coverage, the authors have found four flaps to
provide reliable coverage for most elbow deficits within their practice; these flaps are the
latissimus dorsi flap, the radial forearm flap, the anconeus flap, and the free anterior
lateral thigh flap. This article provides an overview of treatment options for elbow
coverage, with specific emphasis on the use of these four specific flaps.
Index 265
CONTENTS vii |
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| publisher | Saunders |
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| spelling | Elbow trauma guest ed. Scott P. Steinmann Philadelphia [u.a.] Saunders 2008 IX S., S. 141 - 268 zahlr. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Orthopedic clinics of North America 39,2 Elbow Joint injuries Elbow Joint surgery Elbow Fractures Elbow injuries Elbow surgery Steinmann, Scott P. Sonstige oth Orthopedic clinics of North America 39,2 (DE-604)BV000001089 39,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016501668&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Elbow trauma Orthopedic clinics of North America Elbow Joint injuries Elbow Joint surgery Elbow Fractures Elbow injuries Elbow surgery |
| title | Elbow trauma |
| title_auth | Elbow trauma |
| title_exact_search | Elbow trauma |
| title_exact_search_txtP | Elbow trauma |
| title_full | Elbow trauma guest ed. Scott P. Steinmann |
| title_fullStr | Elbow trauma guest ed. Scott P. Steinmann |
| title_full_unstemmed | Elbow trauma guest ed. Scott P. Steinmann |
| title_short | Elbow trauma |
| title_sort | elbow trauma |
| topic | Elbow Joint injuries Elbow Joint surgery Elbow Fractures Elbow injuries Elbow surgery |
| topic_facet | Elbow Joint injuries Elbow Joint surgery Elbow Fractures Elbow injuries Elbow surgery |
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