scholarly journals Forelimb bone curvature in terrestrial and arboreal mammals

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3229 ◽  
Author(s):  
Keith Henderson ◽  
Jess Pantinople ◽  
Kyle McCabe ◽  
Hazel L. Richards ◽  
Nick Milne
Keyword(s):  
Distal Part ◽  
Elbow Flexion ◽  
Distal Humerus ◽  
Muscle Action ◽  
Elbow Extension ◽  
Triceps Muscle ◽  
Longitudinal Loading ◽  
The Difference

It has recently been proposed that the caudal curvature (concave caudal side) observed in the radioulna of terrestrial quadrupeds is an adaptation to the habitual action of the triceps muscle which causes cranial bending strains (compression on cranial side). The caudal curvature is proposed to be adaptive because longitudinal loading induces caudal bending strains (increased compression on the caudal side), and these opposing bending strains counteract each other leaving the radioulna less strained. If this is true for terrestrial quadrupeds, where triceps is required for habitual elbow extension, then we might expect that in arboreal species, where brachialis is habitually required to maintain elbow flexion, the radioulna should instead be cranially curved. This study measures sagittal curvature of the ulna in a range of terrestrial and arboreal primates and marsupials, and finds that their ulnae are curved in opposite directions in these two locomotor categories. This study also examines sagittal curvature in the humerus in the same species, and finds differences that can be attributed to similar adaptations: the bone is curved to counter the habitual muscle action required by the animal’s lifestyle, the difference being mainly in the distal part of the humerus, where arboreal animals tend have a cranial concavity, thought to be in response the carpal and digital muscles that pull cranially on the distal humerus.

A Biomechanical Study of the Ulnar Nerve at the Elbow

1995 ◽  
Vol 20 (5) ◽  
pp. 623-627 ◽  
Author(s):  
F. A. SCHUIND ◽  
D. GOLDSCHMIDT ◽  
C. BASTIN ◽  
F. BURNY
Keyword(s):  
Ulnar Nerve ◽  
Distal Part ◽  
Relative Elongation ◽  
Elbow Flexion ◽  
Proximal Part ◽  
Biomechanical Study ◽  
Cubital Tunnel ◽  
Elbow Extension ◽  
Full Flexion ◽  
Significant Change

The relative elongation with elbow flexion of the ulnar nerve, proximal and distal to the cubital tunnel, and of the cubital tunnel retinaculum, was measured in cadaver specimens by stereophotogrammetry. The proximal part of the ulnar nerve elongated significantly with full elbow flexion. No significant change of length was measured in the distal part of the nerve. The length of the cubital tunnel retinaculum increased by an average of 45% from full elbow extension to full flexion.

scholarly journals Botulinum toxin for treatment of cocontractions related to obstetrical brachial plexopathy

2005 ◽  
Vol 63 (3a) ◽  
pp. 588-591 ◽  
Author(s):  
Carlos O. Heise ◽  
Lilian R. Gonçalves ◽  
Egberto R. Barbosa ◽  
Jose Luiz D. Gherpelli
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Elbow Flexion ◽  
Botulinum Toxin Type ◽  
Brachial Plexopathy ◽  
Elbow Extension ◽  
Triceps Muscle ◽  
Elbow Function ◽  
Persistent Disability

Botulinum toxin type A was recently introduced for treatment of biceps - triceps muscle cocontraction, which compromises elbow function in children with obstetrical brachial plexopathy. This is our preliminary experience with this new approach. Eight children were treated with 2 - 3 U/kg of botulinum toxin injected in the triceps (4 patients) and biceps (4 patients) muscle, divided in 2 or 3 sites. All patients submitted to triceps injections showed a long-lasting improvement of active elbow flexion and none required new injections, after a follow-up of 3 to 18 months. Three of the patients submitted to biceps injections showed some improvement of elbow extension, but none developed anti-gravitational strength for elbow extension and the effect lasted only three to five months. One patient showed no response to triceps injections. Our data suggest that botulinum toxin can be useful in some children that have persistent disability secondary to obstetrical brachial plexopathy.

Transfer of a Motor Fascicle From the Ulnar Nerve to the Branch of the Radial Nerve Destined to the Long Head of the Triceps for Restoration of Elbow Extension in Brachial Plexus Surgery

Neurosurgery ◽  
2011 ◽  
Vol 70 (2) ◽  
pp. E516-E520 ◽  
Author(s):  
Leandro Pretto Flores
Keyword(s):  
Computed Tomography ◽  
Brachial Plexus ◽  
Ulnar Nerve ◽  
Radial Nerve ◽  
Nerve Transfer ◽  
Elbow Flexion ◽  
Shoulder Abduction ◽  
Elbow Extension ◽  
Long Head ◽  
Brachial Plexus Surgery

Abstract BACKGROUND AND IMPORTANCE: Restoration of elbow extension has not been considered of much importance regarding functional outcomes in brachial plexus surgery; however, the flexion of the elbow joint is only fully effective if the motion can be stabilized, what can be achieved solely if the triceps brachii is coactivated. To present a novel nerve transfer of a healthy motor fascicle from the ulnar nerve to the nerve of the long head of the triceps to restore the elbow extension function in brachial plexus injuries involving the upper and middle trunks. CLINICAL PRESENTATION: Case 1 is a 32-year-old man sustaining a right brachial extended upper plexus injury in a motorcycle accident 5 months before admission. The computed tomography myelogram demonstrated avulsion of the C5 and C6 roots. Case 2 is a 24-year-old man who sustained a C5-C7 injury to the left brachial plexus in a traffic accident 4 months before admission. Computed tomography myelogram demonstrated signs of C6 and C7 root avulsion. The technique included an incision at the medial border of the biceps, in the proximal third of the involved arm, followed by identification of the ulnar nerve, the radial nerve, and the branch to the long head of the triceps. The proximal stump of a motor fascicle from the ulnar nerve was sutured directly to the distal stump of the nerve of the long head of the triceps. Techniques to restore elbow flexion and shoulder abduction were applied in both cases. Triceps strength Medical Research Council M4 grade was obtained in both cases. CONCLUSION: The attempted nerve transfer was effective for restoration of elbow extension in primary brachial plexus surgery; however, it should be selected only for cases in which other reliable donor nerves were used to restore elbow flexion.

scholarly journals Inveterate elbow dislocation: surgical reduction with triceps lengthening

2021 ◽  
Vol 8 (9) ◽  
Keyword(s):  
Mayo Clinic ◽  
Physical Therapist ◽  
Elbow Dislocation ◽  
Elbow Flexion ◽  
Plaster Cast ◽  
Lateral Approach ◽  
Surgical Reduction ◽  
Left Elbow ◽  
Triceps Muscle ◽  
K Wires

Inveterate elbow dislocations remain common in developing countries. We report the case of a 17-year-old child who consulted us after six months of trauma to the left elbow. Clinical examination revealed a deformed elbow, locked in extension with a mobility sector of 5°. The Mayo Clinic Elbow performance score was sixty-six; the downstream vasculo-nervous examination was normal. The face and profile X-ray of the elbow showed a pure posterolateral elbow dislocation. We used the posterior medial para-tricipital and lateral approach, a first stage of arthrolysis was performed. A complete reduction was achieved by progressive and non-traumatic gentle maneuvers. Intraoperative elbow flexion was less than 80°, indicating a retraction of the triceps muscle, so a Z-lengthening plasty was necessary. This reduction was then fixed with two olecranon-humeral K-wires. At the third week, the plaster cast and K-wires were removed. The patient was subsequently referred to a physical therapist. After a ten-month follow-up, an undistorted and functional elbow with a gain of twenty-one points according to the Mayo Clinic score was obtained. Surgical reduction of a neglected elbow dislocation with triceps lengthening plasty, followed by a codified physical therapy program, results in a remarkable restoration of elbow function and stability. Keyword : elbow, dislocation, inveterate, reduction, triceps.

Mind-Muscle Connection: Verbal Instructions Alter Electromyographic Activity for Elbow Flexors and Extensors During Co-Contraction Training

2020 ◽  
pp. 003151252094908
Author(s):  
Rafael A. Fujita ◽  
Marina M. Villalba ◽  
Nilson R. S. Silva ◽  
Matheus M. Pacheco ◽  
Matheus M. Gomes
Keyword(s):  
Strength Training ◽  
Elbow Joint ◽  
Biceps Brachii ◽  
Elbow Flexion ◽  
Emg Activity ◽  
Elbow Extension ◽  
Verbal Instruction ◽  
Triceps Brachii ◽  
Verbal Instructions ◽  
Lateral Head

Co-contraction training has demonstrated similar electromyographic (EMG) activity levels compared to conventional strength training. Since verbal instructions can increase EMG activity on target muscles during conventional exercises, the same should occur during co-contraction. In this study we analyzed whether different verbal instructions would alter the EMG activity of target muscles - biceps brachii (BB) and triceps brachii lateral head (TB) - during co-contraction training for the elbow joint. Seventeen males with experience in strength training performed a co-contraction set in two verbal instruction conditions to emphasize either elbow flexion or elbow extension. Surface electrodes were fixed over biceps brachii and triceps brachii lateral head muscles. We measured EMG mean amplitude and analyzed data with 2-way ANOVA. We found a significant interaction between muscle and verbal instruction ( p = 0.002). Post hoc tests indicated that verbal instructions ( p = 0.001) influenced the BB EMG activity (elbow flexion: M = 68.74, SD = 17.96%; elbow extension: M = 53.47, SD = 16.13%); and also showed difference ( p = 0.006) in the EMG activity between BB and TB with verbal instruction emphasizing the elbow extension (BB: M = 53.47, SD = 16.13%; TB: M = 69.18, SD = 21.79%). There was a difference in the EMG ratio of BB/TB ( p = 0.001) when focusing on elbow flexion ( M = 1.09, SD = 0.30) versus elbow extension ( M = 0.81, SD = 0.25). As verbal instruction modified the magnitude of muscle recruitment during co-contractions for elbow joint muscles, there is a clear mind-muscle connection of importance to this method of training. Also, of importance to trainers, verbal instructions seemed to affect individuals differentially.

scholarly journals Correlation of compound muscle action potential generated by donor nerves with the recovery of elbow flexion in Oberlin transfer in brachial plexus injury

2018 ◽  
Vol 51 (02) ◽  
pp. 137-144
Author(s):  
Mukund Ramchandra Thatte ◽  
Binita Bharat Raut ◽  
Amita Shivyogi Hiremath ◽  
Sushil Ramesh Nehete ◽  
Nayana Somala Nayak
Keyword(s):  
Action Potential ◽  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Compound Muscle Action Potential ◽  
Nerve Transfer ◽  
Elbow Flexion ◽  
Muscle Action ◽  
Muscle Action Potential ◽  
Group A ◽  
Group B

ABSTRACT Objective: To study the correlation of compound muscle action potential of donor nerves with the recovery of elbow flexion in Oberlin transfer in brachial plexus injury. Introduction: Distal nerve transfer using motor fascicle of ulnar or median nerve to restore elbow flexion is a part of reconstructive surgery after upper brachial plexus injury, first described by Oberlin et al. However, one of the most critical influences on functional outcome is number of functioning motor axons in donor fascicle which is reflected by its compound muscle action potential. We studied whether nerve transfers with donor nerves showing higher amplitudes will yield better reinnervation of muscle and therefore better function as estimated by clinical examination. Methods: We prospectively studied 30 cases of upper brachial plexus injury, of which were treated with Oberlin transfer using ulnar or median or both nerves. The prerequisites were no elbow flexion and hand and wrist flexors showing the power of more than Medical research Council MRC Grade 4. Donor nerves selected either ulnar or median having CMAP >4 mv in our electrophysiology laboratory during nerve conduction study. Patients were followed up for 1 year and assessed clinically for restoration of elbow flexion, weight tolerance. Results: A total of 30 patients of Oberlin transfer were evaluated for improvement power of biceps and elbow flexion. (MRC) grading was done at 1 year. Twenty-seven patients had a good result (MRC grade ≥3), i.e., 90% of patients. Based on the MRC grades, we categorised the patients into two groups as follows: Group A and Group B. Group A included patients with MRC Grade 4–5 and Group B included Grades 3–3.5. We tried to establish a correlation between CMAP and MRC scores by comparison of MRC grade patients for their pre CMAPs which revealed a statistically significant higher CMAPs between the groups. (Mann–Whitney U-test, P = 0.028). This indicates the association of higher pre-CMAPs with higher MRC grades. Conclusion: We conclude that higher the compound muscle action potential of donor nerves, better the recovery of elbow flexion in Oberlin transfer in brachial plexus injury.

scholarly journals Ultrasonography-guided closed reduction in the treatment of displaced transphyseal fracture of the distal humerus

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Hai Zhou ◽  
Ge Zhang ◽  
Ming Li ◽  
Xiangyang Qu ◽  
Yujiang Cao ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Elbow Flexion ◽  
Distal Humerus ◽  
Cubitus Varus ◽  
Radiographic Outcomes ◽  
The Mean ◽  
Low Incidence ◽  
The Right ◽  
Successful Reduction

Abstract Background To evaluate the clinical and radiographic outcomes of ultrasonography-guided closed reduction in the treatment of displaced transphyseal fracture of the distal humerus (TFDH). Methods Twenty-seven patients with displaced TFDH were successfully treated by the ultrasonography-guided closed reduction during January 2012 to December 2016 and were retrospectively reviewed. After the mean follow-up of 34.88 months, the clinical and radiographic outcomes of patients were evaluated. The cubitus varus of the affected elbows was also assessed at the latest follow-up. Results The successful rate of ultrasonography-guided closed reduction in the treatment of displaced TFDH was 84% (27/32). The twenty-seven patients with successful reduction were included for the following analysis. There were 20 males and 7 females included in the study, and the mean age at treatment was 15.39 ± 3.10 months; seventeen fractures occurred in the right side elbow and ten in the left side. At the last follow-up, there were significant decreases in the elbow flexion (3°, P = 0.027) and range of motion (5°, P = 0.003) between the injured and uninjured elbow, respectively, whereas no difference in elbow extension was detected (P = 0.110). Flynn’s criteria assessment showed that all the patients achieved excellent or good outcomes both in the functional and cosmetic categories. The clinical and radiographic carrying angles at the last follow-up were 11.67 ± 3.11° and 10.46 ± 3.88°, respectively. And the incidence of cubitus varus after treatment was 7.4% at the last follow-up. Conclusion The ultrasonography-guided closed reduction in the treatment of displaced TFDH is an effective procedure; the adequate fracture reduction can be acquired with the advantages of real-time, non-radioactive, and simple utilization. With the percutaneous pining fixation, satisfactory clinical and radiographic outcomes can be achieved with a low incidence of postoperative cubitus varus.

Long Head of the Triceps Muscle Transfer for Active Elbow Flexion in Arthrogryposis

2010 ◽  
Vol 14 (2) ◽  
pp. 121-124 ◽  
Author(s):  
Gloria R. Gogola ◽  
Marybeth Ezaki ◽  
Scott N. Oishi ◽  
Idris Gharbaoui ◽  
James B. Bennett
Keyword(s):  
Elbow Flexion ◽  
Muscle Transfer ◽  
Triceps Muscle ◽  
Long Head

Effects of Bat Grip on Baseball Hitting Kinematics

2009 ◽  
Vol 25 (3) ◽  
pp. 203-209 ◽  
Author(s):  
Rafael F. Escamilla ◽  
Glenn S. Fleisig ◽  
Coop DeRenne ◽  
Marcus K. Taylor ◽  
Claude T. Moorman ◽  
...  
Keyword(s):  
Angular Velocity ◽  
Range Of Motion ◽  
Elbow Flexion ◽  
Linear Velocity ◽  
Elbow Extension ◽  
Kinematic Parameters ◽  
Time Duration ◽  
Motion System ◽  
Ball Contact ◽  
Pelvis Rotation

A motion system collected 120-Hz data from 14 baseball adult hitters using normal and choke-up bat grips. Six swings were digitized for each hitter, and temporal and kinematic parameters were calculated. Compared with a normal grip, the choke-up grip resulted in 1) less time during stride phase and swing; 2) the upper torso more opened at lead foot contact; 3) the pelvis more closed and less bat linear velocity at bat-ball contact; 4) less range of motion of the upper torso and pelvis during swing; 5) greater elbow flexion at lead foot contact; and 6) greater peak right elbow extension angular velocity. The decreased time during the stride phase when using a choke-up grip implies that hitters quicken their stride when they choke up. Less swing time duration and less upper torso and pelvis rotation range of motion using the choke-up grip supports the belief of many coaches and players that using a choke-up grip results in a “quicker” swing. However, the belief that using a choke-up grip leads to a faster moving bat was not supported by the results of this study.

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