Traumatic Elbow Ligamentous Injury

2022 ◽  
pp. 315-326
Author(s):  
Adam C. Watts
Keyword(s):  
Ligamentous Injury

Motion Analysis of the Cervical Spine

2004 ◽  
Vol 9 (5) ◽  
pp. 1-11
Author(s):  
Patrick R. Luers
Keyword(s):  
Cervical Spine ◽  
Intervertebral Disk ◽  
Radiographic Evaluation ◽  
Ligamentous Injury ◽  
Pattern Of Injury ◽  
Motion Segment ◽  
Single Pattern ◽  
Compensatory Motion ◽  
Loss Of Motion ◽  
Flexion And Extension

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, defines a motion segment as “two adjacent vertebrae, the intervertebral disk, the apophyseal or facet joints, and ligamentous structures between the vertebrae.” The range of motion from segment to segment varies, and loss of motion segment integrity is defined as “an anteroposterior motion of one vertebra over another that is greater than 3.5 mm in the cervical spine, greater than 2.5 mm in the thoracic spine, and greater than 4.5 mm in the lumbar spine.” Multiple etiologies are associated with increased motion in the cervical spine; some are physiologic or compensatory and others are pathologic. The standard radiographic evaluation of instability and ligamentous injury in the cervical spine consists of lateral flexion and extension x-ray views, but no single pattern of injury is identified in whiplash injuries. Fluoroscopy or cineradiographic techniques may be more sensitive than other methods for evaluating subtle abnormal motion in the cervical spine. The increased motion thus detected then must be evaluated to determine whether it represents normal physiologic motion, normal compensatory motion, motion related to underlying degenerative disk and/or facet disease, or increased motion related to ligamentous injury. Imaging studies should be performed and interpreted as instructed in the AMA Guides.

scholarly journals Circulating IL-10 is compromised in patients predisposed to developing and in patients with severe knee osteoarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tyler Barker ◽  
Victoria E. Rogers ◽  
Vanessa T. Henriksen ◽  
Roy H. Trawick ◽  
Nathan G. Momberger ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Cruciate Ligament ◽  
Ligamentous Injury ◽  
Radiographic Evidence ◽  
X Ray ◽  
Tnf Α ◽  
Total Knee ◽  
Anterior Cruciate ◽  
Anterior Cruciate Ligament Surgery ◽  
Necrosis Factor

AbstractThe purpose of this investigation was to identify if serum interleukin (IL)-10 and tumor necrosis factor (TNF)-α concentrations and their ratio (IL-10/TNF-α) are altered in subjects predisposed to developing knee osteoarthritis following ligamentous injury and in those with severe knee osteoarthritis. Serum IL-10 and TNF-α concentrations were measured in four groups of subjects (n = 218): (1) reportedly-healthy and non-injured control subjects (CON; n = 92), (2) subjects scheduled to undergo anterior cruciate ligament surgery (ACL; n = 42), (3) non-surgical subjects with knee osteoarthritis (OA; n = 60), and (4) subjects with knee osteoarthritis scheduled to undergo total knee arthroplasty (TKA; n = 24). X-ray images were used to grade the severity of knee osteoarthritis. Serum IL-10 and the serum IL-10/TNF-α ratio were significantly lower while serum TNF-α was not significantly perturbed with severe compared to moderate knee osteoarthritis (i.e., Kellgren-Lawrence grade 4 vs. 3, respectively). Serum IL-10 was significantly lower in the absence of serum TNF-α alterations in the ACL group. We conclude that serum IL-10 concentrations are compromised in subjects predisposed to developing knee osteoarthritis following ligamentous trauma and in subjects with radiographic evidence of severe knee osteoarthritis.

SCAPHOID TRANSLATION MEASUREMENTS IN NORMAL WRISTS

Hand Surgery ◽  
2013 ◽  
Vol 18 (02) ◽  
pp. 179-187 ◽  
Author(s):  
Ronit Wollstein ◽  
Frederick W. Werner ◽  
Roee Rubenstein ◽  
Christopher R. Nacca ◽  
Richard A. Bilonick ◽  
...  
Keyword(s):  
Random Error ◽  
Precise Measurement ◽  
Scapholunate Ligament ◽  
Radius Fractures ◽  
Ligamentous Injury ◽  
Ulnar Deviation ◽  
Radial Styloid ◽  
Normal Measure ◽  
Indirect Evaluation

The purpose of this study was to establish a normal measure of scaphoid position in the radioulnar plane in standard neutral, radial and ulnar deviation posteroanterior radiographs. This measurement may allow indirect evaluation of the radiocarpal ligaments and comparison between normal and pathologic states (following radius fractures, perilunate dislocations). Measurements were trialed on 74 normal wrist radiographs and 25 cadaver wrists. We evaluated the distance between the radial styloid and the scaphoid and corresponding scaphoid width. The ratio of distance/width at the mid styloid level (0.35, imprecision SD = 0.1) had the lowest random error and is therefore the most precise measurement of true scaphoid translation. This measurement is independent of scapholunate ligament integrity and may provide a better assessment of the radiocarpal component of ulnar translational instability. Abnormal movement of the scaphoid in the radioscaphoid joint likely reflects ligamentous injury. Identifying and addressing these injuries may prevent the development of arthritis.

Pathologic Correlation of Posterior Ligamentous Injury with MRI

Orthopedics ◽  
2010 ◽  
Vol 33 (1) ◽  
pp. 53-55 ◽  
Author(s):  
Mark B. Dekutoski ◽  
Meredith L. Hayes ◽  
Andrew P. Utter ◽  
Jan P. Szatkowski ◽  
John D. Port ◽  
...  
Keyword(s):  
Ligamentous Injury ◽  
Pathologic Correlation

Multiple Ligament Knee Injuries: Does the Knee Dislocation Classification Predict the Type of Surgical Management?

2020 ◽  
Author(s):  
Garrett T. Maxwell ◽  
Ryan J. Warth ◽  
Adeet Amin ◽  
Matthew A. Darlow ◽  
Lane Bailey ◽  
...  
Keyword(s):  
Cohort Study ◽  
Surgical Management ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Knee Injuries ◽  
Knee Dislocation ◽  
Operative Management ◽  
Injury Patterns ◽  
Ligamentous Injury ◽  
The Mean

AbstractThis study aims to evaluate relationships among multiple ligament knee injury (MLKI) patterns as classified according to the knee dislocation (KD) classification and the types of surgical management pursued. We hypothesized that the KD classification would not be predictive of the types of surgical management, and that categorizing injuries according to additional injury features such as structure, chronicity, grade, and topographic location would be predictive of the types of surgical management. This is a Retrospective cohort study. This study was conducted at a level I trauma center with a 150-mile coverage radius. Query of our billing database was performed using combinations of 43 billing codes (International Classification of Diseases [ICD] 9, ICD-10, and Current Procedural Terminology) to identify patients from 2011 to 2015 who underwent operative management for MLKIs. There were operative or nonoperative treatment for individual ligamentous injuries, repair, or reconstruction of individual ligamentous injuries, and staging or nonstaging or nonstaging of each surgical procedure. The main outcome was the nature and timing of clinical management for specific ligamentous injury patterns. In total, 287 patients were included in this study; there were 199 males (69.3%), the mean age was 30.2 years (SD: 14.0), and the mean BMI was 28.8 kg/m2 (SD: 7.4). There were 212 injuries (73.9%) categorized as either KD-I or KD-V. The KD classification alone was not predictive of surgery timing, staging, or any type of intervention for any injured ligament (p > 0.05). Recategorization of injury patterns according to structure, chronicity, grade, and location revealed the following: partial non-ACL injuries were more frequently repaired primarily (p < 0.001), distal medial-sided injuries were more frequently treated operatively than proximal medial-sided injuries (odds ratio [OR] = 24.7; p <0.0001), and staging was more frequent for combined PCL-lateral injuries (OR = 1.3; p = 0.003) and nonavulsive fractures (OR = 1.2; p = 0.0009). The KD classification in isolation was not predictive of any surgical management strategy. Surgical management was predictable when specifying the grade and topographic location of each ligamentous injury. This is a Level IV, retrospective cohort study.

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