A new measurement and analysis method was proposed to investigate the changes in elbow joint moments that occur with the use of a front-wheeled walker. A strain gauge-based walker instrumentation system was developed ...A new measurement and analysis method was proposed to investigate the changes in elbow joint moments that occur with the use of a front-wheeled walker. A strain gauge-based walker instrumentation system was developed to monitor the hand loads during walker-assisted walking and integrated with an upper extremity biomechanical model. Preliminary system data were collected for 12 subjects following informed consent. Bilateral upper extremity kinematic data were acquired with a six-camera motion analysis system. Internal joint moments at the elbow were determined in the three clinical planes using the inverse dynamics method. Results showed that during a walker-assisted gait elbow joint moments mainly distributed in the walker stance period. There was a noted demand on the elbow extensor in the sagittal plane with the greatest record as 0.381 N·m/(kg·m). An interesting "bare phase" of mean elbow joint moments was also found in phase angle-240o-340o of gait cycle. Complete description of elbow joint moments of walker-assisted gait may provide insight into walker use parameters and rehabilitative strategies.展开更多
BACKGROUND Simple lateral elbow dislocation(SLED)is a rare type of elbow dislocation;however,its treatment may be complicated by accompanying soft tissue or neurovascular damage.Herein,we report a rare case of SLED ma...BACKGROUND Simple lateral elbow dislocation(SLED)is a rare type of elbow dislocation;however,its treatment may be complicated by accompanying soft tissue or neurovascular damage.Herein,we report a rare case of SLED managed secondarily with open reduction and soft tissue repair following failure of closed reduction.CASE SUMMARY A 67-year-old woman suffered SLED after falling on her outstretched left hand with her elbow extended.She developed pain,swelling,and movement restriction in the elbow;there were no neurovascular symptoms,except for numbness in the 4th and 5th digits.Radiologic investigation confirmed the SLED,and a closed reduction under anesthesia was performed.The follow-up radiographs at 1-wk revealed failure of reduction;accordingly,open reduction with lateral collateral ligament and common extensor origin repair were carried out.The patient regained full elbow range of motion by six weeks.CONCLUSION Adequate concentric reduction for SLED,conservatively or surgically,reduces complications and provides a more functional joint.展开更多
BACKGROUND The preferred treatment for distal humeral intercondylar fractures is open reduction and internal fixation.While there is consensus about the posterior approach,several posterior approaches have been develo...BACKGROUND The preferred treatment for distal humeral intercondylar fractures is open reduction and internal fixation.While there is consensus about the posterior approach,several posterior approaches have been developed.It is debatable as to which approach is best.AIM To compare triceps reflecting anconeus pedicle(TRAP)and olecranon osteotomy approaches for internal fixation of distal humeral intercondylar fracture.METHODS In total,40 cases of Arbeitsgemeinschaft für Osteosynthesefragen/Association of the Study of Internal Fixation type C,closed,and Gustilo type I intercondylar humeral fractures were included.Patients ranged in age from 18 years to 70 years.The patients were randomized into two groups:TRAP group and olecranon osteotomy group,with 20 cases in each.All were followed up at 6 wk,3 months,6 months,and 12 months.Functional outcomes were measured in terms of flexion-extension arc,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score.RESULTS The mean age was 43.2 years in the TRAP group and 37.5 years in the olecranon osteotomy group.The mean operative time and mean duration of hospital stay in the TRAP group were significantly higher than in the olecranon osteotomy group(119.5 vs 111.5 min and 9.85 vs 5.45 d,respectively).The mean arc of flexion-extension,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score were comparable without any significant difference in the groups at the 12-month follow-up(107.0 vs 106.2,18.3 vs 15.7,and 84.2 vs 86.2,respectively).Ulnar paresthesia and superficial infections were comparable in both groups(2 cases vs 3 cases and 3 cases vs 2 cases,respectively).Hardware prominence was significantly higher in the olecranon osteotomy group,mostly due to tension band wiring.CONCLUSION Both approaches were equivalent,but there is a need for further study including higher numbers of subjects and longer study duration to prove the benefits of one approach over the other.展开更多
目的评估手术治疗肘关节恐怖三联征的临床疗效。方法连续收集本院2020年1月-2022年1月收住并接受手术治疗28例肘关节恐怖三联征患者的临床资料,动态随访1年,观察患者的VAS疼痛评分、肘关节屈伸、前臂旋转范围、肘关节功能恢复情况和并...目的评估手术治疗肘关节恐怖三联征的临床疗效。方法连续收集本院2020年1月-2022年1月收住并接受手术治疗28例肘关节恐怖三联征患者的临床资料,动态随访1年,观察患者的VAS疼痛评分、肘关节屈伸、前臂旋转范围、肘关节功能恢复情况和并发症发生情况。结果28例患者中男性19例、女性9例,平均年龄(31.28±11.52)岁。尺骨冠状突骨折Regan-Morrey I型5例、II型18例、III型5例;桡骨头骨折Mason I型9例、II型13例、III型6例。分别采用不同麻醉方式、手术入路和术式完成骨折内固定和韧带修复,随访结束时28例骨折均骨性愈合(100%),发生1例异位骨化(3.57%)被成功纠治(100%)。与术前比较,患者术后1年的肘关节疼痛(VAS评分:7.21±2.18 VS 2.01±0.21,P<0.001)、肘关节屈伸度(29.68±16.13 VS 130.81±18.95,P<0.001)、前臂旋前范围(10.63±8.25 VS 76.35±2.45,P<0.001)、旋后范围(10.21±8.89 VS 75.32±3.85,P<0.001)、肘关节功能(Mayo评分:38.36±18.63 VS 87.45±12.38,P<0.001)均显著改善。结论手术治疗肘关节恐怖三联征疗效显著,选择合适手术入路及手术模式重建肘关节的稳定性、术后早期康复锻炼,是获得满意疗效的关键。展开更多
基金National Natural Science Foundation of China (No. 60501005)National High Technology Research and Development Program of China(No. 2007AA04Z236)Key Program of Tianjin Science and Technology Support Plan (No. 07ZCKFSF01300)
文摘A new measurement and analysis method was proposed to investigate the changes in elbow joint moments that occur with the use of a front-wheeled walker. A strain gauge-based walker instrumentation system was developed to monitor the hand loads during walker-assisted walking and integrated with an upper extremity biomechanical model. Preliminary system data were collected for 12 subjects following informed consent. Bilateral upper extremity kinematic data were acquired with a six-camera motion analysis system. Internal joint moments at the elbow were determined in the three clinical planes using the inverse dynamics method. Results showed that during a walker-assisted gait elbow joint moments mainly distributed in the walker stance period. There was a noted demand on the elbow extensor in the sagittal plane with the greatest record as 0.381 N·m/(kg·m). An interesting "bare phase" of mean elbow joint moments was also found in phase angle-240o-340o of gait cycle. Complete description of elbow joint moments of walker-assisted gait may provide insight into walker use parameters and rehabilitative strategies.
文摘BACKGROUND Simple lateral elbow dislocation(SLED)is a rare type of elbow dislocation;however,its treatment may be complicated by accompanying soft tissue or neurovascular damage.Herein,we report a rare case of SLED managed secondarily with open reduction and soft tissue repair following failure of closed reduction.CASE SUMMARY A 67-year-old woman suffered SLED after falling on her outstretched left hand with her elbow extended.She developed pain,swelling,and movement restriction in the elbow;there were no neurovascular symptoms,except for numbness in the 4th and 5th digits.Radiologic investigation confirmed the SLED,and a closed reduction under anesthesia was performed.The follow-up radiographs at 1-wk revealed failure of reduction;accordingly,open reduction with lateral collateral ligament and common extensor origin repair were carried out.The patient regained full elbow range of motion by six weeks.CONCLUSION Adequate concentric reduction for SLED,conservatively or surgically,reduces complications and provides a more functional joint.
文摘BACKGROUND The preferred treatment for distal humeral intercondylar fractures is open reduction and internal fixation.While there is consensus about the posterior approach,several posterior approaches have been developed.It is debatable as to which approach is best.AIM To compare triceps reflecting anconeus pedicle(TRAP)and olecranon osteotomy approaches for internal fixation of distal humeral intercondylar fracture.METHODS In total,40 cases of Arbeitsgemeinschaft für Osteosynthesefragen/Association of the Study of Internal Fixation type C,closed,and Gustilo type I intercondylar humeral fractures were included.Patients ranged in age from 18 years to 70 years.The patients were randomized into two groups:TRAP group and olecranon osteotomy group,with 20 cases in each.All were followed up at 6 wk,3 months,6 months,and 12 months.Functional outcomes were measured in terms of flexion-extension arc,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score.RESULTS The mean age was 43.2 years in the TRAP group and 37.5 years in the olecranon osteotomy group.The mean operative time and mean duration of hospital stay in the TRAP group were significantly higher than in the olecranon osteotomy group(119.5 vs 111.5 min and 9.85 vs 5.45 d,respectively).The mean arc of flexion-extension,Disabilities of Arm,Shoulder and Hand score,and Mayo Elbow Performance Score were comparable without any significant difference in the groups at the 12-month follow-up(107.0 vs 106.2,18.3 vs 15.7,and 84.2 vs 86.2,respectively).Ulnar paresthesia and superficial infections were comparable in both groups(2 cases vs 3 cases and 3 cases vs 2 cases,respectively).Hardware prominence was significantly higher in the olecranon osteotomy group,mostly due to tension band wiring.CONCLUSION Both approaches were equivalent,but there is a need for further study including higher numbers of subjects and longer study duration to prove the benefits of one approach over the other.
文摘目的评估手术治疗肘关节恐怖三联征的临床疗效。方法连续收集本院2020年1月-2022年1月收住并接受手术治疗28例肘关节恐怖三联征患者的临床资料,动态随访1年,观察患者的VAS疼痛评分、肘关节屈伸、前臂旋转范围、肘关节功能恢复情况和并发症发生情况。结果28例患者中男性19例、女性9例,平均年龄(31.28±11.52)岁。尺骨冠状突骨折Regan-Morrey I型5例、II型18例、III型5例;桡骨头骨折Mason I型9例、II型13例、III型6例。分别采用不同麻醉方式、手术入路和术式完成骨折内固定和韧带修复,随访结束时28例骨折均骨性愈合(100%),发生1例异位骨化(3.57%)被成功纠治(100%)。与术前比较,患者术后1年的肘关节疼痛(VAS评分:7.21±2.18 VS 2.01±0.21,P<0.001)、肘关节屈伸度(29.68±16.13 VS 130.81±18.95,P<0.001)、前臂旋前范围(10.63±8.25 VS 76.35±2.45,P<0.001)、旋后范围(10.21±8.89 VS 75.32±3.85,P<0.001)、肘关节功能(Mayo评分:38.36±18.63 VS 87.45±12.38,P<0.001)均显著改善。结论手术治疗肘关节恐怖三联征疗效显著,选择合适手术入路及手术模式重建肘关节的稳定性、术后早期康复锻炼,是获得满意疗效的关键。
