• Clinics in Shoulder and Elbow
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• v.26 no.2
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• pp.126-130
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• 2023

Background: Arm swing plays a role in gait by accommodating forward movement through trunk balance. This study evaluates the biomechanical characteristics of arm swing during gait. Methods: The study performed computational musculoskeletal modeling based on motion tracking in 15 participants without musculoskeletal or gait disorder. A three-dimensional (3D) motion tracking system using three Azure Kinect (Microsoft) modules was used to obtain information in the 3D location of shoulder and elbow joints. Computational modeling using AnyBody Modeling System was performed to calculate the joint moment and range of motion (ROM) during arm swing. Results: Mean ROM of the dominant elbow was 29.7°±10.2° and 14.2°±3.2° in flexion-extension and pronation-supination, respectively. Mean joint moment of the dominant elbow was 56.4±12.7 Nm, 25.6±5.2 Nm, and 19.8±4.6 Nm in flexion-extension, rotation, and abduction-adduction, respectively. Conclusions: The elbow bears the load created by gravity and muscle contracture in dynamic arm swing movement.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.293-298
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• 2010

Purpose: Since an injured elbow joint can disturb the activity of daily life by limiting motion, especially if the motion is restricted over 40 degree of flexion contracture and under 105 degree of further flexion, it is imperative to select the best method and the timing of treatment of the elbow stiffness. Therefore this review will discuss open surgical techniques for stiff elbows based on the literature. Materials and Methods: It is important to take sufficient clinical examination of the patient, including history taking. And, a surgeon should select appropriate procedure after accurately understanding about the status and cause of the stiff elbow with radiographic methods. Surgical methods include arthroscopic release open release, distraction arthroplasty, total elbow replacement and there are four approachs in the open release - anterior approach, medial "over the top" approach, limited lateral approach: column procedure, posterior extensile approach-. Results and Conclusion: Although at present the arthroscopic technique is emphasized for the treatment of elbow stiffness, a surgeon should know conventional open techniques.

• Clinics in Shoulder and Elbow
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• v.8 no.1
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• pp.36-42
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• 2005

Purpose: To evaluate the clinical results of anterior subcutaneous ulnar nerve transposition operation and the factors that influence the results for cubital tunnel syndrome. Materials and Methods: Seventeen cases of cubital tunnel syndrome were treated by anterior subcutaneous transposition between March 2001 and December 2003. The mean age was 56 years and mean follow up period was 20.4 months. All patients were reviewed retrospectively. The preoperative evaluation was done by Dellon's classification and the clinical results were evaluated by Messina’s classification. We analyzed the effect of the operation and the relations between the results and the preoperative factors, for example, duration of symptom, age, cause of illness, present of association with diabetes mellitus or preoperative flexion contracture of the elbow were analyzed. Results: The results according to Messina's classification were 4 cases of excellent, 9 cases of good, 3 cases of fair, and 1 case of poor. The preoperative factors like duration of symptom, age, cause of illness and flexion contracture of the elbow didn't show any statistical difference in the result of operation, but the cases which have diabetes mellitus were unsatisfactory with statistical difference (p=0.018). Conclusion: Anterior subcutaneous ulnar nerve transposition is relatively easy and good operative method in cubital tunnel syndrome.

• Clinics in Shoulder and Elbow
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• v.8 no.1
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• pp.14-18
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• 2005

Purpose: Limitation of motion of the elbow joint due to stiffness affect on life quality of the patients. So contracture of the elbow should be treated as soon as possible. Among the many treatment modalities, we described the result of arthroscopic treatment. Materials and Methods: From Mar. 2000 to Mar. 2003, 40 patients, who received the arthroscopic treatment by author for contracted elbow, were the subjects. We estimated the range of motion (ROM) of elbow joint before and after surgery by goniometer. The clinical result was evaluated by Severance elbow scoring system. The final ROM was evaluated at the point of no further increasement of joint motion. Male ware 30 cases, female ware 7 cases, average 42.6 years old and mean follow up period were 31 months. During arthroscopic treatment we had done release of the joint capsule or resection, synovectomy, removal of loose bodies. We used traditional portals. Results: The avarage preoperative ROM of elbow joint was 72.5 degree(range, 5 - 132 degree) and the increasement of ROM was totally 49.3 degree in flexion 26.5 degree and extension 22.8 degree. There was no other complication. Conclusion: Arthroscopic treatment for contracted elbow permit early joint ROM and it decrease the secondary injury to the elbow joint. Also there are few complications. It is thought to be a good treatment modality in contracted elbow joint.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.84-88
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• 2011

Purpose: We report here on two cases of calcific tendinitis at the origin of the common extensor tendons of the forearm. Materials and Methods: A 42 year-old female complained of left elbow pain and flexion contracture. After obtaining the simple radiographs and MRI, surgical excision of the calcific deposits was done under the diagnosis of calcific tendinitis. A 25 year-old female complained of right elbow pain and a limited range of motion. Simple radiographs showed a calcific deposit just distal to the lateral epicondyle, and then she was managed with extracorporeal shock wave therapy. Results: The pain disappeared completely and both patients regained a full range of motion after treatments. Conclusion: Calcific tendinitis at the origin of the common extensor tendons of the forearm should be included in the differential diagnosis of the lateral elbow diseases that cause pain and a limited range of motion.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.266-269
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• 2010

Purpose: We report case of neglected elbow dislocation for three years. Material and method: A 45 years old female patient presented with neglected elbow dislocation for three years. Since the patient had contracture in both lateral and medial collateral ligament of elbow, dissection was done. After total separation of posterior articular capsule and incision of anterior articular capsule, by manual manipulation, reduction of radiohumeral and ulnohumeral joints were obtained. We applied modified Morrey type hinged external fixation in the elbow and done early elbow exercise. Result and Conclusion: Since we have experienced a satisfactory result in the case with neglected elbow dislocation for 3 years by using open reduction and hinged external fixation, we report it with the literature.

• Clinics in Shoulder and Elbow
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• v.8 no.1
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• pp.5-8
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• 2005

Rotator interval should be as loose as possible, though not so loose as to break the shoulder mechanism. This region is a source of significant shoulder pathology resulting in patient discomfort and dysfunction. The clinical features fall into two categories. Rotator interval tightness is associated with impingement, contracture with adhesive capsulitis, and widening with anteroinferior, posterior or multidirectional instability. Coracoid impingement can cause damage to the structures of the rotator interval, Injury of the interval are associated with subscapularis tears as well as biceps tendinitis, fraying, subluxation, and dislocation. An understanding of the normal and pathologic anatomy can lead to successful diagnosis and treatment of lesions in the rotator interval.

• Archives of Reconstructive Microsurgery
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• v.7 no.1
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• pp.35-40
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• 1998

The incidence of brachial plexus injury is increasing because of the development of motor vehicle but the the results of treatment was reported poor due to its complex anatomical structure and changes of function and sensory during the recovery after trauma. But the results of treatment has been improved by the recently introduced high sensitive diagnostic method that can evaluate accurately the site and extent of the injury and treatment method. Restoration of the elbow flexion is the most important goal of treatment after brachial plexus injury and nerve graft, neurotization and muscle transfer were used for methods of treatment. From December 1992 to May 1994, the author performed 6 cases of latissimus dorsi transfer at the same side for the improvement of elbow flexion in the patients of brachial plexus injury. There were 5 cases of male, one case of female and average age was 22 years old. The causes of injury were traffic accident in 3 cases, gun shot injury, falldown and birth injury in each one case and in all cases, the type of injury were upper arm type. The average follow up period were 1 year 5 months ranging from 12 months to 4 years 5 months. In all cases, active elbow flexion was impossible before operation and average muscle power was grade I. We analysed the active range of motion, muscle power and the functional results. At the last follow up, range of active elbow flexion was average $124^{\circ}$ and flexion contracture was average 11 degrees and the average of muscle power was grade IV. In the functional analysis, there were two cases of excellent, three cases of good and 1 case of fair. There was no complications including wound infection, vascular compromise and donor site problem. The results of latissimus dorsi transfer for improvement elbow flexion in the patients of brachial plexus injury is one of the useful mettled for the restoration of elbow flexion.

• Clinics in Shoulder and Elbow
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• v.6 no.2
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• pp.115-126
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• 2003

Although painful conditions of varying degrees of severity involving the soft tissues (i .e., muscles, tendons, ligaments, periosteum and peripheral nerves) occur frequently, their underlying pathogenesis is poorly understood. The term peripheral neuropathic pain has recently been suggested to embrace the combination of positive and negative symptoms in patients whose pain is due to pathological changes or dysfunction in peripheral nerves or nerve root. The spinal nerve root, because of its vulnerable position, is very easily prone to injury from pressure, stretch, angulation, and friction. Therefore, not a few of musculoskeletal chronic pains are result of nerve root dysfunction. Neuropathic changes due to nerve root dysfunction are primarily in soft tissue especially muscle, tendon and joint. It shows tenderness over muscle motor points and palpable muscle contracture bands and restricted Joint range. Careful palpation and physical examination is the important tool that, be abne to detect all of these phenomena.

• Clinical and Experimental Pediatrics
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• v.45 no.10
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• pp.1288-1291
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• 2002

Fetal valproate syndrome has been described as a distinctive pattern of minor anomalies of the face and digits. This pattern has not been delineated completely but appears to involve brachycephaly with a high forehead, shallow orbit, ocular hypertelorism, small nose, small mouth, low set posteriorly rotated ears, long overlapping fingers and toes, and hyperconvex fingernail. Cleft palate and congenital heart disease have occasionally been described in babies exposed to valproate during embryogenesis. We report a neonate born from an epileptic mother receiving sodium valproate during pregnancy. This neonate presented with characteristic facial abnormalities, both elbow contractures, and overlapping of right first and second toe, forth and fifth toe, and left first and second toe. This case raises the possibility that these abnormal appearances might be caused by intrauterine valproate exposure.