[Ligamentous elbow injuries-When is surgical treatment still indicated?].

The elbow joint is a hinge-type synovial joint and is the second most frequently dislocated joint in adults and the most frequently dislocated joint in children. To find the right treatment options a precise understanding of the injury pattern, anatomy, biomechanics and pathology (simple vs. complex dislocation) is essential for a good reconstruction of the function and to prevent chronic instability and pain.

[Return to throwing sports after upper extremity injury and overuse : A criteria-based approach using an ulnar collateral ligament injury as an example].

Background: Uniform procedures for rehabilitation and follow-up treatment after injuries and surgeries at the upper extremity do not exist. Accordingly, only a few approaches for the follow-up treatment of instabilities of the elbow joint have been described.

Objectives: The authors show how rehabilitation before sport-specific training after rupture of the ulnar collateral ligament in a female handball player was objectivized and controlled using the results of functional tests.

Arthroscopic rod technique compared to stress ultrasound in the dynamic evaluation of lateral ligament instabilities of the elbow.

Introduction: The purpose was to compare the arthroscopic rod technique to stress ultrasound in the dynamic assessment of lateral elbow instabilities.

Materials And Methods: Fifteen elbows of eight specimen with a mean age of 66.4 ± 13.

LUCL reconstruction of the elbow: clinical midterm results based on the underlying pathogenesis.

Purpose: Traumatic and atraumatic insufficiency of the lateral ulnar collateral ligament (LUCL) can cause posterolateral rotatory instability (PLRI) of the elbow. The influence of the underlying pathogenesis on functional outcomes remains unknown so far. The objective of this study was to determine the impact of the initial pathogenesis of PLRI on clinical outcomes after LUCL reconstruction using an ipsilateral triceps tendon autograft.

The value of elbow arthroscopy in diagnosing and treatment of radial head fractures.

Background: Surgical treatment of radial head fractures is increasingly performed arthroscopically. These fractures often feature concomitant injuries to the elbow joint, which may be under-diagnosed in the radiological examinations. Little is known about the diagnostic value of arthroscopy, the treatment options that arise from arthroscopically assisted fracture fixation and clinical results.

Proximal radius fracture morphology following axial force impact: a biomechanical evaluation of fracture patterns.

Background: The most common location for articular fractures of the radial head is often reported to be the anterior lateral aspect of the radial head with the arm in neutral position. However, these findings mainly base on clinical observations rather than precise biomechanical measurements. The purpose of this study was to evaluate the formation of proximal radius fractures, the association between axial forces and fracture morphology, energy to failure and bone stiffness in a biomechanical in-vitro setup.

Reattachment of the flexor and extensor tendons at the epicondyle in elbow instability: a biomechanical comparison of techniques.

Background: Elbow dislocation represents a common injury, especially in the younger population. If treated surgically, the reattached tendons require a high amount of primary stability to allow for an early rehabilitation to avoid postoperative stiffness. The purpose of this study was to assess the biomechanical properties of a single and a double row technique for reattachment of the common extensor and common flexor muscles origin.

The influence of radio frequency ablation on intra-articular fluid temperature in the ankle joint - a cadaver study.

Background: Radio frequency ablation devices have found a widespread application in arthroscopic surgery. However, recent publications report about elevated temperatures, which may cause damage to the capsular tissue and especially to chondrocytes. The purpose of this study was the investigation of the maximum temperatures that occur in the ankle joint with the use of a commercially available radio frequency ablation device.

Intramedullary Cortical Button Repair for Distal Biceps Tendon Rupture: A Single-Center Experience.

Purpose: The aim of this retrospective study was to evaluate the clinical outcome and complication rate of intramedullary cortical button repair for distal biceps tendon rupture (partial and complete tears).

Methods: Between 2010 and 2014, a total of 28 patients with an acute distal biceps tendon rupture underwent intramedullary cortical button repair. Twenty-four patients (mean age, 49 years) with a mean follow-up of 28 months were included in the study.

A combination of an anteromedial, anterolateral and midlateral portals is sufficient for 360° exposure of the radial head for arthroscopic fracture fixation.

Purpose: Arthroscopic fixation of radial head fractures is an alternative to open reduction and internal fixation; the latter, however, presents the advantage of minimal soft-tissue damage. The exposure of the radial head for adequate screw placement can be technically challenging. The aim of this study was to evaluate the inter-observer agreement on the effective contact arc in the axial plane of the radial head of three different elbow arthroscopy portals.

Arthroscopic arthrolysis provides good clinical outcome in post-traumatic and degenerative elbow stiffness.

Purpose And Hypothesis: The purpose of this retrospective study was to report on the functional outcome after arthroscopic arthrolysis in patients with post-traumatic or degenerative elbow stiffness. It was hypothesized that this operative procedure leads to improved range of motion (ROM) and improved functional outcome in both groups.

Methods: Patients who underwent arthroscopic arthrolysis of the elbow between 2010 and 2015 were included in this study.

Biomechanical testing to evaluate the cut-through resistance of intramedullary nails for the proximal humerus.

Intramedullary nailing for stabilization of proximal humeral fractures is well-established. Complications as part of a cut-through, such as backing out of locking screws, loss of reduction, and perforation of the screws into the glenoid, are equally well-known. The test bench presented in this study enables testing of the cut-through behavior of multiple intramedullary implants on a simulated osteoporotic three-part fracture configuration with three different loading circumstances (A, B and C).

[Post-traumatic osteoarthritis of the elbow joint : Endoprosthetic options in young patients].

Background: In young patients, post-traumatic osteoarthritis of the elbow is a rare condition. Whereas clinical manifestations often differ from radiological findings, pain and stiffness are variably combined in symptomatic forms. In deciding whether to perform surgery, the patient's age, activity level, and symptoms, as well as the location and severity of the osteoarthritis have to be taken into account.

[Rehabilitation of Ligamentous Elbow Instability in Athletes].

Ligamentous instability of the elbow is a common pathology affecting athletes in different types of sports. It may lead to a permanent impairment of an athlete's ability to train and compete. The advancements made in arthroscopic, biomechanical and clinical diagnostic procedures allow for a better understanding of the etiology of elbow discomfort.

Rehabilitation, clinical outcome and return to sporting activities after posterolateral elbow instability: a systematic review.

Introduction: The aim of this study was to systematically review the literature for rehabilitation concepts, clinical outcome and sporting performance after surgical or non-surgical treatment of Posterolateral Rotatory Instability of the elbow (PLRI).

Evidence Acquisition: In order to identify any published clinical study reporting on rehabilitation concepts and sporting performance following surgical or non-surgical treatment of PLRI a systematic search in literature was conducted. Rehabilitation protocols were reviewed according to main rehabilitation protocol categories (bracing, range of motion [ROM], strengthening and return to sport [RTS]).

[Complication management in implant dislocation].

There are many reasons for an implant malposition. Besides knowlege about prevention of implant dislocation, accurate planning of the osteosynthesis, extensive knowlege of the anatomy of the region in question, using all necessary diagnostic tools, choosing the correct approach and the best implant for fracture fixation are also important factors. Nevertheless, implant complications can still be found and if an intraoperative or postoperative implant dislocation occurs a suitable management is necessary.

The Elbow Self-Assessment Score (ESAS): development and validation of a new patient-reported outcome measurement tool for elbow disorders.

Purpose: To develop and validate an elbow self-assessment score considering subjective as well as objective parameters.

Methods: Each scale of the American Shoulder and Elbow Surgeons-Elbow Score, the Broberg and Morrey rating system (BMS), the Patient-Rated Elbow Evaluation (PREE) Questionnaire, the Mayo Elbow Performance Score (MEPS), the Oxford Elbow Score (OES) and the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) was analysed, and after matching of the general topics, the dedicated items underwent a fusion to the final ESAS's item and a score containing 22 items was created. In a prospective clinical study, validity, reliability and responsiveness in physically active patients with traumatic as well as degenerative elbow disorders were evaluated.

Novel technique for sternoclavicular joint reconstruction using a gracilis tendon autograft.

Unlabelled: Surgical treatment of sternoclavicular joint instability can be challenging and carries the inherent risk of damaging vital structures if the posterior capsule is violated during surgery. In the current manuscript, a novel and easy technique for open reduction and tendon graft stabilization of the unstable sternoclavicular joint is presented. Analogous to other techniques, the graft is passed through drill holes in a figure-of-eight configuration.

[Arthroscopy of the elbow: diagnostic and therapeutic approaches].

The elbow is one of the most complex joints of the human body. Bony, ligamentous and muscular constraints ensure elbow stability. During recent years elbow arthroscopy has become more and more popular resulting from technical and surgical innovations.

[Acromion reconstruction after arthroscopic subacromial decompression and iatrogenic acromial destruction].

Objective: Reconstruction of the acromion, to achieve pain relief and better function of the deltoid muscle.

Indications: After partial or complete removal of the acromion.

Contraindications: General surgical contraindications.

[Distal clavicle fracture].

Objective: Reposition and fixation of unstable distal clavicle fractures with a low profile locking plate (Acumed, Hempshire, UK) in conjunction with a button/suture augmentation cerclage (DogBone/FibreTape, Arthrex, Naples, FL, USA).

Indications: Unstable fractures of the distal clavicle (Jäger and Breitner IIA) in adults. Unstable fractures of the distal clavicle (Jäger and Breitner IV) in children.

Virtual morphological comparison of three intramedullary nailing systems for the treatment of proximal humeral fractures.

Proximal humerus fractures treated with intramedullary nails show good results. However, the correct anatomical reconstruction of four-part fractures is demanding especially when using intramedullary nails. We therefore compared different intramedullary nail designs for the proximal humerus in a virtual morphological manner.

Elbow dislocations: a review ranging from soft tissue injuries to complex elbow fracture dislocations.

This review on elbow dislocations describes ligament and bone injuries as well as the typical injury mechanisms and the main classifications of elbow dislocations. Current treatment concepts of simple, that is, stable, or complex unstable elbow dislocations are outlined by means of case reports. Special emphasis is put on injuries to the medial ulnar collateral ligament (MUCL) and on posttraumatic elbow stiffness.

Double intramedullary cortical button versus suture anchors for distal biceps tendon repair: a biomechanical comparison.

Purpose: The aim of this biomechanical in vitro study was to compare the novel technique of double intramedullary cortical button (DICB) fixation with the well-established method of suture anchor (SA) fixation for distal biceps tendon repair.

Methods: A matched-pair analysis (24 human cadaveric radii) was performed with respect to cyclic loadings and failure strengths. Twelve specimens per group were cyclically loaded for 1,000 cycles at 1.