Reduction of olecranon fractures with no or minimal dorsal cortex comminution based on the contour of the posterior ulnar cortex: does it restore the greater sigmoid notch?

Author(s):  
Seung Hoo Lee ◽  
Min Bom Kim ◽  
Young Ho Lee ◽  
Hyo-Jin Kang
Author(s):  
Valentin Rausch ◽  
Sina Neugebauer ◽  
Tim Leschinger ◽  
Lars Müller ◽  
Kilian Wegmann ◽  
...  

Abstract Introduction This study aimed to describe the involvement of the lesser sigmoid notch in fractures to the coronoid process. We hypothesized that injuries to the lateral aspect of the coronoid process regularly involve the annular ligament insertion at the anterior lesser sigmoid notch. Material and Methods Patients treated for a coronoid process fracture at our institution between 06/2011 and 07/2018 were included. We excluded patients < 18 years, patients with arthritic changes or previous operative treatment to the elbow, and patients with concomitant injuries to the proximal ulna. In patients with involvement of the lesser sigmoid notch, the coronoid height and fragment size (anteroposterior, mediolateral, and craniocaudal) were measured. Results Seventy-two patients (mean age: 47 years ± 17.6) could be included in the study. Twenty-one patients (29.2%) had a fracture involving the lateral sigmoid notch. The mean anteroposterior fragment length was 7 ± 1.6 mm. The fragment affected a mean of 43 ± 10.8% of the coronoid height. The mean mediolateral size of the fragment was 10 ± 5.0 mm, and the mean cranio-caudal size was 7 ± 2.7 mm. Conclusion Coronoid fractures regularly include the lesser sigmoid notch. These injuries possibly affect the anterior annular ligament insertion which is important for the stability of the proximal radioulnar joint and varus stability of the elbow.


2019 ◽  
Vol 13 (1) ◽  
pp. 208-216
Author(s):  
Thord von Schewelov ◽  
Fredrik Hertervig ◽  
Per-Olof Josefsson ◽  
Jack Besjakov ◽  
Ralph Hasserius

Background: It is unclear if the outcomes differ in different subtypes of olecranon fractures. Objective: Evaluate the outcomes of different Colton types of olecranon fractures, and if outcomes differ in dominant and non-dominant arms and in men and women. Methods: We evaluated primary journals and radiographs in 40 men and 55 women with isolated olecranon fractures and classified fractures according to Colton. Mean 19 years after fracture event, we re-examined subjective, clinical and radiographic outcomes in the former patients, using the uninjured arms as controls. Results: 89% of patients with Colton type I fractures reported at follow-up no subjective differences between the elbows, 84% with type II oblique/transverse fractures and 84% with type II comminuted fractures (p=0.91). The uninjured to former fractured arm differences in elbow range of motion and strength were no different in the 3 fracture types, the proportions of individuals with radiographic elbow degenerative changes were greater in type II than in type I factures (p<0.001), and there were no differences between the proportions of individuals with reduced joint space in the 3 groups (p=0.40). The outcomes were no different if the fractures had occurred in the dominant or non-dominant arms (p=0.43), or in men or women (p=0.43). Conclusion: There were no different outcomes after Colton type I, type II oblique/transverse or type II comminuted fractures, no different outcomes between fractures in dominant or non-dominant arms and no different outcomes in men and women.


2021 ◽  
Vol 10 (2) ◽  
pp. e325-e331
Author(s):  
Roddy McGee ◽  
Shain Howard ◽  
Daniel LeCavalier ◽  
Adam Eudy ◽  
Randa Bascharon ◽  
...  

2021 ◽  
pp. 175857322098785
Author(s):  
Aparna Viswanath ◽  
Jill L Thomas ◽  
Adam C Watts

The coronoid is one of the elbow’s primary static stabilisers, and the importance of reconstruction following fracture with instability has been established. In the developing elbow, instability can lead to greater sigmoid notch dysplasia that can make reconstruction challenging. A novel technique to improve osseous stability with an opening wedge ‘stamp osteotomy’ reconstruction of the coronoid is described combined with a lateral ligament reconstruction, in two patients with recurrent posteromedial rotatory instability. The technique improves congruity and coverage of the greater sigmoid notch with the trochlea whilst maintaining articular cartilage. Extra-articular iliac crest bone graft is used to maintain the position with buttress plate support. The surgical technique is described and the clinical and radiographic outcome reported in two patients. Level of evidence: IV.


Author(s):  
Ida K. Rantalaiho ◽  
Inari E. Laaksonen ◽  
Anssi J. Ryösä ◽  
Katariina Perkonoja ◽  
Kari J. Isotalo ◽  
...  

Open Mind ◽  
2020 ◽  
Vol 4 ◽  
pp. 40-56 ◽  
Author(s):  
Erez Freud ◽  
Marlene Behrmann ◽  
Jacqueline C. Snow

According to the influential “Two Visual Pathways” hypothesis, the cortical visual system is segregated into two pathways, with the ventral, occipitotemporal pathway subserving object perception, and the dorsal, occipitoparietal pathway subserving the visuomotor control of action. However, growing evidence suggests that the dorsal pathway also plays a functional role in object perception. In the current article, we present evidence that the dorsal pathway contributes uniquely to the perception of a range of visuospatial attributes that are not redundant with representations in ventral cortex. We describe how dorsal cortex is recruited automatically during perception, even when no explicit visuomotor response is required. Importantly, we propose that dorsal cortex may selectively process visual attributes that can inform the perception of potential actions on objects and environments, and we consider plausible developmental and cognitive mechanisms that might give rise to these representations. As such, we consider whether naturalistic stimuli, such as real-world solid objects, might engage dorsal cortex more so than simplified or artificial stimuli such as images that do not afford action, and how the use of suboptimal stimuli might limit our understanding of the functional contribution of dorsal cortex to visual perception.


2019 ◽  
Vol 45 (4) ◽  
pp. 339-347
Author(s):  
Atsuo Shigi ◽  
Kunihiro Oka ◽  
Kohji Kuriyama ◽  
Hiroyuki Tanaka ◽  
Hideki Yoshikawa ◽  
...  

Understanding the complex fragmentation of intra-articular distal radial fractures contributes to achieving anatomical reduction during surgery. This study aimed to clarify three-dimensional displacement patterns of intra-articular fragmentation in dorsally angulated, intra-articular distal radial fractures. We identified five characteristic intra-articular fragments: a key fragment, dorsal ulnar corner, dorsal wall, radial column and anterior radial column. The key fragment was displaced with radial deviation, pronation and extension and with dorsal, proximal and radial translations. The dorsal ulnar corner displacement resulted in a gap, a step-off and a deepened concavity for the lunate facet and sigmoid notch. The dorsal wall displacement resulted in a deepened concavity, a gap and a step-off of the dorsal scaphoid facet. The displacements of the radial column and anterior radial column caused a step-off between the scaphoid and lunate facets. The five characteristic intra-articular fragments each created a characteristic gap and step-off in the articular surface. Level of evidence: IV


2006 ◽  
Vol 95 (3) ◽  
pp. 1926-1935 ◽  
Author(s):  
Liang-Fa Liu ◽  
Alan R. Palmer ◽  
Mark N. Wallace

In the auditory system, some ascending pathways preserve the precise timing information present in a temporal code of frequency. This can be measured by studying responses that are phase-locked to the stimulus waveform. At each stage along a pathway, there is a reduction in the upper frequency limit of the phase-locking and an increase in the steady-state latency. In the guinea pig, phase-locked responses to pure tones have been described at various levels from auditory nerve to neocortex but not in the inferior colliculus (IC). Therefore we made recordings from 161 single units in guinea pig IC. Of these single units, 68% (110/161) showed phase-locked responses. Cells that phase-locked were mainly located in the central nucleus but also occurred in the dorsal cortex and external nucleus. The upper limiting frequency of phase-locking varied greatly between units (80−1,034 Hz) and between anatomical divisions. The upper limits in the three divisions were central nucleus, >1,000 Hz; dorsal cortex, 700 Hz; external nucleus, 320 Hz. The mean latencies also varied and were central nucleus, 8.2 ± 2.8 (SD) ms; dorsal cortex, 17.2 ms; external nucleus, 13.3 ms. We conclude that many cells in the central nucleus receive direct inputs from the brain stem, whereas cells in the external and dorsal divisions receive input from other structures that may include the forebrain.


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