Open reduction of an old and unreduced posterior elbow dislocation

The old unreduced elbow dislocation is not very frequent, but when it is found, it is a challenge for every surgeon. We present a case of 65 years old man who came to the hospital with a dislocated elbow. After the first attempt to reduce, the elbow was mobilized in sling for 2 weeks, but during a small effort, the joint dislocated again. Another two orthopedic reduction were tried, followed by cast immobilization, but the elbow dislocated again. The patient presented in our service after two months from the injury with stiff joint in a vicious position. On imagistic examinations (Rx, CT, MRI), it was found comminuted fracture of coronoid process, posterior dislocation of olecranon and both collateral ligaments were torn. An open reduction was performed during which the joint surface was cleaned up, the anterior capsule was reattached to the coronoid process with an anchor, and then, collateral ligament was restored with the help of autograft, a gracilis muscle (bone fixed with two anchors). Postoperatively, the patient slowly began to mobilize the elbow with splint protection. After a year, the patient returned for follow-up; the function was completely restored and he had no pain.

Anquilose temporomandibular: enxerto condrocostal

The authors had stud ied the treatment of the temporo mandibular Joint using the Condro Costal graft and ressection of the coronoid process.

Computed tomography findings in a cohort of 169 dogs with elbow dysplasia - a retrospective study

Background Canine elbow dysplasia (CED) is a complex developmental skeletal disorder associated with a number of pathological conditions within the cubital joint. Because CED is a heritable disease, it is important to identify and remove the affected animals from breeding. The first objective of this study was to describe the prevalence of medial coronoid process disease (MCPD) without (MCD) or with (FMCP) fragmented medial coronoid process, osteochondrosis (OC) and/or osteochondritis dissecans (OCD), ununited anconeal process (UAP), radio-ulnar incongruence (INC R-U) and humero-ulnar incongruence (INC H-U) in dogs with the use of CT imaging. The second aim was to determine the influence of demographics on the prevalence of investigated pathologies in dogs with clinical evidence of elbow dysplasia. Results In this retrospective study, CT data records of 169 dogs of different breeds presented to the small animal veterinary clinic from 2012 to 2018 were included. 69.23% of dogs diagnosed with CED were young (≤ 2 years old). The mean age of dogs presented with INC R-U was 1.68 ± 1.82 years, while in dogs without INC R-U the mean age was 2.64 ± 2.59 years. The mean age of dogs with INC H-U was 1.94 ± 2.06 years, while without INC H-U 3.29 ± 2.09 years. Labrador Retrievers, German Shepherd and Bernese Mountain dogs were most frequently presented with CED-associated lameness. In 122 dogs OA of varying severity was found. Conclusion INC H-U, FMCP and MCD were among the most frequently found components of CED found in the present study. OCD and UAP were the least frequently diagnosed. Dogs presented with INC R-U and INC H-U were significantly younger than dogs without these CED components. Boxers, Dog de Bordeaux, American Staffordshire terriers and mixed-breed dogs were diagnosed later in life than the other breeds. OA of varying severity was found in 72.18% of dogs. Males accounted for more than 75% of the study population.

Relation of Computed Tomography-Based Static Axial Radioulnar Incongruence Measurements under General Anaesthesia and Dynamic, In Vivo RUI during the Walk in Canine Elbow Joints with and without Medial Coronoid Process Disease

Objective This study aimed to evaluate the correlation of static axial radioulnar incongruence (sRUI) measured under general anaesthesia with the real in vivo dynamic RUI (dRUI) during walking. Study design This was a prospective clinical study that included 6 sound elbows (5 dogs) and 7 medial coronoid process disease (MCPD) affected elbows (6 dogs). Materials and Methods Static axial radioulnar incongruence was measured using the sphere fitting technique on computed tomography-based three-dimensional (3D) models of radius and ulna. The in vivo pose of radius and ulna was derived from radiostereometric analysis during the walk and transferred onto previously calculated 3D models. Dynamic RUI was measured on those adjusted models using the sphere fitting technique, providing a measurement of RUI over time during walk. Results Mean sRUI was 0.2 mm (standard deviation [SD]: 0.30) in control and 1.4 mm (SD: 0.73) in elbow joints with MCPD; being significantly different (p = 0.0035; confidence interval [CI]: 0.4772–1.8824). Mean dRUI in controls (−0.4 mm; SD: 0.47) was significantly different (p = 0.0004; CI: 0.9918–2.5225) from dRUI in the affected elbows (1.4 mm; SD: 0.73). Comparison of sRUI and dRUI within each group showed difference in the control group (0.2 vs. −0.4 mm; p = 0.0138; CI: 0.1820–1.0014). In affected elbows, no difference between sRUI and dRUI was found (1.4 vs. 1.4 mm; p = 0.8963). Conclusion In normal elbow joints, sRUI does not represent the in vivo condition during weight bearing. Dynamic and slightly negative RUI occurs during loading (0.2 mm positive to −0.4 mm negative RUI). In MCPD affected elbows with sRUI, no dynamic change of RUI occurs during the walk.