scholarly journals Impact of Movement with Mobilization and Triceps Eccentric Strengthening in Tennis Elbow: Case Report

2021 ◽  
pp. 10-14
Author(s):  
Nabeela Fatema ◽  
Bodhisattva Dass ◽  
Rinkle Hotwani
Keyword(s):  
Elbow Joint ◽  
Tennis Elbow ◽  
Limited Range ◽  
Treatment Session ◽  
Manual Muscle Testing ◽  
Outer Side ◽  
Lateral Epicondyle ◽  
Muscle Testing ◽  
Limited Range Of Motion ◽  
The Right

Background: Tennis elbow can be caused by repetitive wrist and arm motions. Pain is the primary symptom. It usually occurs on the outside of the elbow and sometimes in the forearm and wrist. Treatment includes rest, pain relievers and physiotherapy. Case Presentation: A 28years old male patient presented with a complaint of pain in outer side of the right side elbow. In subjective examination, He gave history of pain while playing tennis mainly in smashing the ball or passing shot, riding bike for more than 2kilometers, difficulty in holding objects sometimes as well. When this pain was unbearable to him he came to Physiotherapy department. Treatment: A Treatment session initially started with Cryotherapy (Ice Pack) application for 5min. On lateral epicondyle of right elbow. Then Ultrasound 0.8 watt/Cm² for 7minutes given, these helped in pain reduction. After 2days patient is asked to follow the commands to perform Triceps strengthening along with wrist strengthening with the help of Half Kg Dumb bell.  There was an effect on the reduction of the symptoms of the patient which were pain, reduce strength and limited range of motion of wrist in right hand. After 1week of treatment, we added Mobilization with movement (Mulligan) technique at elbow joint. The same procedure was continued for 2weeks after which patient's symptoms were minimized as to the day of assessment. Outcome measures used for the evaluation of the symptoms were NPRS Scale for Pain, Manual Muscle Testing (MMT) for Strength. Conclusion: Triceps strengthening along with Mulligan technique for elbow joint was found to be effective in patients with severe pain and reduced strength.

scholarly journals Surgical Treatment for Malunion of the Lateral Humeral Epicondyle with Posterior Subluxation of the Radial Head: A Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Koichi Yano ◽  
Yasunori Kaneshiro ◽  
Hideki Sakanaka
Keyword(s):  
Lateral Collateral Ligament ◽  
High Energy ◽  
Limited Range ◽  
Forearm Rotation ◽  
Collateral Ligament ◽  
Lateral Epicondyle ◽  
Limited Range Of Motion ◽  
Contracture Release ◽  
Normal Congruence ◽  
The Right

A 24-year-old right-handed man suffered right olecranon and lateral epicondylar fracture from high energy trauma. Fixation of olecranon was performed by a previous doctor. Three months after operation, he presented with limited range of motion (ROM) of the right elbow caused by malunion of the lateral epicondylar fracture and subluxation of the radiohumeral joint. Preoperative ROM of the right elbow was flexion 110° and extension −75°. Forearm rotation was pronation 85° and supination 65°. Fragment excision of the lateral epicondyle, which was 27 mm in length, and lateral collateral ligament repair using anchors were performed. Fourteen months postoperatively, contracture release of the elbow was performed. Twenty-four months postoperatively, radiograph of the elbow showed normal congruence without osteoarthritic changes and the ROM of the right elbow was flexion 120° and extension −35°. Forearm rotation was pronation 90° and supination 70°. In the surgical setting, in case of the size of the lateral epicondylar fragment is relatively large, the fragment should be fixed or lateral collateral ligament should be repaired when the instability of the elbow is found.

scholarly journals Dysplasia epiphysealis hemimelica of the radial head: a rare case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hiva Mohamadian ◽  
Mansour Bahardoust ◽  
Borzouyeh Molazem Sanandaji ◽  
Saba Saberi
Keyword(s):  
Radial Head ◽  
Elbow Joint ◽  
Limited Range ◽  
Lower Limbs ◽  
Case Presentation ◽  
Limited Range Of Motion ◽  
Rare Case Report ◽  
The Right ◽  
Dysplasia Epiphysealis Hemimelica

Abstract Background Dysplasia epiphysealis hemimelica (DEH) is a rare benign overgrowth generally affecting the epiphyses and short bones of the lower limbs. DEH in the elbow joint is extremely rare, and to date, only three cases of DEH have been reported in the radial head. Case presentation In this study, we report a case of DEH located in the radial head of the right elbow of a 10-year-old boy, which was presented with elbow pain and limited range of motion. In clinical examination, an asymmetrical enlargement was observed over the elbow. The lesion was resected surgically, and the patient’s symptoms resolved afterward. The histologic analysis of the lesion confirmed the diagnosis of DEH. Conclusion This report highlights the role of DEH in the differential diagnosis of elbow pathologies, particularly its differentiation from osteochondroma.

ANATOMIC AND CLINICAL STUDY OF A NEUROVASCULAR CAUSE OF LATERAL EPICONDYLITIS

2009 ◽  
Vol 12 (01) ◽  
pp. 11-19
Author(s):  
Xin-Ru Du ◽  
Ling-Xiu Zhao
Keyword(s):  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Extensor Tendon ◽  
Triceps Brachii ◽  
Tissue Samples ◽  
Lateral Epicondyle ◽  
The Common ◽  
Pass Through ◽  
The Right ◽  
Neurovascular Bundles

Because of few anatomic reports investigating the mechanism of lateral epicondylitis (tennis elbow), we performed cadaveric and clinical studies to investigate the involvement of neurovascular bundles passing through the common extensor origin. We dissected and observed under a light microscope tissue samples of neurovascular bundles passing through the common extensor tendon from 40 upper left and right limbs from cadavers. Tissue samples were prepared by hematoxylin & eosin and Weil's myelin staining. We also investigated the records of 20 patients who had been treated for lateral epicondylitis between 1991 and 2004. From cadavers, we found 60 bundles in the common extensor tendon, each 0.5 to 1.0 mm in diameter, with more bundles in the right than left limbs. Twenty-four of these bundles passed over the vertex of the lateral epicondyle of the humerus, and most of the bundles contained only one artery each. The bundles mostly originated from the radial recurrent artery, passing through the aponeurosis of the extensor corpi radialis brevis, but in some cases originated from the radial collateral artery, passing through the aponeurosis of the triceps brachii muscle. The bundles had a membranous covering when passing through the aponeurosis and produced a hiatus. Histological analysis of resected common extensor tendon tissue, 1 cm in diameter, of patients showed hyaline degeneration and fibrosis formation infiltration. Neurovascular bundles passed through the common extensor tendon in nine cases; six cases showed pulsing bleeding. After a mean follow-up of two years (6–48 months), 16 cases showed excellent results, two showed good results and two showed reliefs. Lateral epicondylitis could be caused by damage to neurovascular bundles when they pass through the common extensor origin; one cause of pain is the neurovascular bundle being compressed when passing through the common extensor tendon, secondary to the pathologic degeneration of the origin of the common extensor tendon.

scholarly journals Oesophageal carcinoma with solitary patellar metastasis: a rare case report

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110098
Author(s):  
Yi Zhao ◽  
Qianqian Zhang ◽  
Helin Feng ◽  
Xiyan Zhu
Keyword(s):  
Bone Scintigraphy ◽  
Oesophageal Carcinoma ◽  
Limited Range ◽  
Additional Treatment ◽  
X Rays ◽  
Methylene Diphosphonate ◽  
Limited Range Of Motion ◽  
Rare Case Report ◽  
Paclitaxel Liposome ◽  
The Right

The incidence of tumours found in the patella, including primary and metastatic tumours, is low. Solitary metastasis of oesophageal carcinoma (OC) in the patella is even rarer. A 50-year-old man presented to our clinic because of pain and limited range of motion in the right knee for 4 hours and after a fall. On the basis of the patient’s medical history, he was diagnosed with OC 2 months previously and underwent two cycles of paclitaxel liposome combined with tiggio chemotherapy (oral tiggio, 40 mg, two times/day, with a treatment cycle of 3 weeks). A 99mTc-methylene diphosphonate bone scintigraphy scan showed increased radioactivity in the right patella. A right knee biopsy showed the presence of patellar metastasis from OC. Unfortunately, the patient denied additional treatment and was discharged for personal reasons. At the 1-month follow-up, which was conducted by a telephone survey, we learned that the patient had died of acute pulmonary embolism. X-rays and computed tomography are useful for diagnosing patellar metastases, but 99mTc-methylene diphosphonate bone scintigraphy can help physicians diagnose patellar metastasis of OC more rapidly. Biopsy with pathology is the gold standard for diagnosing patellar metastases. Additionally, timely surgical treatment prolongs the survival time of these patients.

scholarly journals Solitary osteochondroma of scapula: A case report

2017 ◽  
Vol 6 (3) ◽  
pp. 69-71
Author(s):  
B D Sharma ◽  
J Sitaula ◽  
A Prajapati ◽  
A P Regmi
Keyword(s):  
Case Report ◽  
Surgical Excision ◽  
Ventral Surface ◽  
Limited Range ◽  
Histopathological Study ◽  
Long Bones ◽  
Limited Range Of Motion ◽  
Solitary Osteochondroma ◽  
Benign Tumours ◽  
The Right

Osteochondromas are the most common benign tumours of bone. They are most commonly seen in the metaphyseal regions of long bones (femur, tibia, humerus). The scapula is rarely involved, and very few cases of solitary osteochondroma of scapula have been reported in literature. We present the case of a 17 year old male who presented with pain and limited range of motion of his right shoulder. CT scan revealed an osteochondroma on the dorsomedial surface of the right scapula extending into the ventral surface. Surgical excision was done and histopathological study showed osteochondroma of the scapula.

Strength–Duration Curves of Radial Nerve in Patients With Lateral Elbow Pain

2020 ◽  
Vol 29 (6) ◽  
pp. 754-759 ◽  
Author(s):  
Blanca de la Cruz Torres
Keyword(s):  
Radial Nerve ◽  
Tennis Elbow ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Painful Condition ◽  
Duration Of Symptoms ◽  
Lateral Epicondyle ◽  
Lateral Elbow Pain ◽  
Left Limb ◽  
The Right

Context:Lateral epicondylalgia (LE) refers to a painful condition at or around the lateral epicondyle of the humerus. LE is one of the most common injuries of the elbow; however, the cause of the pathology is not clear. Patients often experience symptoms consistent with a radial nerve injury; however, data on the involvement of the radial nerve are needed.Objective:To analyze the relationship between electrophysiologic excitability and morphology of the radial nerve in patients with unilateral chronic LE.Design:Cross-sectional study.Setting:Department of Physiotherapy, University of Seville.Patients:A total of 56 elbows (28 right, 28 left) in 28 patients (12 females, 16 males; age 49 [7.37] y) were recruited by convenience sampling.Main Outcome Measures:Strength–duration curves (chronaxia and accommodation index) and cross-sectional area (CSA) of the radial nerve were made in all participants. All parameters were compared between both limbs. Also, pain with palpation in the lateral epicondyle and functional pain of involved extremities was assessed using visual analog scale and the Patient-Rated Tennis Elbow Evaluation, respectively.Results:Symptomatic limb showed higher CSA values of the radial nerve when compared with the asymptomatic limb (P < .001). On the symptomatic limb, duration of symptoms was positively correlated with CSA values. Chronaxia values were all normal and similar between both limbs (P = .35). Regarding accommodation index, 14 (54%) patients showed accommodation indices that suggested pathological radial nerve on the right limb, 4 (14%) on the left limb, 5 (18%) on both limbs, and 4 (14%) had none of the affected nerves. Eight-six percent of patients showed accommodation indices that suggested pathological radial nerve, independently of symptomatic limb. In these cases, affected nerves had higher CSA than the unaffected nerve (P = .01). On the affected nerves, duration of symptoms was positively correlated with accommodation indices.Conclusions:These findings suggest that patients with unilateral chronic LE show a decreased excitability in any radial nerve, independently of the symptomatic limb, and that pathological nerves have higher CSA than the nonpathological nerves.

scholarly journals Patellofemoral Pain and Asymmetrical Hip Rotation

2005 ◽  
Vol 85 (11) ◽  
pp. 1201-1207 ◽  
Author(s):  
Michael T Cibulka ◽  
Julie Threlkeld-Watkins
Keyword(s):  
Knee Pain ◽  
Patellofemoral Joint ◽  
External Rotation ◽  
Womac Score ◽  
Patellofemoral Pain ◽  
Manual Muscle Testing ◽  
Muscle Testing ◽  
Medial Rotation ◽  
The Right ◽  
Hip Rotation

Abstract Background and Purpose. Patellofemoral joint problems are the most common overuse injury of the lower extremity, and altered femoral or hip rotation may play a role in patellofemoral pain. The purpose of this case report is to describe the evaluation of and intervention for a patient with asymmetrical hip rotation and patellofemoral pain. Case Description. The patient was a 15-year-old girl with an 8-month history of anterior right knee pain, without known trauma or injury. Prior to intervention, her score on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was 24%. Right hip medial (internal) rotation was less than left hip medial rotation, and manual muscle testing showed weakness of the right hip internal rotator and abductor muscles. The intervention was aimed at increasing right hip medial rotation, improving right hip muscle strength (eg, the muscle force exerted by a muscle or a group of muscles to overcome a resistance), and eliminating anterior right knee pain. Outcomes. After 6 visits (14 days), passive left and right hip medial rotations were symmetrical, and her right hip internal rotator and abductor muscle grades were Good plus. Her WOMAC score was 0%. Discussion. The patient had right patellofemoral pain and an uncommon pattern of asymmetrical hip rotation, with diminished hip medial rotation and excessive hip lateral (external) rotation on the right side. The patient's outcomes suggest that femoral or hip joint asymmetry may be related to patellofemoral joint pain.

scholarly journals TORTIKOLIS MUSKULAR KONGENITAL

2014 ◽  
Vol 5 (3) ◽  
Author(s):  
Imelda E. Kawatu ◽  
Engeline Angliadi
Keyword(s):  
Muscle Hypertrophy ◽  
Limited Range ◽  
Neck Muscle ◽  
Congenital Muscular Torticollis ◽  
Limited Range Of Motion ◽  
Good Improvement ◽  
The Right ◽  
Surgical Treatments ◽  
Muscular Torticollis ◽  
Fetal Position

Abstract: Torticollis, or wryneck, is a group of symptoms based on many causes that clinically manifests itself as a crooked or rotated neck. Congenital muscular torticollis is the most common type of congenital torticolllis which occurs in four per 1000 births and one per 300 live births with 75% of these cases on the right side. It was found that 90.1% of plagiocephalic cases incured this torticollis. In this condition, due to contractions of the neck muscles, the head turns and tilts to one side, meanwhile the chin points to the opposite side. Congenital muscular torticollis is caused by a shortening of the sternocleidomastoid muscle due to trauma during labour or abnormal fetal position in utero. Signs and symtoms of congenital muscular torticollis are recognized as early as two months after birth in which the head turns to one side associated with neck muscle hypertrophy, muscle spasm, and a limited range of motion (ROM). The management of congenital muscular torticollis consists of pharmacological, non-pharmacological, and surgical treatments. The prognosis is stated as good if there is a good improvement after 6 months of rehabilitation, but it is stated bad if there is no improvement after 6 months of treatment with a continuation of the asymetrical face. Keywords: congenital muscular torticollis, management   Abstrak: Tortikolis adalah kekakuan leher yang menimbulkan spasme otot yang secara klinis bermanifestasi sebagai leher yang bengkok atau terputar. Tortikolis bukan merupakan suatu diagnosis melainkan kumpulan gejala dengan berbagai gangguan yang mendasarinya. Tortikolis muskular kongenital ialah bentuk yang paling umum dari tortikolis kongenital dengan insiden sekitar 4 per 1000 kelahiran, dan 1 dari setiap 300 kelahiran hidup. Pada tortikolis muskular kongenital terjadi kontraksi otot-otot leher (75% terbanyak pada sisi kanan) yang menyebabkan posisi kepala turn dan tilt ke satu sisi dan dagu mengarah ke sisi yang berlawanan. Penyebab terjadinya tortikolis muskular kongenital ialah pemendekan otot sternokleidomastoid akibat trauma selama proses persalinan, atau posisi bayi dalam kandungan. Umumnya, gejala dan tanda klinis diketahui pada 2 bulan pertama dimana kepala mengarah ke arah sisi sakit, pembesaran otot-otot leher, spasme otot, dan keterbatasan lingkup gerak sendi leher. Penanganan tortikolis muskular kongenital terdiri dari farmakologis, non-farmakologis, dan pembedahan. Prognosis disebut baik bila tercapai hasil yang baik setelah 6 bulan terapi dengan penanganan rehabilitasi, dan memburuk bila tidak terdapat perubahan dalam 6 bulan terapi ditandai oleh wajah yang asimetris. Kata kunci: tortikolis muskular kongenital, penanganan

Effect of strengthening exercises in Hirayama disease: a case study

2020 ◽  
Vol 27 (11) ◽  
pp. 1-7
Author(s):  
Tinu Sethi ◽  
Sushma Rawat ◽  
SL Munde
Keyword(s):  
Hand Function ◽  
Manual Dexterity ◽  
Manual Muscle Testing ◽  
Hirayama Disease ◽  
Hand Functions ◽  
Muscle Testing ◽  
Hand Grip ◽  
Strengthening Exercises ◽  
The Right

Background/Aims The effects of strengthening exercises in patients with Hirayama disease are not well documented. This case study examined the effect of strengthening exercises on hand functions in a patient with Hirayama disease. Methods An 18-year-old man with weakness in the right hand was given a hand-function strengthening programme consisting of 40 minutes of exercises, which were performed 5 days a week over an 8-week period. The patient used theraputty, a gel ball, finger dexterity board, gym kit and hand grip exerciser. The effects of the programme were evaluated using manual muscle testing, a hand-held dynamometer, pinchometer and the Minnesota Manual Dexterity Test. Results The patient's manual muscle testing grades improved following the strengthening programme. Results from the Dynamometer, pinchometer and Minnesota Manual Dexterity Test objectively exhibited increased muscle strength and improved hand functions. Conclusions Strengthening exercises are effective in alleviating muscle weakness and improving hand functions associated with Hirayama disease.

Dynamic External Fixator as Treatment for Congenital Little Finger Contracture

2020 ◽  
Author(s):  
Kenji Ohira ◽  
Yoshitaka Hamada ◽  
Takeyasu Toyama ◽  
Yoshitaka Minamikawa
Keyword(s):  
Clinical Practice ◽  
Soft Tissue ◽  
External Fixator ◽  
Limited Range ◽  
Joint Contracture ◽  
Soft Tissue Release ◽  
Hand Therapy ◽  
Limited Range Of Motion ◽  
The Right ◽  
Little Finger

Abstract The surgical soft tissue release of extension contracture at metacarpophalangeal (MP) joint is technically easy; however, the preventive hand therapy after surgery is really difficult in clinical practice. Congenital MP joint contracture, especially little finger, is also difficult to spread its limited range of motion (ROM). Here, we present a patient with a congenital MP joint contracture of the little finger managed with dynamic external fixator (DEF). A 21-year-old male irritated from limited ROM associated with pain of the right little finger of more than 1 year. The symptom started after trauma on his hand while playing lacrosse. Further examination revealed that his MP joint was congenitally contracted. To address this pathology, DEF followed by orthotic therapy was done. Two years after the procedure and therapy, the MP joint ROM of the finger surpassed that of the contralateral unaffected digit without pain and recurrence. The patient was able to return to his sports of lacrosse.

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