[Radiological diagnosis in contracted elbow joint. Value of CT and MRI]

The Effect of Acupuncture on Elbow Joint Sports Injuries Based on Magnetic Resonance Imaging

Purpose. Elbow joint injuries are extremely common in most athletes. Athletes’ chronic elbow injuries can involve multiple complex anatomical structures related to orthopedics. Therefore, it is of great significance to explore the characteristics of magnetic resonance (MR) images of chronic sports injuries of the elbow joint and the influence of acupuncture treatment on MR images and clinical symptoms. Methods. A total of 60 elbow joints of 39 athletes from 15-25 years old were selected for coronal, sagittal, and axial MR scans to observe the image characteristics; 60 elbow joints were randomly divided into acupuncture group and control group and observed changes in MR images and clinical symptoms after acupuncture treatment. Results. After acupuncture treatment, the clinical symptoms were significantly improved. MR images showed that the elbow joint effusion was reduced, and the bone marrow edema was reduced. The effective rate of acupuncture treatment is as high as 100%, while the effective rate of the control group is only 40%. Acupuncture treatment has significantly improved the range of motion of the elbow joint. Conclusion. Acupuncture treatment can significantly relieve athletes’ elbow joint pain and locking symptoms, improve joint range of motion, and is beneficial to recovery of special training and high-level competitive competitions. It is a sensitive, effective, and noninvasive method.

A new pathologic classification for elbow stiffness based on our experience in 216 patients

BACKGROUND

Elbow stiffness commonly causes functional impairment and upper-limb disability. This study aimed to develop a new pathologic classification to further understand and standardize elbow arthrolysis from a new perspective, as well as to determine clinical outcomes.

METHODS

Extension-flexion dysfunction was classified into 4 types: EF_I, tethers alone; EF_II, tethers with blocks; EF_III, articular malformation; and EF_IV, bony ankylosis. Forearm rotation dysfunction was classified into 3 types: FR_I, contracture alone; FR_II, radial head malunion or nonunion; and FR_III, proximal radioulnar bony ankylosis. A total of 216 patients with elbow stiffness were prospectively included and categorized preoperatively. All surgical procedures were performed by the same chief surgeon; different types underwent specific procedures. Patient data, elbow motion, and functional scores were analyzed.

RESULTS

Mean range of motion (ROM) increased from 40° preoperatively to 118° at final follow-up; 88% of patients regained ROM of 100° or greater. The forearm rotation arc (FRA) with forearm rotation dysfunction increased from a preoperative mean of 76° to 128°; 82% of patients regained an FRA of 100° or greater. The mean Mayo Elbow Performance Index (MEPI) increased from 63 to 91 points; the proportion of patients with good or excellent results was 95%. EF_I patients had the best ROM (129°) and MEPI (93 points) and EF_IV patients achieved the most-changed ROM (116°), whereas EF_III patients had the worst ROM (104°) and MEPI (84 points) and the least-changed ROM (64°). The FRA was best in FR_I patients (142°), followed by FR_II patients (118°), and worst in FR_III patients (82°); in contrast, the changed FRA was greatest in FR_III patients (82°), followed by FR_II patients (64°), and least in FR_I patients (37°).

CONCLUSION

This study suggests that the proposed pathologic classification provides a new perspective on the understanding and standardization of elbow arthrolysis, providing satisfactory clinical outcomes.

The posttraumatic stiff elbow: an update

Posttraumatic elbow stiffness is a disabling condition that remains challenging to treat despite improvement of our understanding of the pathogenesis of posttraumatic contractures and new treatment regimens. This review provides an update and overview of the etiology of posttraumatic elbow stiffness, its classification, evaluation, nonoperative and operative treatment, and postoperative management.

POST-TRAUMATIC STIFFNESS OF THE ELBOW

Elbow stiffness is a common problem after joint trauma, causing functional impairment of the upper limb. The severity of the dysfunction depends on the nature of the initial trauma and the treatment used. Appropriate clinical evaluation and complementary examinations are essential for therapeutic planning. Several surgical techniques are now available and the recommendation must be made in accordance with patient characteristics, degree of joint limitation and the surgeon's skill. Joint incongruence and degeneration have negative effects on the prognosis, but heterotrophic ossification alone has been correlated with a favorable surgical prognosis.

The posttraumatic stiff elbow: a review of the literature

Loss of motion is a common complication of elbow trauma. Restoration of joint motion in the posttraumatic stiff elbow can be a difficult, time-consuming, and costly challenge. In this review of the literature, the biologic response to trauma and the possible etiologic events that may lead to fibrosis of the capsules and heterotopic ossification will be discussed, as well as nonsurgical and surgical management of stiffness and expected outcomes of treatment.

Demonstration of the articular cartilage of the canine ulnar trochlear notch using high-field magnetic resonance imaging

The articular cartilage covering the ulnar trochlear notch (UTN) of both elbow joints from 25 adult canine cadavers was demonstrated by the use of high-field magnetic resonance imaging (MRI) with a fat-suppressed, three-dimensional, spoiled gradient echo sequence. The dogs used for this study were divided into five groups: giant, large, mid-sized, small, and chondrodystrophic breeds. The distribution of articular cartilage of the UTN was assessed on MR images. The joints were then opened, and the distribution of the articular cartilage of the UTN was verified. In 29/50 joints, there was good agreement between gross findings of the distribution of the articular cartilage of the UTN and MRI interpretation. Reasons for the poor results in small and chondrodystrophic breeds were decreased thickness of the articular cartilage, small size of the articular surface and of its structural features, and the frequent inability to visualize the joint space.