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Coronoid Process Fracture

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81. AIUM Practice Parameter for the Performance of a Musculoskeletal Ultrasound Examination

to external rotation. Posterior subluxation is assessed visually and by measuring the a angle, which is the angle between the posterior margin of the scapula and the line drawn tangentially to the humeral head and posterior edge of the glenoid. The normal value of the a angle is 30° or less. The clavicle and proximal humerus are also evaluated for fracture. ? 6 B. Specifications for an Elbow Examination An elbow examination may be indicated to evaluate for synovial hypertrophy or synovitis, crystal (...) space and other recesses of the elbow are assessed for effusion, synovial hypertrophy, and intra-articular bodies. Longitudinal and transverse scanning of the anterior humeroradial and humeroulnar joints and coronoid and radial fossae is performed to assess the articular cartilage and cortical bone. The annular recess of the neck of the radius is scanned dynamically with forearm pronation and supination. The same dynamic assessment can be made for the biceps brachii tendon and its attachment

2017 American Institute of Ultrasound in Medicine

82. CRACKCast E052 – Orthopedics – Humerus and Elbow

injury – hyperextension with a valgus force levers the ulna from the trochlea The distal humerus gets lodged on the coronoid process Arm held in 45 degrees of flexion Assess for brachial artery and median nerve injury From initial injury, reduction, or swelling Radiographs are important pre-reduction to investigate for possible fractures Reduction: Facilitated by procedural sedation, intra-articular anesthesia or regional block Assistant provides counter traction Elbow at 30 degrees of flexion (...) Three articulations: Trochlea and the deep trochlear notch of the ulna Capitellum and the radial head allowing elbow flexion The radial head rotating on the capitellum and radial notch of the ulna Bones Distal humerus tapers into: Medial (wrist flexors) and lateral (wrist extensors) condyles, which sandwich the coronoid fossa in-between Fractures through the distal humerus usually result in displacement because of these muscular attachments The epicondyles sit above the articular condyles Volarly

2016 CandiEM

83. Are eponyms used correctly or not? A literature review with a focus on shoulder and elbow surgeryEditor's Choice FREE

1 Flowchart depicting the process of article selection. From the original publications, these eponymous terms are defined as follows: The Bankart lesion (Arthur Sidney Blundell Bankart, 1879–1951) is a detachment of the glenoid ligament from the anterior margin of the glenoid cavity after anterior glenohumeral injury. It should be noted that ‘bony Bankart’ is an interesting term, as Bankart wrote explicitly that he never had seen recurrent dislocation after glenoid fracture or bony abnormality (...) misses the capitellum in 16% of radiographs of normal elbows . Delpont M , Jouve J-L , Sales de Gauzy J , et al . Proximal ulnar osteotomy in the treatment of neglected childhood Monteggia lesion . Mellema JJ , Doornberg JN , Dyer GSM , et al . Distribution of coronoid fracture lines by specific patterns of traumatic elbow instability . Ray R , Gaston M . Treatment of late-presenting Monteggia variant with an isolated, simple flexion ulnar osteotomy . Ha T , Grant S , Huntley JS . Monteggia type IV

2016 Evidence-Based Medicine (Requires free registration)

84. Articular Contact Area and Pressure in Posteromedial Rotatory Instability of the Elbow. (PubMed)

the joint subluxation and incongruity spontaneously reduced (at a mean [and standard error] of 60° ± 5° of flexion), at which point the mean contact pressure decreased from 870 ± 50 kPa (pre-reduction) to 440 ± 40 kPa (post-reduction) (p < 0.001) and the mean contact area increased from 80 ± 8 mm to 150 ± 58 mm (p < 0.001). This reduction of the subluxation was also followed by a shift of the contact area from the coronoid fracture edge toward the lower portion of the coronoid. At the flexion angle (...) could be subsequent to joint incongruity and an increase in contact pressure between the coronoid fracture surface and the trochlea.

2018 The Journal of Bone and Joint Surgery. American Volume

85. Insertional anatomy of the anterior medial collateral ligament on the sublime tubercle of the elbow. (PubMed)

Insertional anatomy of the anterior medial collateral ligament on the sublime tubercle of the elbow. Acute injuries to the anterior medial collateral ligament (AMCL) can occur due to valgus trauma or during other dislocating events to the elbow. AMCL lesions are often associated with bony lesions, such as radial head fractures or fractures of the coronoid process. We analyzed the insertion of the AMCL on the sublime tubercle in relation to surrounding osseous structures. We aimed to increase (...) the understanding of the involvement of the AMCL in bony lesions to the sublime tubercle.We investigated 86 elbows from 43 embalmed human specimens. We measured the most ventral extensions of the AMCL at the sublime tubercle in relation to a clearly defined and reproducible landmark. We used as our landmark a horizontal line (baseline) originating on the lesser sigmoid notch in a right angle to the ulnar ridge.The mean distance of the coronoid process tip to the baseline was 4.0 mm (standard deviation [SD], 1.3

2018 Journal of Shoulder and Elbow Surgery

86. Terrible triad of the elbow: evaluation of surgical treatment (PubMed)

; they were evaluated by the Disabilities of the Arm, Shoulder and Hand (DASH) score, the degree of patient satisfaction, the degree of trauma energy, radiographic images, range of motion, and complications.There was a higher incidence of Regan and Morrey type II coronoid process fractures; in relation to the injuries, nine patients had deinsertion of the brachialis. Half of the patients suffered a fall from their own height as the mechanism of trauma. The extent of elbow flexion and extension averaged (...) Terrible triad of the elbow: evaluation of surgical treatment This study aims at analyzing retrospectively the clinical-functional and radiographic results of surgical treatment of the terrible elbow triad, with at least 12 months of postoperative follow-up evaluating elbow function.A group of patients for retrospective analysis from 2004 to 2015 was defined, in which 12 patients were studied. They underwent surgery due to fracture of the radial head, coronoid fracture, and elbow dislocation

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2018 Revista brasileira de ortopedia

87. Three Dimensional Osteometric Analysis of Mandibular Symmetry and Morphological Consistency in Cats (PubMed)

and left measurements, and the ratio of jaw widths at the coronoid process and mandibular foramen were calculated. All analyses were performed using R version 3.3.3 and the multcomp library. Results: None of the right:left ratios were detected as being significantly different from 1 and the coefficient of variation values were all very small showing that when cats deviate from the mean ratio they do so by only a small amount. Measurements analyzed to determine how consistent individual measurements (...) and developing techniques for caudal mandibular fracture repair. Methods: Twenty-seven mixed breed cats (26 Domestic Shorthaired and 1 Domestic Longhaired) with no history of head trauma, intact undamaged mandibles, both mandibular fourth premolars and first molars present which had a full skull CT scan were included in this study. Anatomical reference points were defined on maximum intensity projections of multiplanar reconstruction of the mandibles and measurements taken. The ratios between paired right

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2018 Frontiers in veterinary science

88. Intraoral vertico-sagittal ramus osteotomy: modification of the L-shaped osteotomy. (PubMed)

the operative site. Proximal segment dislocation from the glenoid fossa was observed on one side (0.82%). Non-union of the osteotomy was not observed in any patient. Intraoperative fracture of the coronoid process occurred in 2.46%, but none necessitated treatment of the fracture. Nerve dysfunction was found in 2.46% at the 12-month postoperative follow-up. The modified technique presented herein was developed to reduce postoperative nerve dysfunction and intraoperative hemorrhage.Copyright © 2017 (...) Intraoral vertico-sagittal ramus osteotomy: modification of the L-shaped osteotomy. The sagittal split ramus osteotomy and intraoral vertical ramus osteotomy carry the potential risk of postoperative nerve paralysis, bleeding, and fracture and dislocation of the condyle. In 1992, Choung first described the intraoral vertico-sagittal ramus osteotomy for the purpose of avoiding postoperative dislocation of the condyle. However, there is still potential for damaging the inferior alveolar nerve

2017 International Journal of Oral and Maxillofacial Surgery

89. Complex varus elbow instability: a terrible triad model. (PubMed)

Complex varus elbow instability: a terrible triad model. The terrible triad is a debilitating injury that involves elbow dislocation with injury to the lateral collateral ligament (LCL) complex, the radial head, and the coronoid process. This study investigated the role of these components in varus stability of the elbow.We investigated the role of these components in varus stability of the elbow using 10 cadaveric fresh frozen upper extremities. The testing order allowed each of four states (...) to be tested (intact, LCL complex deficient or repaired, radial head resected or replaced) at two flexion angles and multiple coronoid resection levels. Values for restraining load (newtons [N]) at 1.5 cm of varus displacement were obtained on a materials testing machine.Beyond a 50% loss of the coronoid process, neither repair of the LCL nor replacing the radial head alone resulted in a statistically significant increase in varus stability. For a loss of the coronoid process between 67-75%, repair

2017 Journal of Shoulder and Elbow Surgery

90. Maxillofacial trauma

for symmetry. The affected side is usually more depressed diplopia is common due to orbital involvement. Impaired upward gaze with resultant diplopia is usually a result of oedema and haemorrhage of the periorbital tissues. Occasionally, this may be due to rectus muscle entrapment with a concomitant orbital floor fracture impaired mouth opening or closure may occur if the zygomatic arch is depressed and affects the underlying temporalis muscle and its insertion at the coronoid process of the mandible (...) and enduring impairment of the patient and can have medicolegal ramifications. Maxillofacial injuries – a common presentation to both general practice and hospital settings in Australia – can be easily overlooked. Weekend sporting events and social activities are common settings for facial injuries, especially in combination with alcohol. Patients often initially present to their general practitioner for assessment and advice. The diagnosis of maxillofacial fractures can be challenging, as haematoma

2012 Clinical Practice Guidelines Portal

91. Radial nerve palsy after the use of an adjuvant hinged external fixator in a complex fracture–dislocation of the elbow: a case report and review of the literature (PubMed)

Radial nerve palsy after the use of an adjuvant hinged external fixator in a complex fracture–dislocation of the elbow: a case report and review of the literature The combination of an elbow dislocation, a radial head fracture, and a coronoid process fracture is known as "terrible triad" injury of the elbow. This injury is one of the most challenging injuries of the musculoskeletal system and almost always causes instability of the elbow. The use of an adjuvant hinged external fixator (...) in such injuries is still debated.In this case report we present a case of radial nerve palsy after setting up an adjuvant hinged external fixator in a complex fracture-dislocation of the elbow. The patient was a 39-year-old white man. A revision of his radial nerve was undertaken at 7 weeks. A radial nerve injury at two levels facing the humeral apex pins was found intraoperatively; the pins were carefully removed and partial nerve grafts done. The functional outcome at 18 months was excellent.This case

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2016 Journal of medical case reports

92. Scoring mandibular fractures: a tool for staging diagnosis, planning treatment, and predicting prognosis. (PubMed)

Scoring mandibular fractures: a tool for staging diagnosis, planning treatment, and predicting prognosis. Mandibular fractures (MF) are a daily problem in maxillofacial surgery. A staging system for classifying MF is of paramount importance to plan surgery, to define prognosis, and to exchange information among trauma centers. In this article, a classification for MF is proposed.The mandible is divided into six sites (symphysis, body, angle, ramus, coronoid, and condyle) and the mandibular (...) nerve divides the alveolar process (i.e., the upper part containing teeth) from the basal bone (placed caudally with respect to the nerve). MF can be summarized using three abbreviations: A = alveolar, B = basal, and C = complete. Consequently, MFs are staged as follows: F in situ = a greenstick fracture; F1 = a single mobile fragment of alveolar or basal bone; F2 = double mobile fractures of the alveolar or basal portion or a single complete separation of the mandibular arch continuity; F3

2009 Journal of Trauma

93. Proximal ulna fractures. (PubMed)

Proximal ulna fractures. Proximal ulna fractures are relatively common. They range in severity from a simple transverse olecranon fracture to a highly complex fracture dislocation involving a comminuted coronoid process. The anatomy, fracture pathology, treatment approach, and rehabilitation are presented in this article.

2009 Journal of Hand Surgery - American

94. Terrible triad of the elbow: treatment protocol and outcome in a series of eighteen cases. (PubMed)

Terrible triad of the elbow: treatment protocol and outcome in a series of eighteen cases. The terrible triad is an uncommon injury, which includes an elbow posterior dislocation with fractures of the radial head and coronoid process of the ulna. In addition there is rupture of the lateral and medial collateral ligaments. The short-term and long term results are historically poor, with a high rate of complications. The main objective of this study is to report the results of a multicentre study (...) results, ten good results, three fair results, and two poor results. Five early and three late complications were reported. This particular case of elbow dislocation is very unstable and leads to many complications. The surgeon should attempt to restore stability by preserving the radial head whenever possible or replacing it with prosthesis otherwise, by repairing the lateral collateral ligament and performing fixation of the coronoid fracture. If after anatomical restoration of stability elements

2015 Injury

95. Radial head replacement or repair for the terrible triad of the elbow: which procedure is better? (PubMed)

Radial head replacement or repair for the terrible triad of the elbow: which procedure is better? The terrible triad of the elbow comprises an ulnar coronoid process fracture, a radial head (RH) fracture and posterior dislocation of the elbow. It is considered severe by many clinicians because it is difficult to repair and has a poor prognosis; therefore, it deserves more attention.Thirty-nine patients with terrible triad of the elbow characterized by a Mason type-III RH fracture were randomly (...) ) were significantly better in the RH replacement group. In addition, patients in the RH replacement group displayed significantly fewer post-surgery complications than those in the RH repair group (P = 0.04).Treating Mason type-III RH fracture in a terrible triad of the elbow with a metal RH prosthesis resulted in better clinical outcomes and fewer post-surgery complications than treating a terrible triad of the elbow by repairing it with screws or plates. RH replacement might be a more effective

2015 ANZ journal of surgery Controlled trial quality: uncertain

96. TERRIBLE TRIAD OF THE ELBOW: EVALUATION OF SURGICAL TREATMENT (PubMed)

TERRIBLE TRIAD OF THE ELBOW: EVALUATION OF SURGICAL TREATMENT To evaluate the epidemiology of and surgical results from treating elbow fracture-dislocations, including only the cases in which dislocation is associated with fracture of the coronoid process and the radial head (terrible triad).Nineteen patients were evaluated: 12 males and 7 females. The medical records were analyzed to gather data about the mechanism of injury, fracture pattern, time elapsed until surgery and type of procedure

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2015 Revista brasileira de ortopedia

97. Complications of treating terrible triad injury of the elbow: a systematic review. (PubMed)

Complications of treating terrible triad injury of the elbow: a systematic review. Terrible triad injury of the elbow (TTIE), comprising elbow dislocation with radial head and coronoid process fracture, is notoriously challenging to treat and has typically been associated with complications and poor outcomes. The objective of this systematic review was to summarize the most recent available evidence regarding functional outcomes and complications following surgical management of TTIE.Medline

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2014 PloS one

98. Upper Limb Prosthetics (Diagnosis)

fossa (medially) allow the humerus to accept the head of the radius and the coronoid process of the ulna when the joint is in full flexion. On the central aspect of the posterior humerus above the trochlea of the humeral condyle is the olecranon fossa, which allows the humerus to accept the olecranon of the ulna when the joint is in extension. The olecranon is the proximal end of the ulna, from which the C-shaped trochlea notch is carved. For more information about the relevant anatomy, see (...) Upper Limb Prosthetics (Diagnosis) Elbow and Above-Elbow Amputations: Background, Indications, Contraindications Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTIzNzg4Ni1vdmVydmlldw== processing > Elbow and Above

2014 eMedicine.com

99. Upper Limb Orthotics (Diagnosis)

fossa (medially) allow the humerus to accept the head of the radius and the coronoid process of the ulna when the joint is in full flexion. On the central aspect of the posterior humerus above the trochlea of the humeral condyle is the olecranon fossa, which allows the humerus to accept the olecranon of the ulna when the joint is in extension. The olecranon is the proximal end of the ulna, from which the C-shaped trochlea notch is carved. For more information about the relevant anatomy, see (...) Upper Limb Orthotics (Diagnosis) Elbow and Above-Elbow Amputations: Background, Indications, Contraindications Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTIzNzg4Ni1vdmVydmlldw== processing > Elbow and Above

2014 eMedicine.com

100. Ulnar Neuropathy (Diagnosis)

epicondyle, the ulnar nerve pierces the flexor-pronator aponeurosis, the fibrous common origin of the flexor and pronator muscles. The ligament of Spinner is an additional aponeurosis between the flexor digitorum superficialis of the ring finger and the humeral head of the flexor carpi ulnaris. This septum is independent of the other aponeuroses and attaches directly to the medial epicondyle and the medial surface of the coronoid process of the ulna. With anterior transposition of the ulnar nerve (...) process The tubercle of the coronoid process is 1.5 times larger in men Contreras et al suggested that the coronoid process may be a potential site for ulnar nerve compression in men and that the increased subcutaneous fat around the ulnar nerve in women may provide a protective advantage against acute ulnar neuropathy. [ ] Previous Next: Prognosis A favorable surgical outcome is more likely for sensory function than for motor function. Overall, however, a favorable outcome occurs in 85-95% of cases

2014 eMedicine.com

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