The Experts below are selected from a list of 141 Experts worldwide ranked by ideXlab platform
David Ring - One of the best experts on this subject based on the ideXlab platform.
-
Persistent Medial Subluxation of the Ulna with RadioTrochlear Articulation
Mashhad University of Medical Sciences, 2017Co-Authors: Amir R. Kachooei, David RingAbstract:Two patients-one with a terrible triad fracture dislocation and one with an anterior olecranon fracture dislocation—weretreated for maltracking of the elbow (medial subluxation). The radial head articulated with the lateral trochlea while theulnar Trochlear Notch was perched over the medial trochlea. The late revision surgery could not correct the subluxationbecause the joints were accustomed to the new alignment, however the overall function was reasonable
-
anterior olecranon fracture dislocations of the elbow in children a report of four cases
Journal of Bone and Joint Surgery American Volume, 2009Co-Authors: Thierry G Guitton, Robert G H Albers, David RingAbstract:A subset of olecranon fractures with loss of normal articular apposition (subluxation or dislocation) is recognized in adults as anterior and posterior olecranon fracture-dislocations1-6, but such injuries in skeletally immature patients have been rarely described7-9. The anterior olecranon fracture-dislocation may resemble an anterior Monteggia lesion in that there is anterior dislocation of the radial head with respect to the capitellum; however, the forearm (the radioulnar relationship) remains intact and the injury is primarily to the ulnohumeral joint by means of disruption of the Trochlear Notch (Figs. 1-A and 1-B). The coronoid is fractured in approximately half of the patients, the radial head is rarely injured, and the collateral ligaments are generally spared10. Olecranon fractures are relatively uncommon in skeletally immature patients11-13, and we were able to identify the cases of only three skeletally immature patients with an apparent anterior olecranon fracture-dislocation reported in the literature7-9. Figs. 1-A and 1-B Drawings differentiating between anterior olecranon fracture-dislocation and anterior Monteggia injuries. Fig. 1-A In the anterior olecranon fracture-dislocation, the proximal radioulnar joint remains aligned and intact, but there is an anterior dislocation of the radiocapitellar joint along with the rest of the forearm. Fig. 1-B In the anterior Monteggia fracture, there is a fracture of the ulna with anterior dislocation of the radial head. We identified four skeletally immature patients with an anterior olecranon fracture-dislocation from a fracture registry. This report describes the injury characteristics, treatment methods, and results of these four patients. ### Materials and Methods Between 1974 and 2002, all fractures treated at our institution were entered into a database …
-
interposition arthroplasty of the elbow with hinged external fixation for post traumatic arthritis
Journal of Shoulder and Elbow Surgery, 2008Co-Authors: Jose Nolla, David Ring, Santiago A Lozanocalderon, Jesse B JupiterAbstract:This retrospective case series reviewed 9 men and 4 women (mean age, 41 years) with severe post-traumatic elbow arthrosis treated with interposition arthroplasty and temporary hinged external fixation. In 2 patients, treatment was considered to have failed because of early postoperative instability, and their results were classified as poor. The remaining 11 were followed up for a mean of 4 years (range, 1-11 years). The mean arc of flexion improved from 48° before surgery to 110° after surgery. The mean postoperative Broberg-Morrey score was 77 points, reflecting a mean improvement of 41 points (range, 13-68 points) and corresponding with 1 excellent, 4 good, 4 fair, and 4 poor results. Four patients had severe instability associated with bone loss of the distal humerus or Trochlear Notch. Interposition arthroplasty can improve elbow motion and function but at the expense of elbow stability despite hinged external fixation.
-
effective treatment of fracture dislocations of the olecranon requires a stable Trochlear Notch
Clinical Orthopaedics and Related Research, 2004Co-Authors: Job N Doornberg, David Ring, Jesse B JupiterAbstract:: Our goal with this study was to better define and characterize fracture-dislocations of the olecranon and to provide additional data regarding complications and elbow function after operative treatment. Twenty-six patients with fracture-dislocations of the elbow were reviewed retrospectively. Ten had anterior and 16 had posterior fracture-dislocations. Five of 10 patients with anterior injuries and all of the patients with posterior injuries had an associated fracture of the coronoid process of the ulna. One of 10 patients with anterior and 13 of 16 patients with posterior injuries had fracture of the radial head. Only one patient had a true dislocation of the ulnohumeral joint. In the other 25 patients the articular surfaces remained apposed. All 26 patients were treated operatively and followed up for at least 3 years (average, 6 years). The results were good or excellent in 21 of 26 patients according to the system of Broberg and Morrey. The five unsatisfactory results were related to inadequate fixation of the coronoid with subsequent arthrosis (three patients), proximal radioulnar synostosis (three patients), and a subsequent fracture of the distal humerus (one patient). Fracture-dislocations of the olecranon occur in anterior and posterior patterns with specific injury characteristics and pitfalls. The key to effective treatment is stable restoration of the Trochlear Notch.
-
treatment of unreduced elbow dislocations with hinged external fixation
Journal of Bone and Joint Surgery American Volume, 2002Co-Authors: Jesse B Jupiter, David RingAbstract:Background: The results of operative treatment of an unreduced elbow dislocation have been regarded with pessimism. Suggested procedures have included tendon-lengthening, tendon transfer, or reconstruction of ligament or bone. Methods: Three women and two men (average age, forty-nine years) with an unreduced dislocation of the elbow without associated fractures were treated with open relocation of the joint and hinged external fixation at an average of eleven weeks (range, six to thirty weeks) after the initial injury. The lateral soft tissues, including the origin of the lateral collateral ligament complex, were reattached to the lateral epicondyle in three patients, but no attempt was made to reconstruct the ligaments, tendons, or bone. A passive worm gear incorporated into a hinged external fixator was used to mobilize the elbow initially, and active mobilization was gradually introduced. The hinge was removed at an average of five weeks after the procedure. Results: At an average of thirty-eight months (range, twelve to ninety-eight months), a stable, concentric reduction had been maintained in all five patients, with radiographic signs of mild arthrosis in four. The average arc of flexion was 123×, and all patients had full forearm rotation. The average score on the Mayo Elbow Performance Index was 89 points, with two excellent and three good results. The average scores on the Disabilities of the Arm, Shoulder and Hand (DASH) and American Shoulder and Elbow Surgeons outcome instruments (13 and 92 points, respectively) reflected mild residual pain and disability. Conclusions: Treatment of unreduced elbow dislocations with open reduction and hinged external fixation as much as thirty weeks after the injury can restore a stable, mobile joint without the need for tendon-lengthening or transfer, ligament reconstruction, or deepening of the Trochlear Notch of the ulna.
Shinichi Tamura - One of the best experts on this subject based on the ideXlab platform.
-
in vivo elbow biomechanical analysis during flexion three dimensional motion analysis using magnetic resonance imaging
Journal of Shoulder and Elbow Surgery, 2004Co-Authors: Akira Goto, Kazuomi Sugamoto, Tsuyoshi Murase, Hisao Moritomo, Kunihiro Oka, Takehiro Arimura, Yoshikazu Nakajima, Takaharu Yamazaki, Yoshinobu Sato, Shinichi TamuraAbstract:The purpose of this article is to evaluate in vivo 3-dimensional kinematics of the elbow joint during elbow flexion. We studied the ulnohumeral and radiohumeral joint noninvasively in 3 elbows in healthy volunteers using a markerless bone registration algorithm. Magnetic resonance images were acquired in 6 positions of elbow flexion. The inferred contact areas on the ulna against the trochlea tended to occur only on the medial facet of the Trochlear Notch in all of the elbow positions we tested. The inferred contact areas on the radial head against the capitellum occurred on the central depression of the radial head in all of the tested elbow positions except for 135 degrees flexion, where the anterior rim of the radial head articulates with the capitellum.
-
in vivo elbow biomechanical analysis during flexion three dimensional motion analysis using magnetic resonance imaging
Journal of Shoulder and Elbow Surgery, 2004Co-Authors: Akira Goto, Kazuomi Sugamoto, Tsuyoshi Murase, Hisao Moritomo, Kunihiro Oka, Takehiro Arimura, Yoshikazu Nakajima, Takaharu Yamazaki, Yoshinobu Sato, Shinichi TamuraAbstract:The purpose of this article is to evaluate in vivo 3-dimensional kinematics of the elbow joint during elbow flexion. We studied the ulnohumeral and radiohumeral joint noninvasively in 3 elbows in healthy volunteers using a markerless bone registration algorithm. Magnetic resonance images were acquired in 6 positions of elbow flexion. The inferred contact areas on the ulna against the trochlea tended to occur only on the medial facet of the Trochlear Notch in all of the elbow positions we tested. The inferred contact areas on the radial head against the capitellum occurred on the central depression of the radial head in all of the tested elbow positions except for 135° flexion, where the anterior rim of the radial head articulates with the capitellum.
Jesse B Jupiter - One of the best experts on this subject based on the ideXlab platform.
-
interposition arthroplasty of the elbow with hinged external fixation for post traumatic arthritis
Journal of Shoulder and Elbow Surgery, 2008Co-Authors: Jose Nolla, David Ring, Santiago A Lozanocalderon, Jesse B JupiterAbstract:This retrospective case series reviewed 9 men and 4 women (mean age, 41 years) with severe post-traumatic elbow arthrosis treated with interposition arthroplasty and temporary hinged external fixation. In 2 patients, treatment was considered to have failed because of early postoperative instability, and their results were classified as poor. The remaining 11 were followed up for a mean of 4 years (range, 1-11 years). The mean arc of flexion improved from 48° before surgery to 110° after surgery. The mean postoperative Broberg-Morrey score was 77 points, reflecting a mean improvement of 41 points (range, 13-68 points) and corresponding with 1 excellent, 4 good, 4 fair, and 4 poor results. Four patients had severe instability associated with bone loss of the distal humerus or Trochlear Notch. Interposition arthroplasty can improve elbow motion and function but at the expense of elbow stability despite hinged external fixation.
-
effective treatment of fracture dislocations of the olecranon requires a stable Trochlear Notch
Clinical Orthopaedics and Related Research, 2004Co-Authors: Job N Doornberg, David Ring, Jesse B JupiterAbstract:: Our goal with this study was to better define and characterize fracture-dislocations of the olecranon and to provide additional data regarding complications and elbow function after operative treatment. Twenty-six patients with fracture-dislocations of the elbow were reviewed retrospectively. Ten had anterior and 16 had posterior fracture-dislocations. Five of 10 patients with anterior injuries and all of the patients with posterior injuries had an associated fracture of the coronoid process of the ulna. One of 10 patients with anterior and 13 of 16 patients with posterior injuries had fracture of the radial head. Only one patient had a true dislocation of the ulnohumeral joint. In the other 25 patients the articular surfaces remained apposed. All 26 patients were treated operatively and followed up for at least 3 years (average, 6 years). The results were good or excellent in 21 of 26 patients according to the system of Broberg and Morrey. The five unsatisfactory results were related to inadequate fixation of the coronoid with subsequent arthrosis (three patients), proximal radioulnar synostosis (three patients), and a subsequent fracture of the distal humerus (one patient). Fracture-dislocations of the olecranon occur in anterior and posterior patterns with specific injury characteristics and pitfalls. The key to effective treatment is stable restoration of the Trochlear Notch.
-
treatment of unreduced elbow dislocations with hinged external fixation
Journal of Bone and Joint Surgery American Volume, 2002Co-Authors: Jesse B Jupiter, David RingAbstract:Background: The results of operative treatment of an unreduced elbow dislocation have been regarded with pessimism. Suggested procedures have included tendon-lengthening, tendon transfer, or reconstruction of ligament or bone. Methods: Three women and two men (average age, forty-nine years) with an unreduced dislocation of the elbow without associated fractures were treated with open relocation of the joint and hinged external fixation at an average of eleven weeks (range, six to thirty weeks) after the initial injury. The lateral soft tissues, including the origin of the lateral collateral ligament complex, were reattached to the lateral epicondyle in three patients, but no attempt was made to reconstruct the ligaments, tendons, or bone. A passive worm gear incorporated into a hinged external fixator was used to mobilize the elbow initially, and active mobilization was gradually introduced. The hinge was removed at an average of five weeks after the procedure. Results: At an average of thirty-eight months (range, twelve to ninety-eight months), a stable, concentric reduction had been maintained in all five patients, with radiographic signs of mild arthrosis in four. The average arc of flexion was 123×, and all patients had full forearm rotation. The average score on the Mayo Elbow Performance Index was 89 points, with two excellent and three good results. The average scores on the Disabilities of the Arm, Shoulder and Hand (DASH) and American Shoulder and Elbow Surgeons outcome instruments (13 and 92 points, respectively) reflected mild residual pain and disability. Conclusions: Treatment of unreduced elbow dislocations with open reduction and hinged external fixation as much as thirty weeks after the injury can restore a stable, mobile joint without the need for tendon-lengthening or transfer, ligament reconstruction, or deepening of the Trochlear Notch of the ulna.
Tsuyoshi Murase - One of the best experts on this subject based on the ideXlab platform.
-
does cubitus varus cause morphologic and alignment changes in the elbow joint
Journal of Shoulder and Elbow Surgery, 2013Co-Authors: Yohei Kawanishi, Junichi Miyake, Toshiyuki Kataoka, Shinsuke Omori, Kazuomi Sugamoto, Hideki Yoshikawa, Tsuyoshi MuraseAbstract:Background In cubitus varus after pediatric supracondylar fracture, late development of Trochlear deformity causing additional varus angulation and joint misalignment relating to late complications of the tardy ulnar nerve palsy or posterolateral rotatory instability have been suggested. However, it is unclear whether these morphologic and alignment changes of the elbow joint occur in cubitus varus. The object of this study was to investigate morphologic changes of the bones and alignment changes of the elbow joint in longstanding cubitus varus using 3-dimensional computer bone models created from computed tomography data. Materials and methods We studied 14 patients with longstanding cubitus varus after pediatric supracondylar fractures. Three-dimensional bone models of the bilateral humerus, radius, and ulna were created from computed tomography data. We compared the morphology and alignment of the elbow joint between the affected side and contralateral unaffected side. Results The posterior trochlea, distal part of the lateral capitellum, diameters of the radial head, and articular surface of the ulna in cubitus varus were larger than those of the contralateral elbow. In the ulna, the convex portion of the Trochlear Notch shifted laterally in cubitus varus. Joint alignment in cubitus varus was affected by a shift of the ulna to a more distal and medial position with external rotation and flexion. Conclusions In longstanding cubitus varus, the morphology and alignment of the elbow joint are observed to differ from those of the normal side.
-
in vivo elbow biomechanical analysis during flexion three dimensional motion analysis using magnetic resonance imaging
Journal of Shoulder and Elbow Surgery, 2004Co-Authors: Akira Goto, Kazuomi Sugamoto, Tsuyoshi Murase, Hisao Moritomo, Kunihiro Oka, Takehiro Arimura, Yoshikazu Nakajima, Takaharu Yamazaki, Yoshinobu Sato, Shinichi TamuraAbstract:The purpose of this article is to evaluate in vivo 3-dimensional kinematics of the elbow joint during elbow flexion. We studied the ulnohumeral and radiohumeral joint noninvasively in 3 elbows in healthy volunteers using a markerless bone registration algorithm. Magnetic resonance images were acquired in 6 positions of elbow flexion. The inferred contact areas on the ulna against the trochlea tended to occur only on the medial facet of the Trochlear Notch in all of the elbow positions we tested. The inferred contact areas on the radial head against the capitellum occurred on the central depression of the radial head in all of the tested elbow positions except for 135 degrees flexion, where the anterior rim of the radial head articulates with the capitellum.
-
in vivo elbow biomechanical analysis during flexion three dimensional motion analysis using magnetic resonance imaging
Journal of Shoulder and Elbow Surgery, 2004Co-Authors: Akira Goto, Kazuomi Sugamoto, Tsuyoshi Murase, Hisao Moritomo, Kunihiro Oka, Takehiro Arimura, Yoshikazu Nakajima, Takaharu Yamazaki, Yoshinobu Sato, Shinichi TamuraAbstract:The purpose of this article is to evaluate in vivo 3-dimensional kinematics of the elbow joint during elbow flexion. We studied the ulnohumeral and radiohumeral joint noninvasively in 3 elbows in healthy volunteers using a markerless bone registration algorithm. Magnetic resonance images were acquired in 6 positions of elbow flexion. The inferred contact areas on the ulna against the trochlea tended to occur only on the medial facet of the Trochlear Notch in all of the elbow positions we tested. The inferred contact areas on the radial head against the capitellum occurred on the central depression of the radial head in all of the tested elbow positions except for 135° flexion, where the anterior rim of the radial head articulates with the capitellum.
F Leitner - One of the best experts on this subject based on the ideXlab platform.
-
ultrasonic bone contour extraction to refine anatomic landmark acquisition in computer assisted measurement of knee kinematics
Orthopaedic Proceedings, 2018Co-Authors: D Graham, A Massonsibut, Russell D F, F LeitnerAbstract:Image-free navigation technology relies heavily on the surgeon carefully registering bony anatomical landmarks, a critical step in achieving accurate registration which affects the entire procedure. Currently this step may depend on placing a pointer superficially, with soft-tissue and skin obscuring these bony landmarks. We report initial results of using newly developed experimental software which automatically recognises the bone soft-tissue interface. This is the first critical step in development of automatic computer generation of the bone surface topography from ultrasound scanning.Individual 2D ultrasound images (n=651) of the anterior femoral condyles and Trochlear Notch were used. Images were taken from 29 volunteers (20 male, 9 female). The software extracted bone-soft tissue interface by a two-step method based on a gradient evaluation and the elimination of false-positives with a graph closure. The Trochlear Notch was automatically defined by geometrical modelisation. Coordinates of both bone...
-
ultrasonic bone contour extraction to refine anatomic landmark acquisition in computer assisted measurement of knee kinematics
Journal of Bone and Joint Surgery-british Volume, 2013Co-Authors: D Graham, D F Russell, A Massonsibut, F LeitnerAbstract:Image-free navigation technology relies heavily on the surgeon carefully registering bony anatomical landmarks, a critical step in achieving accurate registration which affects the entire procedure. Currently this step may depend on placing a pointer superficially, with soft-tissue and skin obscuring these bony landmarks. We report initial results of using newly developed experimental software which automatically recognises the bone soft-tissue interface. This is the first critical step in development of automatic computer generation of the bone surface topography from ultrasound scanning. Individual 2D ultrasound images (n=651) of the anterior femoral condyles and Trochlear Notch were used. Images were taken from 29 volunteers (20 male, 9 female). The software extracted bone-soft tissue interface by a two-step method based on a gradient evaluation and the elimination of false-positives with a graph closure. The Trochlear Notch was automatically defined by geometrical modelisation. Coordinates of both bone interface and Trochlear Notch position for each separate image were compared to a separate analysis performed manually by a single investigator. Error was calculated using root mean squared (RMS). Median error (RMS) in locating bone soft-tissue interface was 0.67 mm, (mean 0.93 mm, SD 0.84 mm). Median error for Trochlear Notch topography was 1.01mm, (mean 1.41 mm, SD 1.37 mm). Bone soft-tissue interface can be accurately defined and displayed by this software. Direct visualisation of critical bony landmarks could replace the current comparatively subjective placement of a pointer on superficial tissues. This has powerful application in both non-invasive and surgical computer-assisted acquisition of knee kinematics, and may have further applications in orthopaedic surgery.
