Intraoperative visualization of the posterolateral ulnohumeral joint space is reliable to indicate overlengthening in radial head arthroplasty.

Introduction: Avoiding overlengthening in radial head arthroplasty (RHA) is essential for the prognosis of the elbow joint. An overlengthening from 2 mm is visible due to widening of the anterolateral ulnohumeral joint space but intraoperatively, this particular joint space is difficult to visualize. The commonly used Kocher approach allows visualization of the posterolateral joint space without additional instruments or further surgical release of the already unstable elbow.

[Epicondylosis : Open surgical procedure-when and how for lateral and medial epicondylitis?].

Background: Epicondylosis of the elbow are common pathologies, with a higher incidence for radial epicondylosis. Approximately 90% are self-limiting under conservative treatment.

Treatment: Multiple surgical procedures exist for the treatment of refractory cases.

Lateral Ulnar Collateral Ligament Reconstruction for Posterolateral Rotatory Instability After Failed Common Extensor Origin Release: Outcomes at Minimum 2-Year Follow-up.

Background: In patients with chronic lateral epicondylitis who have failed nonoperative treatment, open or percutaneous release of the common extensor origin (CEO) without subsequent reconstruction tends to result in good clinical outcomes. However, surgery can lead to iatrogenic injuries of the lateral collateral ligamentous complex, causing posterolateral rotatory instability (PLRI).

Purpose: To determine the clinical outcomes of lateral ulnar collateral ligament (LUCL) reconstruction using a triceps tendon graft after failed open CEO surgery.

Translation of the Mayo Elbow Performance Score (MEPS) into German (MEPS-G).

Background: The Mayo Elbow Performance Score is a clinical assessment to rate the performance of the elbow from a medical and/or therapeutic perspective. It is simple and efficient to operate and therefore frequently used in research as well as in clinics. However, an adequate translation of the MEPS into the German language and a verification of the quality criteria for the use in the German health system are currently lacking.

Advanced Surgical Trauma Care Course - Evaluation of a Fracture Simulation Course Concept with Intact Soft Tissue.

Purpose: Currently, surgical training in the clinical scenario is limited by duty-hour restrictions as well as an increasing specialization within the numerous surgical fields. In such an environment, surgical training in subspecialties becomes both, more important and challenging. Against this background, purpose of the present study was to evaluate a new course format for advanced training in fracture treatment.

Plate Osteosynthesis of Proximal Ulna Fractures-A Biomechanical Micromotion Analysis.

Purpose: Double plating has been promoted, in recent years, as an alternative treatment method for proximal ulna fractures. This study aimed to compare the biomechanical properties of double-plate osteosynthesis with posterior plate fixation using a novel investigational design utilizing a 3-dimensional camera system to analyze fracture micromotion.

Methods: Fourteen fresh-frozen specimens were available for this study.

The influence of three-dimensional planning on decision-making in total shoulder arthroplasty.

Background: Long-term results and complication rates in shoulder arthroplasty are related to implant positioning. Current literature reports increased precision in glenoid component positioning using 3-dimensional (3D) computed tomography (CT) planning tools. This study evaluated the accuracy of glenoid version and inclination measurements using 2D CT scans compared with a validated 3D software program and its influence on decision making on implant selection.

Long-term analysis of revision reverse shoulder arthroplasty using cemented long stems.

Background: Revision of failed shoulder arthroplasty is often associated with poor results and a high rate of complications. Significant humeral bone loss after removal of long stems poses a considerable surgical challenge. Therefore, the aim of our study was the evaluation of the clinical and radiologic outcome of cemented long-stem humeral components in revision reverse shoulder arthroplasty with a minimum 5 years' follow-up.

Is the distal radioulnar variance useful for identification of radial head prosthesis overlengthening? A cadaver study.

Background: Overlengthening by radial head prosthetic replacement leads to insufficient functionality and increased capitellar wear. It has been shown that in monopolar prostheses, the radial overlengthening by an overstuffed prosthesis leads to significant differences in the distal radioulnar variance at the wrist. This study evaluated ipsilateral ulnar variance as a predictor for overlengthening after implantation of a multipolar prosthesis.

Shoulder arthroplasty in Germany: 2005-2012.

Introduction: The field of shoulder endoprothetics has undergone a rapid development in the last years. The purpose of the study was to provide an overview of the development of shoulder arthroplasties in Germany from 2005 until 2012. This study hypothesized that the surgical procedures of the shoulder joint is still increasing and have not reached a plateau until 2012.

Fractures of the Radial Head.

Radial head fractures are the most common fractures around the elbow. Because they are often accompanied by ligamentous injuries, we recommend considering them to be osteoligamentous injuries rather than simple fractures, even in undisplaced or minimally displaced fractures. Surgeons should always suspect and actively exclude concomitant ligament tears.

The circumferential graft technique for treatment of multidirectional elbow instability: a comparative biomechanical evaluation.

Background: Ligament reconstruction with a circumferential graft represents an innovative technique for treatment of multidirectional elbow instability. This biomechanical study compared the stability of the intact elbow joint with the circumferential graft technique and the conventional technique.

Methods: Seven fresh frozen cadaveric elbows were evaluated for stability against valgus and varus/posterolateral rotatory forces (3 Nm) over the full range of motion.

From radial head to radiocapitellar to total elbow replacement: A case report.

Introduction: Radiocapitellar arthroplasty represents a possible treatment option for isolated osteoarthritis of the radial column. We report the first case of early failure of this procedure.

Presentation Of Case: We present the case of a 41-year old male who sustained a terrible triad injury to his right elbow and subsequently underwent radial head arthroplasty.

Peri-implant failure in dual plating of the distal humerus-A biomechanical analysis with regard to screw and plate positioning.

Purpose: The aim of this biomechanical study was to analyse the influence of plate and screw positioning on peri-implant failure in dual plate osteosynthesis. We hypothesized that screw positioning rather than plate configuration influences the risk of peri-implant fractures.

Methods: Twenty macerated humerus specimens were available.

Elbow Positioning and Joint Insufflation Substantially Influence Median and Radial Nerve Locations.

Background: The median and radial nerves are at risk of iatrogenic injury when performing arthroscopic arthrolysis with anterior capsulectomy. Although prior anatomic studies have identified the position of these nerves, little is known about how elbow positioning and joint insufflation might influence nerve locations.

Questions/purposes: In a cadaver model, we sought to determine whether (1) the locations of the median and radial nerves change with variation of elbow positioning; and whether (2) flexion and joint insufflation increase the distance of the median and radial nerves to osseous landmarks after correcting for differences in size of the cadaveric specimens.

Reliability of Magnetic Resonance Imaging Signs of Posterolateral Rotatory Instability of the Elbow.

Purpose: To evaluate radiographic signs of posterolateral rotatory instability (PLRI) on magnetic resonance imaging (MRI). The goal was to establish objective radiographic criteria to aid in the diagnosis of PLRI.

Methods: The MRI scans of 60 patients were evaluated retrospectively.

The treatment of simple elbow dislocation in adults.

Background: Simple elbow dislocation is a complex soft-tissue injury that can cause permanent symptoms. Its incidence is 5 to 6 cases per 100 000 persons per year. Its proper treatment is debated; options range from immobilization in a cast to surgical intervention.

The course of the median and radial nerve across the elbow: an anatomic study.

Introduction: Nerve transection has been described as complication of arthroscopic elbow arthrolysis. Therefore, the goal of this study was to define bony landmarks for intraoperative orientation regarding the location of the median and radial nerve.

Methods: In 22 formalin-fixated upper extremities, the radial and median nerves were dissected and marked with respect to their native course.

Is an extension of the safe zone possible without jeopardizing the proximal radioulnar joint when performing a radial head plate osteosynthesis?

Background: Proximal radial fractures are common elbow injuries. Because of the fracture pattern, stability criteria, or plate configuration, a plate position outside the "safe zone" (SZ) may be required in some cases when performing a radial head plate osteosynthesis. We examined the gross anatomy of the radial head and analyzed different so-called low-profile and precontoured radial head and neck plates with respect to the SZ.

Do the radial head prosthesis components fit with the anatomical structures of the proximal radioulnar joint?

Purpose: The fitting accuracy of radial head components has been investigated in the capitulo-radial joint, and reduced contact after prosthetic replacement of the radial head has been observed. The kinematics of the proximal radioulnar joint (PRUJ) are affected by radial head arthroplasty as well, but have not yet been investigated in this regard.

Methods: The elbow joints of 60 upper extremities of formalin-fixed body donors were disarticulated to obtain a good view of the PRUJ.

Anatomical fit of seven different palmar distal radius plates.

Introduction: The purpose of this study was to compare the anatomical fit of different, precontoured palmar distal radius plates.

Methods: The anatomical fit of seven different types of palmar distal radius plates [Königsee variable fixed-angle radius plate 7/3-hole, Königsee variable fixed-angle radius plate 5/3-hole (Allendorf, Germany), Medartis 2.5 Adaptive TriLock, Medartis 2.

Anatomic relations between the lateral collateral ligament and the radial head: implications for arthroscopic resection of the synovial fold of the elbow.

Purpose: The purpose of this study was to determine the anatomic relationship between the radial head and the lateral collateral ligament (LCL) and when the LCL would be at risk of iatrogenic injury during arthroscopic resection of the synovial fold.

Methods: Thirty-four formalin-fixed upper extremities were dissected. A projection of the LCL onto the radial head was marked with a needle.

Course of the radial nerve in relation to the center of rotation of the elbow--the need for a rational safe zone for lateral pin placement.

Purpose: To investigate the course and variability of the radial nerve along the lateral humerus in relation to the center of rotation of the elbow joint in the context of lateral pin placement for hinged external fixation.

Methods: A total of 95 formalin-fixed upper extremities were dissected. The course of the radial nerve along the lateral aspect of the humerus was measured at 3 landmarks with respect to the center of rotation of the elbow.

Sequence of the Essex-Lopresti lesion--a high-speed video documentation and kinematic analysis.

Background And Purpose: The pathomechanics of the Essex-Lopresti lesion are not fully understood. We used human cadavers and documented the genesis of the injury with high-speed cameras.

Methods: 4 formalin-fixed cadaveric specimens of human upper extremities were tested in a prototype, custom-made, drop-weight test bench.