Surgical stabilization of traumatic elbow joint luxation and proximal ulnar fracture in a silvery langur (Trachypithecus cristatus)

2021 ◽  
pp. 1-5
Author(s):  
Isabel A. Jimenez ◽  
Daniel I. Spector ◽  
Sarah B. Chaney ◽  
Robert Moore ◽  
Jean A. Paré
Keyword(s):  
Range Of Motion ◽  
Group Dynamics ◽  
Elbow Joint ◽  
Lateral Collateral Ligament ◽  
Annular Ligament ◽  
Monteggia Fracture ◽  
Type Ii ◽  
Collateral Ligament ◽  
Left Elbow ◽  
Ulnar Fracture

Abstract CASE DESCRIPTION A 3-year-old 5-kg sexually intact female silvery langur housed in a single-species group at a zoological institution was presented because of acute trauma to the left forelimb. CLINICAL FINDINGS Radiography of the left forelimb revealed a type II Monteggia fracture (proximal ulnar fracture with cranial displacement and caudal luxation of the radial head). During surgery, disruption of the annular ligament and rupture of the lateral collateral ligament were noted. TREATMENT AND OUTCOME The langur underwent open reduction and internal fixation of the ulnar fracture and placement of a radioulnar positional screw, a prosthetic lateral collateral ligament, and a temporary hinged type 1A external skeletal fixator. The langur was returned to group housing, underwent behavioral training, and was periodically anesthetized for physical therapy sessions to improve range of motion of the left elbow joint. The external skeletal fixator was removed 4 weeks after surgery, and the radioulnar positional screw was removed 6 weeks after surgery. Three months after surgery, the range of motion of the langur’s left elbow joint was considered normal, and the animal returned to normal activity. CLINICAL RELEVANCE For the captive silvery langur of the present report, surgical stabilization and postoperative management of a type II Monteggia fracture of the left forelimb were successful with recovery of elbow joint function. These techniques may be applied to other captive nonhuman primates, including those that brachiate or are members of social species that must be housed with conspecifics in the postoperative period to maintain group dynamics.

scholarly journals Stress And Strain At The Lateral Collateral Ligament Complex Of The Elbow Joint

2007 ◽  
Author(s):  
G O Mbaka ◽  
A B Ejiwunmi ◽  
V U Chukwuma ◽  
O O Odusote
Keyword(s):  
Elbow Joint ◽  
Lateral Collateral Ligament ◽  
Qualitative Assessment ◽  
Annular Ligament ◽  
Stress And Strain ◽  
Collateral Ligament ◽  
Lateral Aspect ◽  
Full Extension ◽  
Radial Collateral Ligament ◽  
The Impact

Background: The radial collateral ligament was previously believed to be the only ligament existing at the lateral aspect of the elbow joint until Morrey and An (1976) classified the ligaments to include radial collateral (RCL) and lateral ulnar collateral ligaments (LUCL). There is therefore the need to assess the impact these ligaments in elbow joint stability. Objective: To investigate how the RCL and LUCL are affected by stress and strain in both routine and forceful movements of the limb. Materials and Methods: Eight (8) embalmed upper extremities were used for this investigation. The elbow joint was dissected with care taken to preserve the lateral ulnar collateral ligament seen in seven of the limbs. Qualitative assessment of ligament tension was made under valgus and varus stresses. The angles at which stress was applied were 450, 700, 750, 900, 1100, 1200 and full extension. These angles were chosen partly because most movements during racket sporting activities take place at higher angles (Regan et al 1991). The angles were determined by hand held goniometer while the arm was firmly held in a retort stand. Results: The RCL is more able to absorb stress and strain because of its greater flexibility enhanced by its attachment at the annular ligament. However, LUCL a thickened mass, in both valgus and varus stresses was taut throughout most of the entire arc of flexion. It is a much stronger ligament that effectively stabilizes elbow joint in both routine and forceful movement. Conclusion: This study has been able to establish that LUCL is more prone to stress and strain. Being attached from bone to bone, it equally provides greater stability at the lateral aspect of elbow joint. KEY WORDS: Elbow joint; Ulna and Radial Collateral Ligament; stress and strain.

scholarly journals Repair of a Divergent Elbow Dislocation with Distal Ulnar Fracture in a Dog Using TightRope and External Skeletal Fixation

VCOT Open ◽  
2021 ◽  
Vol 04 (01) ◽  
pp. e58-e64
Author(s):  
Marcos Garcia ◽  
Camille Bismuth ◽  
Claire Deroy-Bordenave
Keyword(s):  
Elbow Dislocation ◽  
Lateral Collateral Ligament ◽  
Normal Activity ◽  
Long Term Results ◽  
Collateral Ligament ◽  
Elbow Luxation ◽  
Ulnar Fracture ◽  
Fixation System

AbstractThe aim of this study was to report the outcome in a 6-year-old male English Setter dog that suffered a combination of divergent elbow dislocation and open distal ulnar fracture. This study is a case report. After surgical reduction in the elbow luxation, the dog was treated with the TightRope fixation system used as replacement of the lateral collateral ligament, a radioulnar positional screw, and external skeletal fixation. Removal of all implants was performed 3 months postoperatively. The 6-month follow-up visit found the dog without lameness, displaying normal activity, and with normal elbow range of motion and normal Campbell's test. Successful surgical management was achieved with good long-term results using TightRope, a positional screw, and an external skeletal fixator.

Lateral collateral ligament of the elbow joint: Anatomy and kinematics

1996 ◽  
Vol 5 (2) ◽  
pp. 103-112 ◽  
Author(s):  
Bo Sanderhoff Olsen ◽  
Michael T. V˦sel ◽  
Jens O. Søjbjerg ◽  
Peter Helmig ◽  
Otto Sneppen
Keyword(s):  
Elbow Joint ◽  
Lateral Collateral Ligament ◽  
Collateral Ligament

scholarly journals A novel Medial Patellofemoral Ligament Reconstruction Technique; Preliminary Clinical Results

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0007
Author(s):  
Hasan Basri Sezer ◽  
Raffi Armağan ◽  
Muharrem Kanar ◽  
Osman Tuğrul Eren
Keyword(s):  
Range Of Motion ◽  
Medial Patellofemoral Ligament ◽  
Femoral Tunnel ◽  
Full Range ◽  
Lateral Collateral Ligament ◽  
Reconstruction Technique ◽  
Collateral Ligament ◽  
Ligament Rupture ◽  
Patella Luxation ◽  
The Mean

Medial Patellofemoral ligament(MPFL) is the main passive stabilizer of the patellofemoral joint. MPFL is injured in the 2/3 rds of the patients after patella luxation. In this study we present a novel aproach to the anatomical MPFL reconstruction and preliminary results of the technique. We operated 7 patients(4 female and female and 3 male) who applied to our clinic after a patella luxation episode. The mean age was 27,1 years(16-42). The mean follow up time was 23,5 months(24-35). We evaluated the patients clinically and radiologically for concommitant pathologies. 1 patient had patellar cartilage demage and patella alta, 1 patient had medial collateral ligament rupture, 1 patient had lateral collateral ligament and anterior cruciate ligament rupture and these pathologies were treated as well. The operation was done in the supine position on a radiolucent table and under the image intensifier control. The semitendinosus autograft was prepared. The femoral tunnel was drilled and double strand graft was introduced in the femoral tunnel and secured with ToggleLoc femoral fixation device(Biomet). The graft was advanced over the facia to the patellar side and passed through the 2 patellar tunnels and tied to each other. After exercising the knee the graft tension was rechecked at 30 degrees of knee flexion. Early postoperatively range of motion and quadriceps strenghtening exercises were carried out and patients were allowed to bear weight. All of the patients had full range of motion and free of pain. Postoperative x-ray and MRI examinations revealed the correction of patellar tilt and lateral shift of the patella in all patients. The only complication was a fissure of patella in 1 patient in the 6th week of rehabilitation due to anteriorly located patellar tunnel and heavy exercise. We immobilsed the patient in a brace and the patient returned to rehabilitation after 6 weeks when the fissure healed. All the patients returned to the previous functional level. Our anatomical MPFL technique uses ToggleLoc for the femoral side but implant free at the patellar side. The technique provided excellent preliminiary result in all of the patients. The technique allows graft retensioning again and again from both the femoral and the patellar side. The double bundle reconstruction seems to immitate the natural behaviour of the MPFL. However patellar tunnels carry a substantial risk of patella fracture and must be placed with great attention.

Impedance Control of Two d.o.f. CPM Device for Elbow Joint

2014 ◽  
Vol 26 (4) ◽  
pp. 518-518
Author(s):  
Nobutomo Matsunaga ◽  
◽  
Shota Miyaguchi ◽  
Hiroshi Okajima ◽  
Shigeyasu Kawaji
Keyword(s):  
Range Of Motion ◽  
Musculoskeletal System ◽  
Elbow Joint ◽  
Degrees Of Freedom ◽  
Impedance Control ◽  
Reaction Force ◽  
Continuous Passive Motion ◽  
Collateral Ligament ◽  
Passive Motion ◽  
Post Surgery

<div class=""abs_img""><img src=""[disp_template_path]/JRM/abst-image/00260004/16.jpg"" width=""200"" /> Two d.o.f. CPM device</span></div> Continuous passive motion (CPM) involves orthopedic or post-surgery physiotherapy. Following surgery to correct ulna collateral ligament (UCL) injury in the elbow, for example, excessively extending the UCL aggravates the injury and reaction force of the arm increases excessively near the end of the range of motion (ROM). Controlling pro/supination, i.e., rotarymotion of the wrist, effectively suppresses reaction force, but may extend the UCL excessively. We propose a 2 d.o.f. (degrees of freedom) impedance controller as a CPM device for the elbow to suppress reaction force based on the musculoskeletal system. </span>

scholarly journals Finite Element Analysis of Elbow Joint Stability by Different Flexion Angles of the Annular Ligament

2020 ◽  
Author(s):  
Guangming Xu ◽  
ZhengZhong Yang ◽  
JiYong Yang ◽  
Ziyang Liang ◽  
wei Li
Keyword(s):  
Finite Element ◽  
Medial Collateral Ligament ◽  
Contact Area ◽  
Elbow Joint ◽  
Clinical Symptoms ◽  
Elbow Flexion ◽  
Annular Ligament ◽  
Joint Stability ◽  
Collateral Ligament ◽  
Element Analysis

Abstract ObjectiveTo investigate the biomechanical effects of different flexion angles of the annular ligament on elbow joint stability. MethodsLeft elbow CT and MRI scans were chosen from a healthy volunteer, according to a previous research model. A cartilage and ligament model was constructed with SolidWorks software according to the MRI results to simulate the annular ligament during normal, loosen, and rupture conditions at different buckling angles (0, 30, 60, 90, 120). In 15 elbow models, boundary conditions were set according to the literature. The different elbow 3D finite element models were imported into ABAQUS software to calculate and analyze the load, contact area, contact stress and stress of the medial collateral ligament of the olecranon cartilage. Results1. According to the analysis results, olecranon cartilage stress values when the annular ligament under different conditions（normal、loosened、ruptured）with elbow extension, were 2.1 ± 0.18, 2.4 ± 0.75, and 2.9 ± 0.94 MPa. As the buckling angle increased, the stress value decreased; with 120 degrees of elbow flexion, the minimum stress values were 0.9 ± 0.12, 1.1 ± 0.38, and 1.2 ± 0.29 MPa. 2. When the contact surface of the olecranon cartilage was flexed from 0 to 30 degrees, the olecranon cartilage contact area significantly increased, reaching a maximum value of 254±5.35 mm, and then the contact area gradually decreased, reaching a minimum value of 176±2.62 mm when the elbow joint was flexed to 120 degrees. The results when the annular ligament was loosened and ruptured were different from those of the normal annular ligament. The maximum values were 283±4.74and 312±5.49mm at 60 degrees of elbow flexion. The contact area gradually decreased with an increase in the angle, and the minimum values were 210±3.82 and 236±6.59 mm at 120 degrees of elbow flexion. 3. When the elbow joint was extended, the maximum stress of the medial collateral ligament was 6.5±0.23, 11.5±0.78 and 18.7±0.94 MPa under different states; as the stress decreased with an increase in the angle, the corresponding values were 2.8±0.18, 4.8±0.56 and 6.2±0.72 MPa at 120 degrees of elbow flexion. ConclusionThe annular ligament plays an important role in maintaining elbow joint stability. When the annular ligament ruptures, it should be reconstructed as much as possible to avoid the elevation of stress on the surface of the medial collateral ligament of the elbow and on the annular cartilage, which may cause clinical symptoms.

Surgical management of traumatic elbow luxation in two cats using circumferential suture prostheses

2009 ◽  
Vol 22 (01) ◽  
pp. 66-69 ◽  
Author(s):  
D. G. Thomson ◽  
S. Carmichael ◽  
M. Farrell
Keyword(s):  
Postoperative Complications ◽  
Range Of Motion ◽  
Surgical Management ◽  
Lateral Collateral Ligament ◽  
The Other ◽  
Collateral Ligament ◽  
Elbow Luxation ◽  
Lateral Elbow

SummaryTwo Domestic Shorthaired cats were admitted after sustaining a traumatic lateral elbow luxation. Non-surgical management with reduction and external coaptation was unsuccessful at maintaining reduction. At surgery, the lateral collateral ligament (LCL) was intact but grossly elongated in one case, and ruptured in the other. Trans-condylar, trans-radial and trans-ulnar tunnels were drilled from lateral to medial and a suture prosthesis was used in order to augment a suture imbrication of the LCL in the fist cat. The prosthesis was used as a stand-alone procedure in the second case. No postoperative complications occurred and both patients regained excellent elbow range of motion without any observable lameness.

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