Diagnosis and Treatment of Posteromedial Elbow Impingement in the Throwing Athlete.

Purpose Of Review: Posteromedial elbow impingement is a common pathological entity in the throwing athlete. The posteromedial articulation of the elbow is a significant stabilizer to medial elbow forces and valgus stress noted during repetitive throwing. This current review investigates recent literature regarding the relevant anatomy, diagnosis, and treatment of posteromedial impingement in the thrower.

A Combined Revision Surgical Technique for Failed Operative Lateral Epicondylitis With Concomitant Radial Tunnel Syndrome.

Lateral epicondylitis afflicts a large percentage of the population with most recovering through conservative treatment. The 5% to 10% of patients who undergo operative intervention are met with mixed results. Those that fail to improve often demonstrate a complex presentation of inadequate debridement of the "angiofibroblastic tissue," missed concomitant radial tunnel syndrome, and iatrogenic residual devascularized tissue resulting from the index procedure.

Lacertus syndrome: Use of pre- and post-exercise MRI to aid in diagnosis and treatment.

Lacertus syndrome is a chronic exertional compartment syndrome of the forearm that is unlike exertional compartment syndrome of the lower extremity. It differs from traditional exertional compartment syndrome in terms of the anatomy, symptoms and physical exam findings. This is a case where dynamic magnetic resonance imaging is used to confirm the diagnosis rather than relying solely on a clinical diagnosis or invasive compartment pressure monitoring.

Locked Wrist: A Case Report and Literature Review on Pisotriquetral Loose Bodies.

 Pisotriquetral (PT) loose bodies have been described in the literature only a few times as case reports. While PT pathology remains the differential for ulnar-sided wrist pain, it can often be difficult to diagnose, as symptoms can be variable and radiographic imaging may be negative for any findings.  A 24-year-old major league baseball player presented with pain and locking of his wrist during follow through of his bat swing.

Suture Tape Augmentation for Scapholunate Ligament Repair: A Biomechanical Study.

Purpose: Scapholunate (SL) ligament tears in the acute setting can be treated by primary repair through various techniques. The purpose of this study was to compare repair of the SL ligament with suture anchors alone versus repair of the SL ligament augmented with suture tape.

Methods: Twelve fresh-frozen cadavers (6 matched pairs) underwent a dorsal approach to the wrist and the SL ligament was sharply dissected off of its scaphoid attachment.

Acute Flaccid Myelitis: A Single Pediatric Center Experience From 2014 to 2019.

Background: Acute flaccid myelitis has emerged as the leading cause of acute flaccid paralysis in children. Acute flaccid myelitis leads to significant physical disability; hence, objective outcome measures to study disease severity and progression are desirable. In addition, nerve transfer to improve motor function in affected children needs further study.

Cubital tunnel syndrome: a surgical modification to in situ decompression to improve results.

Background: The gold standard for surgical treatment of cubital tunnel syndrome is in situ decompression. However, this procedure does not come without complications. Subluxation of the ulnar nerve and ulnar nerve neuritis from adhesion formation remain 2 potential complications after this procedure.

MRN findings of lateral antebrachial cutaneous nerve impingement in a collegiate athlete.

Dynamic compression of the lateral antebrachial cutaneous nerve (LABCN) occurs with forearm pronation when the LABCN becomes compressed by the lateral margin of the biceps tendon. LABCN compression is a rare occurrence and is often overlooked as an etiology for forearm pain. While this entity has been described in several case reports in the orthopedic literature, it has not yet been described in radiology literature.

Biomechanical Comparison of Fixed- versus Variable-Angle Locking Screws for Distal Humerus Comminuted Fractures.

Background: To compare the stability of fixed- versus variable-angle locking constructs for the comminuted distal humerus fracture (AO/OTA 13-A3).

Methods: Eight pairs of complete humeri harvested from eight fresh frozen cadavers were used for the study. We fixed the intact humeri using 2.

Early Predictors of Microsurgical Reconstruction in Brachial Plexus Birth Palsy.

Background: Microsurgical reconstruction is indicated for infants with brachial plexus birth palsy (BPBP) that demonstrate limited spontaneous neurological recovery. This investigation defines the demographic, perinatal, and physical examination characteristics leading to microsurgical reconstruction.

Methods: Infants enrolled in a prospective multicenter investigation of BPBP were evaluated.

Etiology, Diagnosis, and Treatment of Dynamic Nerve Compression Syndromes of the Elbow Among High-Level Pitchers: A Review of 7 Cases.

Background: Dynamic compressive neuropathies around the elbow are a rare entity described by a relatively small body of literature, mostly consisting of single-case reports. No standardized diagnostic protocols have been described to date. To the authors' knowledge, this study represents the largest case series of dynamic compressive neuropathies in the upper extremity.

Ulnar Nerve Injury in Pediatric Midshaft Forearm Fractures: A Case Series.

Objectives: To describe a midshaft forearm fracture pattern that places the ulnar nerve at risk in the pediatric population and provide 7 clinical case examples describing the injury pattern and treatment methods.

Design: Retrospective observational case series, review of literature, cadaver dissection, and treatment recommendations.

Setting: Multi-institutional, Southeast United States.

Revision of the Failed Thumb Carpometacarpal Arthroplasty.

Purpose: To evaluate the outcome of revision surgery for failed thumb carpometacarpal (CMC) arthroplasty.

Methods: We retrospectively analyzed 32 patients with failed thumb CMC arthroplasty. The primary reason for revision was pain caused by metacarpal subsidence.

Efficacy and safety of collagenase clostridium histolyticum for Dupuytren disease nodules: a randomized controlled trial.

Background: To determine the safety and efficacy of collagenase clostridium histolyticum (CCH) injection for the treatment of palmar Dupuytren disease nodules.

Methods: In this 8-week, double-blind trial, palpable palmar nodules on one hand of adults with Dupuytren disease were selected for treatment. Patients were randomly assigned using an interactive web response system to receive a dose of 0.

Ulnar Nerve Tendon Transfers for Pinch.

Power and tip pinch are an integral part of intrinsic hand function that can be significantly compromised with dysfunction of the ulnar nerve. Loss of power pinch is one component that can significantly affect an individual's ability to perform simple daily tasks. Tip pinch is less affected, as this task has significant contributions from the median nerve.

Ray Resection for Progressive Macrodactyly of the Hand: Surgical Technique and Illustrative Cases.

Macrodactyly of the hand is a rare condition. Although the underlying mechanism is being more fully elucidated, surgical intervention is typically required to improve the size and function of the affected digits. However, when an involved digit(s) is rapidly progressive in size, ray resection amputation may be the most appropriate treatment.

Innervation of the Elbow Joint: A Cadaveric Study.

Purpose: To describe elbow innervation patterns in 15 cadaveric extremities.

Methods: Fifteen fresh-frozen cadaveric upper extremities were dissected under loupe magnification. The median, radial, musculocutaneous, and ulnar nerves were dissected at the elbow joint and explored both proximally and distally to find capsular branches and identifiable anatomical patterns.

Update on tendon transfers for peripheral nerve injuries.

Tendon transfer surgery to restore fundamental wrist and hand function is made possible by the redundancy that exists among the actions of our upper-extremity musculature. Potential donors for transfer are those muscles with adequate power to motor the recipient tendon, similar tendon excursion to the recipient, and function in phase with the recipient. Resolution of wound healing, union of fractures, and mobilization of stiff joints are prerequisites for a functioning tendon transfer.