• Clinics in Shoulder and Elbow
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• v.19 no.4
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• pp.249-251
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• 2016

iepicondylar fracture of the humerus is very rare in adults. To date, there have been limited evidence of this injury in the English literature. We report a case of a 65-year-old female with a biepicondylar fracture of the left distal humerus without dislocation. Open reduction and internal fixation with K-wires, cannulated screw, and suture anchor were performed. We obtained stability of the elbow and a satisfactory functional outcome. Because this type of injury is associated with varus and valgus instability, operative reduction and fixation are essential in order to gain stability and early recovery of normal function.

• Journal of Biomedical Engineering Research
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• v.19 no.4
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• pp.393-401
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• 1998

Based on clinical observations, it is suspected that the bone-tendon origin is the site where piratical failure, leading to pathophysiological changes in the humeral epicondyle after repetitive loading, is initiated Mechanical properties and failure patterns of the common extensor and flexor tendons of the humeral epicondyle under static and repetitive loading have not been well documented. Our goal was to determine mechanical properties of failure strength and strain changes, to correlate strain changes and the number of cyclic repetitions, and to identify the failure pattern of bone-tendon specimens of common extensor and flexor tendons of the humeral epicondyle. Mechnaical properties of human cadaver bone-tendon specimens of the common extensor and flexor tendons of the humeral epicondyle were tested under two different loading rates. No statistically significant difference in ultimate tensile strength was found between male and female specimens or between slow (10 mm/sec) and fast elongation (100 mm/sec) rates. However, a statistically significant difference in ultimate tensile strength between the common extensor (1190.0 N/$cm^2{\pm}$388.8) and flexor 1922.0 N/$cm^2{\pm}$764.4)tendons was found (p<0.05). When loads of 25%, 33%, and 41% of the ultimate tensile strength of their contralateral sides were applied, the number of cycles required to reach 24% strain change for the common extersor and flexor tendons were approximately 8,893, 1,907, and 410, respectively. The relationship between cycles and loads was correlated ($R^2$=0.46) Histological observation showed that complete or partial failure after tensile or cyclic loadings occurred at the transitional zone, which is the uncalcified fibrocartilage zone between tendon and bone of the humeral epicondyle. Sequential histological sections revealed that failure initiated at the upper, medial aspect of the extensor carpi radialis brevis tendon origin. Biomechanical and hstological data obtained in this study indicated that the uncalcified fibrocartilage zone at the bone-tendon origin of the common extensor and flexor tendons is the weak anatomical structure of the humeral epicondyle.

• Journal of Mechanical Science and Technology
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• v.15 no.7
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• pp.1013-1021
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• 2001

A series of rabbit common extensor tendon specimens of the humeral epicondyle were subjected to tensile tests under two displacement rates (100mm/min and 10mm/min) and different elbow flexion positions 45°, 90°and 135°. Biomechanical properties of ultimate tensile strength, failure strain, energy absorption and stiffness of the bone-tendon specimen were determined. Statistically significant differences were found in ultimate tensile strength, failure strain, energy absorption and stiffness of bone-tendon specimens as a consequence of different elbow flexion angles and displacement rates. The results indicated that the bone-tendon specimens at the 45°elbow flexion had the lowest ultimate tensile strength; this flexion angle also had the highest failure strain and the lowest stiffness compared to other elbow flexion positions. In comparing the data from two displacement rates, bone-tendon specimens had lower ultimate tensile strength at all flexion angles when tested at the 10mm/min displacement rate. These results indicate that creep damage occurred during the slow displacement rate. The major failure mode of bone-tendon specimens during tensile testing changed from 100% of midsubstance failure at the 90°and 135°elbow flexion to 40% of bone-tendon origin failure at 45°. We conclude that failure mechanics of the bone-tendon unit of the lateral epicondyle are substantially affected by loading direction and displacement rate.

• Journal of Mechanical Science and Technology
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• v.18 no.4
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• pp.582-591
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• 2004

The purpose of this study was to determine the effects of elbow joint angle on mechanical properties, as represented by ultimate load, failure strain and elastic modulus, of bone-tendon specimens of common extensor tendon of the humeral epicondyle. Eight pairs of specimens were equally divided into two groups of 8 each, which selected arbitrarily from left or right side of each pair, positioned at 45$^{\circ}$ and 90$^{\circ}$ of elbow flexion and subjected to tension to failure in the physiological direction of the common extensor tendon. For comparison of the differences in the failure and elastic modulus between tendon and the bone-junction, data for both were evaluated individually. Significant reduction in ultimate load of bone-tendon specimens was shown to occur at 45$^{\circ}$. The values obtained from the bone-tendon junctions with regard to the failure strain were significant higher than those from tendon in both loading directions, but the largest failure strain at the bone-tendon junction was found at 45$^{\circ}$. The elastic modulus was found to decrease significantly at the bone-tendon junction when the loading direction switched from 90$^{\circ}$ to 45$^{\circ}$. Histological observation, after mechanical tensile tests, in both loading directions showed that failure occurred at the interface between tendon and uncalcified fibrocartilage in the thinnest fibrocartilage zone of the bone-tendon junction. We concluded that differences in measured mechanical properties are a consequence of varying the loading direction of the tendon across the bone-tendon specimen.

• Journal of Veterinary Clinics
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• v.37 no.1
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• pp.46-49
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• 2020

Flexor enthesopathy is an important cause of elbow lameness in dogs. Flexor enthesopathy is divided into primary and concomitant forms deciding the treatment. The imaging characteristics in affected dogs are irregular medial humeral epicondyles, spur, calcified bodies adjacent to medial humeral epicondyle, thickened and contrast enhancement of the affected muscles. In this report, the radiography, computed tomography (CT), and magnetic resonance imaging (MRI) were performed for right forelimb lameness of a 3-year-old dog. The irregular sclerotic changes and spur of the medial humeral epicondyles were shown with calcified bodies on radiography. Thickened flexor muscles in right forelimb and fragmented coronoid processes of both elbows were observed on CT. On MRI, high signal intensity of the bilaterally thickened flexor muscles with contrast enhancement was detected. Based on these results, concomitant flexor enthesopathy with fragmented medial coronoid process of bilateral elbows was diagnosed in this dog.

• Anatomy and Cell Biology
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• v.57 no.2
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• pp.194-203
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• 2024

The anatomical variations of coracobrachialis muscle (CBM) are of great clinical importance. This study aimed to elucidate the morphological variations, innervation patterns and musculocutaneous nerve (MCN) relation to CBM. Upper limbs of fifty cadavers (30 males and 20 females) were examined for proximal and distal attachments, innervation pattern of CBM and its relation to MCN. Four morphological types of CBM were identified according to number of its heads. The commonest type was the two-headed (63.0%) followed by the single belly (22.0%), three-headed (12.0%) and lastly four-headed (3.0%) type. Moreover, an abnormal insertion of CBM was observed in four left limbs (4.0%); one inserting into the medial humeral epicondyle, the second into the upper third of humeral shaft, the third one in the common tendon of biceps, and the fourth one showing a bifurcated insertion. Also, four different innervation patterns of CBM were identified including MCN (80.0%), lateral cord (14.0%), lateral root of median nerve (4.0%), and median nerve itself (2.0%). The course of MCN was superficial to the single belly CBM (19.0%) and in-between the heads in the other types (71.0%). Measurements of the length and original distance of CBM muscular branches originating from MCN revealed no sex or side significant difference. Awareness of the anatomic variations, innervation patterns, and MCN relation of CBM is imperative in recent diagnostic and surgical procedures to obtain definite diagnosis, effective management and good outcome.