Morphological features of the posterior oblique ligament of the ulnar collateral ligament of the elbow joint

2020 ◽  
Vol 42 (3) ◽  
pp. 243-248
Author(s):  
S. Shimizu ◽  
M. Edama ◽  
M. Ikezu ◽  
K. Matsuzawa ◽  
F. Kaneko ◽  
...  
Keyword(s):  
Elbow Joint ◽  
Ulnar Collateral Ligament ◽  
Morphological Features ◽  
Collateral Ligament ◽  
Posterior Oblique Ligament

Unusual Cause of Lateral Elbow Pain: A Case Report of Anconeus Muscle Contusion

2019 ◽  
Vol 34 (2) ◽  
pp. 102-104
Author(s):  
Muhsin E Uluc ◽  
Atilla H Cilengir ◽  
Cemal Kazimoglu ◽  
Özgür Tosun
Keyword(s):  
Case Report ◽  
Elbow Joint ◽  
Rare Case ◽  
Ulnar Collateral Ligament ◽  
Joint Capsule ◽  
Coronoid Process ◽  
Collateral Ligament ◽  
Elbow Pain ◽  
Lateral Elbow Pain ◽  
Lateral Elbow

The anconeus muscle is a small and minor functioning muscle located at the posterolateral elbow region. It helps forearm extension and tightening of the joint capsule. Despite its limited functions, pathologies of the anconeus muscle can mimic other abnormalities of the elbow joint. Here, we report a rare case of a traumatic anconeus muscle contusion in a 15-year-old boy due to falling during dance. MRI showed contusion in the anconeus muscle, as well as strain in the ulnar collateral ligament and edema in the coronoid process of the ulna. To our knowledge, this is the first described case of traumatic anconeus muscle contusion in the literature. The presence of long-lasting lateral elbow pain in trauma cases without fracture should alert clinicians to consider anconeus muscle abnormalities. MRI is the best modality for diagnosis in these cases.

scholarly journals Morphological Features of the Ulnar Collateral Ligament of the Elbow and Common Tendon of Flexor-Pronator Muscles

2020 ◽  
Vol 8 (9) ◽  
pp. 232596712095241
Author(s):  
Masahiro Ikezu ◽  
Mutsuaki Edama ◽  
Kanta Matsuzawa ◽  
Fumiya Kaneko ◽  
Sohei Shimizu ◽  
...  
Keyword(s):  
Ulnar Collateral Ligament ◽  
Joint Capsule ◽  
Morphological Features ◽  
Single Bundle ◽  
Type I ◽  
Type Ii ◽  
Collateral Ligament ◽  
Functional Roles ◽  
Independent Form ◽  
Length Width

Background: The anterior bundle (AB) of the ulnar collateral ligament is the most important structure for valgus stabilization of the elbow. However, anatomic relationships among the AB, posterior bundle (PB) of the ulnar collateral ligament, and common tendon (CT) of the flexor-pronator muscles have not been fully clarified. Purpose: To classify the AB, PB, and CT and to clarify their morphological features. Study Design: Descriptive laboratory study. Methods: This investigation examined 56 arms from 31 embalmed Japanese cadavers. The CT investigation examined 34 arms from 23 embalmed Japanese cadavers with CTs remaining. Type classification was performed by focusing on positional relationships with surrounding structures. Morphological features measured were length, width, thickness, and footprint for the AB and PB and attachment length, thickness, and footprint for the CT. Results: The AB was classified as type I (44 elbows; 78.6%), can be separated as a single bundle, or type II (12 elbows; 21.4%), cannot be separated from the PB and joint capsule. The PB was classified as type I (28 elbows; 50.0%), can be separated as a single bundle; type IIa (6 elbows; 10.7%), posterior edge cannot be separated; type IIb (7 elbows; 12.5%), anterior edge cannot be separated; or type III (15 elbows; 26.8%), cannot be separated from the joint capsule. The CT was classified as type I (18 elbows; 52.9%), can be separated from the AB, or type II (16 elbows; 47.1%), cannot be separated from the AB. Significant differences in frequencies of AB, PB, and CT types were identified between men and women. Morphological features were measured only for type I of each structure, and reliability was almost perfect. Conclusion: These results suggest that the AB, PB, and CT each can be classified into an independent form and an unclear form. Presence of the unclear form was suggested as one factor contributing to morphological variation. Clinical Relevance: This study may provide basic information for clarifying functional roles of the AB, PB, and CT.

scholarly journals Changes in Medial Elbow Joint Space When Elbow Valgus Stress Is Applied at Different Limb Positions and Loads In Vivo

2021 ◽  
Vol 9 (11) ◽  
pp. 232596712110459
Author(s):  
Kanta Yoshioka ◽  
Kanta Matsuzawa ◽  
Tomoya Ikuta ◽  
Sae Maruyama ◽  
Mutsuaki Edama
Keyword(s):  
Repeated Measures ◽  
Elbow Joint ◽  
Ulnar Collateral Ligament ◽  
Elbow Flexion ◽  
Sports Injury ◽  
Joint Space ◽  
Muscle Contractions ◽  
Collateral Ligament ◽  
Valgus Stress

Background: Ulnar collateral ligament (UCL) injury is a common sports injury among overhead-throwing athletes and causes medial elbow pain and instability. UCL injury is generally diagnosed based on symptoms, physical findings, and image evaluation. To standardize the method for evaluating elbow valgus instability, more information is needed regarding changes in the medial elbow joint space (JS) in healthy elbows. Purpose/Hypothesis: The purpose of this study was to measure the JS during the application of elbow valgus stress at different elbow flexion angles and loads and to clarify the presence of defensive muscle contractions during elbow valgus stress. It was hypothesized that the JS will differ according to different limb positions and loads and that defensive contractions will occur when elbow valgus stress is >90 N. Study Design: Controlled laboratory study. Methods: Elbow joints on the nondominant side were examined in 20 healthy male university students (mean age, 21 ± 0.2 years) at 30°, 60°, and 90° of elbow flexion. To create valgus stress on the elbow, loads of 30, 60, 90, 120, and 150 N were applied with a Telos stress device and with gravity stress on the forearm. The medial JS was measured ultrasonographically during the application of elbow valgus stress. Electrodes were attached to the pronator teres muscle, and defensive muscle contractions were measured using electromyography during the application of elbow valgus stress. Repeated-measures analysis of variance and paired t tests were used to compare the JS at each elbow angle and each valgus stress load, and the Bonferroni method was used as a post hoc test. Results: At 30° of elbow flexion, the JS was significantly higher at 30 N versus 0 N and at 60 N versus 0 or 30 N ( P ≤ .018 for all). At 60° of flexion, the JS was significantly higher at 30 N versus 0 N, at 60 N versus 0 and 30 N, and at 90 N versus 0, 30, and 60 N ( P ≤ .024 for all). At 90° of elbow flexion, the JS was significantly higher at 30 N versus 0 N and at 60 N versus 0 and 30 N ( P ≤ .028 for all). Defensive muscle contraction did not occur at any elbow flexion angles at elbow valgus stress ≤60 N. Conclusion: The lack of muscular contraction at elbow valgus stress ≤60 N may reflect the function of the medial collateral ligament. Clinical Relevance: Elbow valgus stress ≤60 N allows for the evaluation of the joint opening.

scholarly journals Valgus Stability is Enhanced by Flexor Digitorum Superficialis Muscle Contraction of the Index and Middle Fingers

2020 ◽  
Author(s):  
Shota Hoshika ◽  
Akimoto Nimura ◽  
Norimasa Takahashi ◽  
Hiroyuki Sugaya ◽  
Keiichi Akita
Keyword(s):  
Muscle Contraction ◽  
Elbow Joint ◽  
Ulnar Collateral Ligament ◽  
Flexor Digitorum Profundus ◽  
Flexor Digitorum Superficialis ◽  
Collateral Ligament ◽  
Valgus Stress ◽  
The Difference ◽  
Flexor Digitorum ◽  
Healthy Males

Abstract Background: Flexor digitorum superficialis (FDS) muscle provides dynamic stabilization and medial elbow support for ulnar collateral ligament (UCL). The FDS contraction significantly affects the medial joint distance (MJD) through grip contraction. However, it remains unclear whether FDS activity alone contributes to medial elbow stability, or together with the activation of the flexor digitorum profundus during grip contraction, and which finger’s FDS is the main contributor to elbow stability. We investigated the resistive effects of isolated FDS contraction in individual fingers against valgus stress in the elbow joint using stress ultrasonography (US).Methods: We investigated 17 healthy males (mean age, 27 ± 5 years). Valgus stress US was performed using the Telos device, with the elbow at 30° flexion. MJD was measured for each arm during 3 separate conditions: at rest (unloaded), under valgus load (50 N) (loaded), and under valgus load with FDS contracted in individual fingers (loaded-contracted). Results: MJD was significantly longer when loaded (5.4 ± 0.4 mm) than unloaded (4.1 ± 0.2 mm, P = .007) or loaded-contracted (4.6 ± 0.3 mm, P = .003) for each finger. When loaded-contracted, MJD differed statistically between the index and ring fingers (P = .03) and between the middle and ring fingers (P = .04). However, the difference between the index and middle fingers was not statistically significant (P = .08).  Conclusions: Individual FDS contraction, particularly of the index and middle fingers contributes most to stabilization against valgus stress. Thus, injury care programs should incorporate FDS exercises of these fingers.

scholarly journals The Effect of Ulnar Collateral Ligament Repair With Internal Brace Augmentation on Articular Contact Mechanics: A Cadaveric Study

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712110010
Author(s):  
Travis S. Roth ◽  
David P. Beason ◽  
T. Bradley Clay ◽  
E. Lyle Cain ◽  
Jeffrey R. Dugas
Keyword(s):  
Contact Mechanics ◽  
Elbow Joint ◽  
Angular Displacement ◽  
Ulnar Collateral Ligament ◽  
Biomechanical Properties ◽  
Joint Torque ◽  
Return To Play ◽  
Ligament Repair ◽  
Collateral Ligament ◽  
Intact State

Background: There has been renewed interest in ulnar collateral ligament (UCL) repair in throwing athletes because of a greater understanding of UCL injuries, improvement in ligament repair technology, and potentially expedited rehabilitation time and return to play relative to UCL reconstruction. Purpose: To evaluate elbow articular contact and overall joint torque after UCL reconstruction and repair augmented with a collagen-coated fiber tape, InternalBrace. Study Design: Controlled laboratory study. Methods: Ten matched pairs of cadaveric arms (mean age, 41 ± 11 years) were dissected to expose the UCL. Each specimen was secured into a custom test fixture at 90°, and 1 specimen from each pair underwent either a modified Jobe UCL reconstruction or UCL repair with InternalBrace. Each specimen underwent 10 cycles of elbow valgus angular displacement between 0° and 5° at a rate of 1 deg/s in the intact state, after UCL avulsion, and then after UCL reconstruction or repair. Articular contact mechanics and overall joint torque and stiffness were recorded. Results: Contact mechanics of reconstructed and repaired specimens were not significantly different. Both reconstruction and repair procedures returned the overall resistance of the joint to valgus torsion to near-intact levels. UCL repair tended to restore joint torque more closely to the intact state than did reconstruction, given that reconstruction showed a nonsignificant trend toward lower torque than the intact state ( P = .07). Conclusion: Neither UCL reconstruction nor UCL repair with InternalBrace overconstrained the elbow joint, as both groups had similar contact pressures compared with the native joint. Both procedures also restored elbow joint torque and stiffness to levels not statistically different from the intact state. Clinical Relevance: Given the sound biomechanical properties of UCL repair with InternalBrace, it may have a significant role as treatment for UCL injuries.

Medial Elbow Joint Laxity in Professional Baseball Pitchers

1998 ◽  
Vol 26 (3) ◽  
pp. 420-424 ◽  
Author(s):  
Todd S. Ellenbecker ◽  
Angelo J. Mattalino ◽  
Erik A. Elam ◽  
Roger A. Caplinger
Keyword(s):  
Elbow Joint ◽  
Joint Space Width ◽  
Ulnar Collateral Ligament ◽  
Joint Space ◽  
Professional Baseball ◽  
Stress Radiography ◽  
Collateral Ligament ◽  
Valgus Stress ◽  
Baseball Pitchers ◽  
Space Width

Injuries to the ulnar collateral ligament frequently occur in throwing athletes because of large, repetitive valgus stresses to the elbow during the cocking and acceleration phases of throwing. Identification of injury to this ligament is important in evaluating the throwing elbow. The purpose of this study was to determine whether differences in medial elbow laxity exist between the dominant and nondominant extremities in uninjured baseball pitchers. Forty uninjured professional baseball pitchers were tested bilaterally with a Telos GA-IIE stress radiography device. Joint space width between the trochlea of the humerus and the coronoid process of the ulna was measured on anteroposterior radiographs obtained with no stress applied and with a 15-daN valgus stress. Results showed significant differences between the medial joint space opening of the dominant and nondominant elbows with no stress applied. With stress, the dominant elbow opened 1.20 0.97 mm, while the nondominant elbow opened 0.88 0.55 mm. A significantly greater difference in medial joint space opening between the stressed and unstressed elbows was measured in the dominant elbow compared with the nondominant elbow (0.32 0.42 mm). This study identifies increased medial elbow laxity in the dominant arm in uninjured pitchers.

scholarly journals Valgus Stability is Enhanced by Flexor Digitorum Superficialis Muscle Contraction of the Index and Middle Fingers

2020 ◽  
Author(s):  
Shota Hoshika ◽  
Akimoto Nimura ◽  
Norimasa Takahashi ◽  
Hiroyuki Sugaya ◽  
Keiichi Akita
Keyword(s):  
Muscle Contraction ◽  
Elbow Joint ◽  
Ulnar Collateral Ligament ◽  
Flexor Digitorum Profundus ◽  
Flexor Digitorum Superficialis ◽  
Collateral Ligament ◽  
Valgus Stress ◽  
The Difference ◽  
Flexor Digitorum ◽  
Healthy Males

Abstract Background: Flexor digitorum superficialis (FDS) muscle provides dynamic stabilization and medial elbow support for ulnar collateral ligament (UCL). The FDS contraction significantly affects the medial joint distance (MJD) through grip contraction. However, it remains unclear whether FDS activity alone contributes to medial elbow stability, or together with the activation of the flexor digitorum profundus during grip contraction, and which finger’s FDS is the main contributor to elbow stability. We investigated the resistive effects of isolated FDS contraction in individual fingers against valgus stress in the elbow joint using stress ultrasonography (US). Methods: We investigated 17 healthy males (mean age, 27 ± 5 years). Valgus stress US was performed using the Telos device, with the elbow at 30° flexion. MJD was measured for each arm during 3 separate conditions: at rest (unloaded), under valgus load (50 N) (loaded), and under valgus load with FDS contracted in individual fingers (loaded-contracted). Results : MJD was significantly longer when loaded (5.4 ± 0.4 mm) than unloaded (4.1 ± 0.2 mm, P = .007 ) or loaded-contracted (4.6 ± 0.3 mm, P = .003 ) for each finger. When loaded-contracted, MJD differed statistically between the index and ring fingers ( P = .03 ) and between the middle and ring fingers ( P = .04 ). However, the difference between the index and middle fingers was not statistically significant ( P = . 08 ). Conclusion s : Individual FDS contraction, particularly of the index and middle fingers contributes most to stabilization against valgus stress. Thus, injury care programs should incorporate FDS exercises of these fingers.

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