scholarly journals Inner Synovial Membrane Footprint of the Anterior Elbow Capsule: An Arthroscopic Boundary

2015 ◽  
Vol 2015 ◽  
pp. 1-10
Author(s):  
Srinath Kamineni ◽  
Abdo Bachoura ◽  
Koichi Sasaki ◽  
Danielle Reilly ◽  
Kate N. Harris ◽  
...  
Keyword(s):  
Current Literature ◽  
Synovial Membrane ◽  
Distal Humerus ◽  
Medial Epicondyle ◽  
Medial Aspect ◽  
Lateral Epicondyle ◽  
Capsular Release ◽  
Working Space ◽  
The Mean ◽  
Gender Based

Introduction. The purpose of this study is to describe the inner synovial membrane (SM) of the anterior elbow capsule, both qualitatively and quantitatively. Materials and Methods. Twenty-two cadaveric human elbows were dissected and the distal humerus and SM attachments were digitized using a digitizer. The transepicondylar line (TEL) was used as the primary descriptor of various landmarks. The distance between the medial epicondyle and medial SM edge, SM apex overlying the coronoid fossa, the central SM nadir, and the apex of the SM insertion overlying the radial fossa and distance from the lateral epicondyle to lateral SM edge along the TEL were measured and further analyzed. Gender and side-to-side statistical comparisons were calculated. Results. The mean age of the subjects was 80.4 years, with six male and five female cadavers. The SM had a distinctive double arched attachment overlying the radial and coronoid fossae. No gender-based or side-to-side quantitative differences were noted. In 18 out of 22 specimens (81.8%), an infolding extension of the SM was observed overlying the medial aspect of the trochlea. The SM did not coincide with the outer fibrous attachment in any specimen. Conclusion. The humeral footprint of the synovial membrane of the anterior elbow capsule is more complex and not as capacious as commonly understood from the current literature. The synovial membrane nadir between the two anterior fossae may help to explain and hence preempt technical difficulties, a reduction in working arthroscopic volume in inflammatory and posttraumatic pathologies. This knowledge should allow the surgeon to approach this aspect of the anterior elbow compartment space with the confidence that detachment of this synovial attachment, to create working space, does not equate to breaching the capsule. Alternatively, stripping the synovial attachment from the anterior humerus does not constitute an anterior capsular release.

ANATOMICAL STUDY OF ARCADE OF STRUTHERS

Hand Surgery ◽  
2010 ◽  
Vol 15 (03) ◽  
pp. 157-159 ◽  
Author(s):  
Piyapong Tiyaworanan ◽  
Surut Jianmongkol ◽  
Tala Thammaroj
Keyword(s):  
Ulnar Nerve ◽  
Anatomical Study ◽  
Medial Epicondyle ◽  
Anatomical Location ◽  
Greater Tuberosity ◽  
Lateral Epicondyle ◽  
Surgical Exploration ◽  
Fresh Frozen ◽  
The Mean ◽  
Proximal Border

The incidence and the anatomical location of the arcade of Struthers as related to the arm length were studied in 62 arms of adult fresh-frozen cadavers. The distance between the greater tuberosity and the lateral epicondyle was designated as the arm length. The arcades of Struthers were identified in 85.4%. The mean arm length was 27.85 ± 1.3 cm. The mean of the distance between proximal border of the arcade of Struthers and the medial humeral epicondyle was 8.24 ± 2.06 cm. The mean ratio between the distance from the proximal border of the arcade to the tip of the medial epicondyle and arm length was 0.29 ± 0.07. We concluded that the anatomical location of the arcade as related to the arm length was 29% proximally, from the tip of the medial epicondyle. This report of the anatomical location of the arcade of Struthers related to the arm length can be useful to identify this structure in the arms which have differences in arm length during the surgical exploration and anterior transposition of the ulnar nerve procedures.

The feline humerus

2005 ◽  
Vol 18 (01) ◽  
pp. 01-06 ◽  
Author(s):  
M. Straw ◽  
S. J. Langley-Hobbs
Keyword(s):  
Cross Sections ◽  
Distal Humerus ◽  
Medial Epicondyle ◽  
Medial Aspect ◽  
Diameter Range ◽  
Humeral Condyle

SummaryThe humeri of eleven feline cadavers were dissected and safe anatomical areas for placing external skeletal fixator pins were determined. Relevant measurements taken of the humeral condyle enabled a determination of a safe pin diameter range of 1.5 to 2.2 mm for transcondylar pins. Further anatomical measurements allowed recommendations to be made to angle pins in the distal humerus in a distolateral proximomedial direction so that the ESF pin penetrates the far cortex at least 20 mm proximal to the medial epicondyle in order to avoid pin penetration of the supracondylar foramen. Cross sections taken of the distal humerus revealed that passage of an IM pin into the medial aspect of the humeral condyle was possible in less than half the cases.

scholarly journals Morphological and Morphometric Study of the Supratrochlear Foramen

2018 ◽  
Vol 35 (01) ◽  
pp. 54-57
Author(s):  
F.A. Silva ◽  
T.S. Silva ◽  
P.R.F.B. Souza ◽  
R.S. Reis ◽  
M.R.S. Ferreira ◽  
...  
Keyword(s):  
Distal Humerus ◽  
Distal Portion ◽  
Medullary Canal ◽  
Human Bone ◽  
Morphometric Study ◽  
Left Handed ◽  
Academic Center ◽  
Preoperative Procedures ◽  
The Mean ◽  
The Right

Introduction The supratrochlear foramen (SF) is located in the distal portion of the humerus, formed in between the coronoid fossa and the olecranon fossa. Is associated with a narrowing of the medullary canal in the distal humerus, in addition to being a phylogenetic characteristic, more common in ancient populations. The objective was to evaluate the incidence of the supratrochlear foramen, it's shape, dimensions and translucency of the septum. Materials and Methods A total of 141 humerus adults, 72 right and 69 left-handed individuals from the collection of the Human Bone of the Academic Center of Vitória-Brazil. The format was classified as oval, round, irregular and cribriform. The vertical (VD) and transversal (TD) diameter were measured and the translucency of the septum was observed. Results Of the 141 humerus, 19.8% (28) had SF 39.3% (11) on the right side and 60.7% (17) on the left side. The oval was the most recurrent, found in 39% of the cases and the translucency was identified in 78% (110) of the bones. The mean VD was 3.653 mm and 3.492 mm on the right and left sides, respectively. The mean of the TD was 4.853 mm on the right side and 5.427 mm on the left. The area averages were 19.633 ± 20.57 mm2 on the right side and 19.919 ± 19.24 mm2 on the left side. Conclusion The knowledge of SF favors the preoperative procedures of patients with fractures in the distal humerus, necessary for the surgeries in the region.

scholarly journals Location of the radial nerve along the humeral shaft between the prone and lateral decubitus positions at different elbow positions

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sitthiphong Suwannaphisit ◽  
Wachirakorn Aonsong ◽  
Porames Suwanno ◽  
Chaiwat Chuaychoosakoon
Keyword(s):  
Radial Nerve ◽  
Minimum Distance ◽  
Posterior Approach ◽  
Elbow Flexion ◽  
Lateral Decubitus Position ◽  
Full Extension ◽  
Posterior Aspect ◽  
Lateral Epicondyle ◽  
Lateral Decubitus ◽  
The Mean

AbstractIdentification of the radial nerve is important during the posterior approach to a humerus fracture. During this procedure, the patient can be placed in the prone or lateral decubitus position depending on the surgeon’s preference. The distance from the radial nerve to the osseous structures will be different in each position. The purpose of this study was to identify the safety zones in various patient and elbow flexion positions. The distances from the olecranon to the center of the radial groove and intermuscular septum and lateral epicondyle to the lateral intermuscular septum were measured using a digital Vernier caliper. The measurements were performed with cadavers in the lateral decubitus and prone positions at different elbow flexion angles. The distance from where the radial nerve crossed the posterior aspect of the humerus measured from the upper part of the olecranon to the center of the radial nerve in both positions at different elbow flexion angles varied from a mean maximum distance of 130.00 mm with the elbow in full extension in the prone position to a minimum distance of 121.01 mm with the elbow in flexion at 120° in the lateral decubitus position. The mean distance of the radial nerve from the upper olecranon to the lateral intermuscular septum varied from 107.13 to 102.22 mm. The distance from the lateral epicondyle to the lateral edge of the radial nerve varied from 119.92 to 125.38 mm. There was not significant contrast in the position of the radial nerve with osseous landmarks concerning different degrees of flexion, except for 120°, which is not significant, as this flexion angle is rarely used.

scholarly journals A rare branching pattern of ulnar nerve in the lower arm

2014 ◽  
Vol 31 (03) ◽  
pp. 159-161
Author(s):  
O. Oyedun ◽  
O. Onatola ◽  
C. Kanu ◽  
O. Zelibe
Keyword(s):  
Case Report ◽  
Ulnar Nerve ◽  
Surgical Repair ◽  
Medial Epicondyle ◽  
Branching Pattern ◽  
Medial Aspect ◽  
Nerve Blockade ◽  
Male Cadaver

Abstract Introduction: The ulnar nerve is one of the two terminal branches of the medial cord. It passes down the medial aspect of the arm and runs posterior to medial epicondyle to enter the forearm without branching. Previously, ulnar nerve variations have been consistently located in origin or course of the distal branches. Case Report: In this present case, an unreported rare bifurcation of ulnar nerve was seen in the left lower arm of a 65 year male cadaver with the resulting posteromedial and anterolateral branches arising above the medial epicondyle in.Its phylogeny and implications are discussed in detail. Conclusion: A lack of awareness of variations might complicate surgical repair and may cause ineffective nerve blockade.

scholarly journals Rheumatic manifestations of Chikungunya virus infection: Prevalence, patterns, and enthesitis

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249867
Author(s):  
Saovanee Benjamanukul ◽  
Manathip Osiri ◽  
Jira Chansaenroj ◽  
Chintana Chirathaworn ◽  
Yong Poovorawan
Keyword(s):  
Chikungunya Virus ◽  
Inflammatory Rheumatic Diseases ◽  
Infection Prevalence ◽  
Chikv Infection ◽  
Lateral Epicondyle ◽  
Factors Associated ◽  
Response Parameter ◽  
Rheumatic Manifestations ◽  
The Mean ◽  
Rheumatic Symptoms

Chikungunya virus (CHIKV) is an arthropod-borne virus transmitted by mosquitoes of the genus Aedes. CHIKV infection causes various rheumatic symptoms, including enthesitis; however, these effects are rarely investigated. The aim of this study was to describe the rheumatic manifestations in CHIKV infection, estimate the prevalence of enthesitis in CHIKV-infected patients, and determine the factors associated with CHIKV-induced enthesitis. We conducted a prospective, observational study in patients with CHIKV infection confirmed by positive RT-PCR or IgM assay from October 2019 to March 2020. Patients with pre-existing inflammatory rheumatic diseases were excluded. A rheumatologist evaluated the demographic and clinical characteristics of the patients, including the number of inflamed joints, enthesitis sites, tendinitis, and tenosynovitis. The Leeds enthesitis index (LEI) and the Maastricht ankylosing spondylitis enthesis score (MASES) were used to evaluate enthesitis sites. Factors associated with enthesitis were determined using logistic regression analysis. One hundred and sixty-four participants diagnosed with CHIKV infection were enrolled. The mean (SD) age of the patients was 48.2 (14) years. The most common pattern of rheumatic manifestations was polyarthritis with or without enthesitis. Enthesitis was observed in 63 patients (38.4%). The most common site of enthesitis was the left lateral epicondyle as assessed by LEI and the posterior superior iliac spine as assessed by MASES. Multivariate analysis indicated that the number of actively inflamed joints and Thai-HAQ score at the initial evaluation were significantly associated with the presence of enthesitis. The main rheumatic manifestations of CHIKV infection were arthritis/arthralgia, with enthesitis as a prominent extraarticular feature. CHIKV infection can cause enthesitis at peripheral and axial sites. We found that enthesitis was associated with a high number of inflamed joints and reduced physical function. These results indicate that the assessment of enthesitis should be considered when monitoring disease activity and as a treatment response parameter in CHIKV-infected patients.

scholarly journals Arthroscopic capsular release for idiopathic frozen shoulder with intra-articular injection and a controlled manipulation

2014 ◽  
Vol 96 (1) ◽  
pp. 55-60 ◽  
Author(s):  
CD Smith ◽  
P Hamer ◽  
TD Bunker
Keyword(s):  
Pain Relief ◽  
Range Of Motion ◽  
Frozen Shoulder ◽  
Stage Ii ◽  
Capsular Release ◽  
Oxford Shoulder Score ◽  
Arthroscopic Capsular Release ◽  
Good Pain Relief ◽  
The Mean ◽  
Shoulder Score

INTRODUCTION The aim of this prospective study was to assess the immediate and long-term effectiveness of arthroscopic capsular release in a large cohort of patients with a precise and isolated diagnosis of stage II idiopathic frozen shoulder. METHODS All patients underwent a preoperative evaluation. Patients with secondary frozen shoulder and those with concurrent pathology at arthroscopy were excluded. This left 136 patients with a stage II arthroscopically confirmed idiopathic frozen shoulder. At each postoperative attendance, a record was made of pain, function and range of motion. At 12 months, the Oxford shoulder score was calculated, and pain and range of motion were assessed. RESULTS Fifty per cent achieved good pain relief within a week and eighty per cent within six weeks of arthroscopic capsular release. The mean preoperative visual analogue scale pain score was 6.6 and the mean postoperative score was 1.0. The mean time to achieving good pain relief was 16 days following surgery. No patient could sleep through the night prior to surgery while 90% reported having a complete night’s sleep at a mean of 12 days after surgery. The mean postoperative Oxford shoulder score was 38/48 and the mean improvement was 19.2. CONCLUSIONS This large series demonstrates that arthroscopic capsular release is a safe procedure, with rapid improvement in pain and a marked improvement in range of motion.

Primary Research on Arabic Visemes, Analysis in Space and Frequency Domain

2011 ◽  
Vol 3 (4) ◽  
pp. 1-19
Author(s):  
Fatma Zohra Chelali ◽  
Amar Djeradi
Keyword(s):  
Standard Deviation ◽  
Frequency Domain ◽  
Current Literature ◽  
Visual Signal ◽  
Primary Research ◽  
Gray Scale ◽  
Male And Female ◽  
The Mean ◽  
Pitch Analysis

Visemes are the unique facial positions required to produce phonemes, which are the smallest phonetic unit distinguished by the speakers of a particular language. Each language has multiple phonemes and visemes, and each viseme can have multiple phonemes. However, current literature on viseme research indicates that the mapping between phonemes and visemes is many-to-one: there are many phonemes which look alike visually, and hence they fall into the same visemic category. To evaluate the performance of the proposed method, the authors collected a large number of speech visual signal of five Algerian speakers male and female at different moments pronouncing 28 Arabic phonemes. For each frame the lip area is manually located with a rectangle of size proportional to 120*160 and centred on the mouth, and converted to gray scale. Finally, the mean and the standard deviation of the values of the pixels of the lip area are computed by using 20 images for each phoneme sequence to classify the visemes. The pitch analysis is investigated to show its variation for each viseme.

Transoral Incisionless Fundoplication: Initial Experience in Patients Referred to an Integrated Academic Institution

2011 ◽  
Vol 77 (10) ◽  
pp. 1386-1389 ◽  
Author(s):  
Allan Nguyen ◽  
Thomas Vo ◽  
Xuan-Mai T. Nguyen ◽  
Brian R. Smith ◽  
Kevin M. Reavis
Keyword(s):  
Gastric Surgery ◽  
Late Complications ◽  
Initial Experience ◽  
Additional Time ◽  
Transoral Incisionless Fundoplication ◽  
Working Space ◽  
Symptom Scores ◽  
The Mean ◽  
New Treatment

Transoral incisionless fundoplication is a new treatment for patients with gastroesophageal reflux disease. We present our initial experience with 10 patients undergoing this procedure with varying past surgical histories. All procedures were performed under general nasotracheal anesthesia. RAND-36 and Visual Analog Scale symptom scores were collected at pre and postoperative appointments for a mean of 9.2 months. The mean procedure time was 68 minutes. There were no intraoperative or postoperative complications. Patients with prior pancreaticoduodenectomy had observed reduced working space due to prior distal gastrectomy and required additional insufflation due to no pyloric resistance to insufflation of the small bowel. The patient with prior fundoplication required additional time and force for fastener penetration of the resultant scar from the partially disrupted fundoplication. All patients were discharged within 23 hours of the procedure. Throughout the follow-up period, patients reported gradual changes in medication requirements and symptom scores. There were no late complications. Transoral incisionless fundoplication is technically safe in well-selected patients including those with prior esophageal and gastric surgery.

scholarly journals USE OF A WASHER DOES NOT AFFECT THE RATE OF IMPLANT REMOVAL OR ELBOW MOTION AFTER FIXATION OF MEDIAL EPICONDYLE FRACTURES

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0018
Author(s):  
Neeraj M. Patel ◽  
Christopher R. Gajewski ◽  
Anthony M. Ascoli ◽  
J. Todd Lawrence
Keyword(s):  
Screw Fixation ◽  
Univariate Analysis ◽  
Medial Epicondyle ◽  
Implant Removal ◽  
Hardware Removal ◽  
Rank Test ◽  
Retrospective Case ◽  
Significant Difference ◽  
The Mean ◽  
The Impact

Background: The use of a washer to supplement screw fixation can prevent fragmentation and penetration during the surgical treatment of medial epicondyle fractures. However, concerns may arise regarding screw prominence and the need for subsequent implant removal. The purpose of this study is to evaluate the impact of washer utilization on the need for hardware removal and elbow range of motion (ROM). Methods: All surgically-treated pediatric medial epicondyle fractures over a 7-year period were queried for this retrospective case-control study. Patients were only included if their fracture was fixed with a single screw with or without a washer. Per institutional protocol, implants were not routinely removed after fracture healing. Hardware removal was performed only if the patient experienced a complication or implant-related symptoms that were refractory to non-operative management. Full ROM was considered flexion beyond 130 degrees and less than a 10-degree loss of extension. Univariate analysis was followed by creation of Kaplan-Meier (one minus survival) curves in order to analyze the time until full ROM was regained after surgery. Curves between patients with and without a washer were compared with a log rank test. Results: Of the 137 patients included in the study, the mean age was 12.2±2.3 years and 85 (62%) were male. A total of 31 (23%) patients ultimately underwent hardware removal. A washer was utilized in 90 (66%) cases overall. There was not an increased need for subsequent implant removal in these patients compared to those that underwent screw fixation alone (p=0.11). The mean BMI of patients that underwent hardware removal (19.1±2.5) was similar to that of children who did not (20.4±3.5, p=0.06). When analyzing a subgroup of 102 athletes only, there was similarly no difference in the rate of implant removal if a washer was used (p=0.64). Overall, 107 (78%) patients regained full ROM at a mean of 13.9±9.7 weeks after surgery (Figure 1). There was no statistically significant difference in the proportions of patients with and without a washer that achieved full ROM (p=0.46). Full ROM was achieved at a mean of 14.1±11.0 weeks in those with a washer compared to 13.6±6.2 weeks in those without one (p=0.21). Conclusions: Use of a washer did not affect the need for subsequent implant removal or elbow ROM after fixation of pediatric medial epicondyle fractures, even in thinner patients or competitive athletes. If there is concern for fracture fragmentation or penetration, a washer can be included without concern that future unplanned surgeries may be required.

Sign in / Sign up

Export Citation Format

Share Document