Complications of Elbow Trauma

Cheung, Emilie V.; Sarkissian, Eric J.

doi:10.1016/j.hcl.2015.06.012

Cited by 14 publications

(7 citation statements)

References 50 publications

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“…Infection is a common risk factor associated with distinct trauma–induced HO. 57,97,98 Using the well-established rat model of high-energy combat injury, Pavey et al 57 recently demonstrated a significantly higher volume of ectopic bone formation at the amputation site with the early colonization of MRSA. Interestingly, MRSA is also known to be the predominant pathogen in severe burn wound infections, 99 where HO is a common occurrence.…”

Section: Potential Causes and Mechanismmentioning

confidence: 99%

The traumatic bone: trauma-induced heterotopic ossification

Dey

Wheatley

Cholok

et al. 2017

Translational Research

111

108

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Heterotopic ossification (HO) is a common occurrence after multiple forms of extensive trauma. These include arthroplasties, traumatic brain and spinal cord injuries, extensive burns in the civilian setting, and combat-related extremity injuries in the battlefield. Irrespective of the form of trauma, heterotopic bone is typically endochondral in structure and is laid down via a cartilaginous matrix. Once formed, the heterotopic bone typically needs to be excised surgically, which may result in wound healing complications, in addition to a risk of recurrence. Refinements of existing diagnostic modalities, like micro- and nano-CT are being adapted toward early intervention. Trauma-induced HO is a consequence of aberrant wound healing, systemic and local immune system activation, infections, extensive vascularization, and innervation. This intricate molecular crosstalk culminates in activation of stem cells that initiate heterotopic endochondral ossification. Development of animal models recapitulating the unique traumatic injuries has greatly facilitated the mechanistic understanding of trauma-induced HO. These same models also serve as powerful tools to test the efficacy of small molecules which specifically target the molecular pathways underlying ectopic ossification. This review summarizes the recent advances in the molecular understanding, diagnostic and treatment modalities in the field of trauma-induced HO.

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Section: Potential Causes and Mechanismmentioning

confidence: 99%

The traumatic bone: trauma-induced heterotopic ossification

Dey

Wheatley

Cholok

et al. 2017

Translational Research

111

108

View full text Add to dashboard Cite

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“…Cubitus varus deformity is a common sequela of elbow fractures in children [1][2][3][4]. Although the cause of cubitus varus deformity remains inconclusive, it is considered a three-dimensional (3D) deformity including varus deformity of the coronal plane, an overextension deformity of the sagittal plane, and an internal rotation deformity of the horizontal plane [5,6].…”

Section: Introductionmentioning

confidence: 99%

Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

Hu¹,

Zhong²,

Lou

et al. 2020

J Orthop Surg Res

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Background: Cubitus varus deformity is a common sequela of elbow fractures in children. Cubitus varus deformity treatment is tending toward 3D correction, which is challenging for orthopedic surgeons. This study aims to explore whether individualized 3D-printed navigation templates can assist with accurate and effective corrective treatment of children with cubitus varus deformity. Methods: Thirty-five patients were treated for cubitus varus deformity from June 2015 to April 2017, including 21 boys and 14 girls, aged 4.6-13.2 years (average, 7.5 years). Of these cases, 17 deformities were on the left side and 18 were on the right side. All were treated with wedge osteotomy of the lateral distal humerus. 3D-printed navigation templates were used in 16 cases, while traditional surgery was used in 19 cases. All patients underwent computed tomography scans before surgery. Computer software was used to analyze the measurements and design and print individualized navigation templates. The navigation templates were matched, and surgery was initially simulated. Intraoperative individualized navigation templates were used to assist with accurate osteotomy and Kirschner wire fixation. Operation times were recorded in all cases, the carrying angles before and after surgery were assessed by computer, and postoperative elbow joint function was evaluated using Bellemore criteria. All measurement data were presented as means ± SD, and Student's t test was used to examine differences between groups. All count data between both groups were compared using the chi-square test or Fisher's exact test analysis. Results: All individualized navigation templates matched well with the corresponding anatomical markers and were consistent with preoperative planning, simulated surgery, and intraoperative procedures. Average operation times from clear exposure to fixed Kirschner wire were 11.69 min (9.6-13.5 min) for the individualized navigation template group and 22.89 min (17.7-26.8 min) for the traditional operation group (p < 0.001). Average differences in postoperation carrying angles between affected and healthy sides were 1.13°(0-2.0°) and 4.21°(0-7.5°), respectively (p < 0.001). Follow-up 6-12 months postoperation showed that elbow function did not differ significantly between groups using the Bellemore criteria (p > 0.05). Conclusions: Individualized navigation templates simplify procedures, reduce operation time, and improve accuracy when used in orthopedic surgery to treat children with cubitus varus deformity.

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“…It exacerbates by activity, especially activities involving elbow flexion-extension and forearm rotation beyond the existing elbow range of motion. 2,33 The magnitude of improvement in pain was clinically important in both groups, as noted by within-group differences in VAS which was greater than the minimal clinically important difference of three points in this study. 34 Besides, the participants in the proprioceptive neuromuscular facilitation stretching group showed a slightly greater improvement in pain intensity with a medium-large effect size.…”

Section: Discussionmentioning

confidence: 53%

“…Posttraumatic elbow stiffness is a common complication of elbow fracture which is treated either conservatively or surgically followed by a period of immobilization with casting or splinting. 1,2 Elbow stiffness is characterized by a reduction in joint range of motion that might remarkably interfere with participating in personal, occupational and daily living activities. 3,4 Even a mild limitation in elbow joint range of motion which is accompanied by pain and fear of movement can lead to reducing the ability of upper limb function, thereby decreasing the health-related quality of life.…”

Section: Introductionmentioning

confidence: 99%

A structured exercise programme combined with proprioceptive neuromuscular facilitation stretching or static stretching in posttraumatic stiffness of the elbow: a randomized controlled trial

et al. 2018

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Objectives: To compare the different stretching techniques, proprioceptive neuromuscular facilitation (PNF) stretching and static stretching, in patients with elbow stiffness after a treated elbow fracture. Design: Randomized-controlled, single-blind study. Setting: Department of physiotherapy and rehabilitation. Subjects: Forty patients with posttraumatic elbow stiffness (24 women; mean age, 41.34 ± 7.57 years). Intervention: PNF stretching group (n = 20), hold-relax PNF stretching combined with a structured exercise programme (two days per week for six weeks); static stretching group (n = 20), static stretching combined with a structured exercise programme (two days per week for six weeks). Main measures: The primary outcome is the Disabilities of the Arm, Shoulder and Hand (DASH). The secondary outcomes are active range of motion (AROM), visual analogue scale (VAS), Tampa Scale for Kinesiophobia, Short Form-12 and Global Rating of Change. Participants were assessed at baseline, after a six-week intervention period and one-month later (follow-up). Results: After treatment, improvement in the mean DASH score was slightly better in the PNF stretching group (8.66 ± 6.15) compared with the static stretching group (19.25 ± 10.30) (p = 0.03). The overall group-by-time interaction for the 2 × 3 mixed-model analysis of covariance (ANCOVA) was also significant for elbow flexion AROM (mean change for PNF stretching group; static stretching group; 41.10, 34.42, p = 0.04), VAS-rest (-1.31,-1.08, p = 0.03) and VAS-activity (-3.78,-3.47, p = 0.01) in favour of PNF stretching group. The other outcomes did not differ significantly between the two groups.

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Complications of Elbow Trauma

Cited by 14 publications

References 50 publications

The traumatic bone: trauma-induced heterotopic ossification

The traumatic bone: trauma-induced heterotopic ossification

Clinical application of individualized 3D-printed navigation template to children with cubitus varus deformity

A structured exercise programme combined with proprioceptive neuromuscular facilitation stretching or static stretching in posttraumatic stiffness of the elbow: a randomized controlled trial

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