Biomechanical evaluation of the intact, injured and surgically reconstructed ulnar collateral ligament of the elbow joint

2021 ◽  
Author(s):  
John Hobart Thinnes
Keyword(s):  
Elbow Joint ◽  
Ulnar Collateral Ligament ◽  
Collateral Ligament ◽  
Biomechanical Evaluation

Unusual Cause of Lateral Elbow Pain: A Case Report of Anconeus Muscle Contusion

2019 ◽  
Vol 34 (2) ◽  
pp. 102-104
Author(s):  
Muhsin E Uluc ◽  
Atilla H Cilengir ◽  
Cemal Kazimoglu ◽  
Özgür Tosun
Keyword(s):  
Case Report ◽  
Elbow Joint ◽  
Rare Case ◽  
Ulnar Collateral Ligament ◽  
Joint Capsule ◽  
Coronoid Process ◽  
Collateral Ligament ◽  
Elbow Pain ◽  
Lateral Elbow Pain ◽  
Lateral Elbow

The anconeus muscle is a small and minor functioning muscle located at the posterolateral elbow region. It helps forearm extension and tightening of the joint capsule. Despite its limited functions, pathologies of the anconeus muscle can mimic other abnormalities of the elbow joint. Here, we report a rare case of a traumatic anconeus muscle contusion in a 15-year-old boy due to falling during dance. MRI showed contusion in the anconeus muscle, as well as strain in the ulnar collateral ligament and edema in the coronoid process of the ulna. To our knowledge, this is the first described case of traumatic anconeus muscle contusion in the literature. The presence of long-lasting lateral elbow pain in trauma cases without fracture should alert clinicians to consider anconeus muscle abnormalities. MRI is the best modality for diagnosis in these cases.

scholarly journals Valgus Stability is Enhanced by Flexor Digitorum Superficialis Muscle Contraction of the Index and Middle Fingers

2020 ◽  
Author(s):  
Shota Hoshika ◽  
Akimoto Nimura ◽  
Norimasa Takahashi ◽  
Hiroyuki Sugaya ◽  
Keiichi Akita
Keyword(s):  
Muscle Contraction ◽  
Elbow Joint ◽  
Ulnar Collateral Ligament ◽  
Flexor Digitorum Profundus ◽  
Flexor Digitorum Superficialis ◽  
Collateral Ligament ◽  
Valgus Stress ◽  
The Difference ◽  
Flexor Digitorum ◽  
Healthy Males

Abstract Background: Flexor digitorum superficialis (FDS) muscle provides dynamic stabilization and medial elbow support for ulnar collateral ligament (UCL). The FDS contraction significantly affects the medial joint distance (MJD) through grip contraction. However, it remains unclear whether FDS activity alone contributes to medial elbow stability, or together with the activation of the flexor digitorum profundus during grip contraction, and which finger’s FDS is the main contributor to elbow stability. We investigated the resistive effects of isolated FDS contraction in individual fingers against valgus stress in the elbow joint using stress ultrasonography (US).Methods: We investigated 17 healthy males (mean age, 27 ± 5 years). Valgus stress US was performed using the Telos device, with the elbow at 30° flexion. MJD was measured for each arm during 3 separate conditions: at rest (unloaded), under valgus load (50 N) (loaded), and under valgus load with FDS contracted in individual fingers (loaded-contracted). Results: MJD was significantly longer when loaded (5.4 ± 0.4 mm) than unloaded (4.1 ± 0.2 mm, P = .007) or loaded-contracted (4.6 ± 0.3 mm, P = .003) for each finger. When loaded-contracted, MJD differed statistically between the index and ring fingers (P = .03) and between the middle and ring fingers (P = .04). However, the difference between the index and middle fingers was not statistically significant (P = .08).  Conclusions: Individual FDS contraction, particularly of the index and middle fingers contributes most to stabilization against valgus stress. Thus, injury care programs should incorporate FDS exercises of these fingers.

The biomechanical evaluation of a novel 3-strand docking technique for ulnar collateral ligament reconstruction in the elbow

2018 ◽  
Vol 27 (9) ◽  
pp. 1672-1678 ◽  
Author(s):  
Phillip N. Williams ◽  
Michelle H. McGarry ◽  
Hansel Ihn ◽  
Brian M. Schulz ◽  
Orr Limpisvasti ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Ulnar Collateral Ligament ◽  
Collateral Ligament ◽  
Biomechanical Evaluation ◽  
Ulnar Collateral Ligament Reconstruction

Biomechanical Evaluation of 2 Techniques for Ulnar Collateral Ligament Reconstruction of the Elbow

2006 ◽  
Vol 34 (10) ◽  
pp. 1599-1603 ◽  
Author(s):  
George A. Paletta ◽  
Steven J. Klepps ◽  
Gregory S. Difelice ◽  
Tracy Allen ◽  
Michael D. Brodt ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Ulnar Collateral Ligament ◽  
Collateral Ligament ◽  
Biomechanical Evaluation ◽  
Ulnar Collateral Ligament Reconstruction

scholarly journals Changes in Medial Elbow Joint Space When Elbow Valgus Stress Is Applied at Different Limb Positions and Loads In Vivo

2021 ◽  
Vol 9 (11) ◽  
pp. 232596712110459
Author(s):  
Kanta Yoshioka ◽  
Kanta Matsuzawa ◽  
Tomoya Ikuta ◽  
Sae Maruyama ◽  
Mutsuaki Edama
Keyword(s):  
Repeated Measures ◽  
Elbow Joint ◽  
Ulnar Collateral Ligament ◽  
Elbow Flexion ◽  
Sports Injury ◽  
Joint Space ◽  
Muscle Contractions ◽  
Collateral Ligament ◽  
Valgus Stress

Background: Ulnar collateral ligament (UCL) injury is a common sports injury among overhead-throwing athletes and causes medial elbow pain and instability. UCL injury is generally diagnosed based on symptoms, physical findings, and image evaluation. To standardize the method for evaluating elbow valgus instability, more information is needed regarding changes in the medial elbow joint space (JS) in healthy elbows. Purpose/Hypothesis: The purpose of this study was to measure the JS during the application of elbow valgus stress at different elbow flexion angles and loads and to clarify the presence of defensive muscle contractions during elbow valgus stress. It was hypothesized that the JS will differ according to different limb positions and loads and that defensive contractions will occur when elbow valgus stress is >90 N. Study Design: Controlled laboratory study. Methods: Elbow joints on the nondominant side were examined in 20 healthy male university students (mean age, 21 ± 0.2 years) at 30°, 60°, and 90° of elbow flexion. To create valgus stress on the elbow, loads of 30, 60, 90, 120, and 150 N were applied with a Telos stress device and with gravity stress on the forearm. The medial JS was measured ultrasonographically during the application of elbow valgus stress. Electrodes were attached to the pronator teres muscle, and defensive muscle contractions were measured using electromyography during the application of elbow valgus stress. Repeated-measures analysis of variance and paired t tests were used to compare the JS at each elbow angle and each valgus stress load, and the Bonferroni method was used as a post hoc test. Results: At 30° of elbow flexion, the JS was significantly higher at 30 N versus 0 N and at 60 N versus 0 or 30 N ( P ≤ .018 for all). At 60° of flexion, the JS was significantly higher at 30 N versus 0 N, at 60 N versus 0 and 30 N, and at 90 N versus 0, 30, and 60 N ( P ≤ .024 for all). At 90° of elbow flexion, the JS was significantly higher at 30 N versus 0 N and at 60 N versus 0 and 30 N ( P ≤ .028 for all). Defensive muscle contraction did not occur at any elbow flexion angles at elbow valgus stress ≤60 N. Conclusion: The lack of muscular contraction at elbow valgus stress ≤60 N may reflect the function of the medial collateral ligament. Clinical Relevance: Elbow valgus stress ≤60 N allows for the evaluation of the joint opening.

scholarly journals The Effect of Ulnar Collateral Ligament Repair With Internal Brace Augmentation on Articular Contact Mechanics: A Cadaveric Study

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712110010
Author(s):  
Travis S. Roth ◽  
David P. Beason ◽  
T. Bradley Clay ◽  
E. Lyle Cain ◽  
Jeffrey R. Dugas
Keyword(s):  
Contact Mechanics ◽  
Elbow Joint ◽  
Angular Displacement ◽  
Ulnar Collateral Ligament ◽  
Biomechanical Properties ◽  
Joint Torque ◽  
Return To Play ◽  
Ligament Repair ◽  
Collateral Ligament ◽  
Intact State

Background: There has been renewed interest in ulnar collateral ligament (UCL) repair in throwing athletes because of a greater understanding of UCL injuries, improvement in ligament repair technology, and potentially expedited rehabilitation time and return to play relative to UCL reconstruction. Purpose: To evaluate elbow articular contact and overall joint torque after UCL reconstruction and repair augmented with a collagen-coated fiber tape, InternalBrace. Study Design: Controlled laboratory study. Methods: Ten matched pairs of cadaveric arms (mean age, 41 ± 11 years) were dissected to expose the UCL. Each specimen was secured into a custom test fixture at 90°, and 1 specimen from each pair underwent either a modified Jobe UCL reconstruction or UCL repair with InternalBrace. Each specimen underwent 10 cycles of elbow valgus angular displacement between 0° and 5° at a rate of 1 deg/s in the intact state, after UCL avulsion, and then after UCL reconstruction or repair. Articular contact mechanics and overall joint torque and stiffness were recorded. Results: Contact mechanics of reconstructed and repaired specimens were not significantly different. Both reconstruction and repair procedures returned the overall resistance of the joint to valgus torsion to near-intact levels. UCL repair tended to restore joint torque more closely to the intact state than did reconstruction, given that reconstruction showed a nonsignificant trend toward lower torque than the intact state ( P = .07). Conclusion: Neither UCL reconstruction nor UCL repair with InternalBrace overconstrained the elbow joint, as both groups had similar contact pressures compared with the native joint. Both procedures also restored elbow joint torque and stiffness to levels not statistically different from the intact state. Clinical Relevance: Given the sound biomechanical properties of UCL repair with InternalBrace, it may have a significant role as treatment for UCL injuries.

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