Left Elbow Joint Research Articles

Comparison of the increase of both muscle strength and hypertrophy of biceps brachii muscle in strengthening exercise with low-intensity resistance training with and without the application of blood flow restriction and high-intensity resistance training

Background: Strengthening exercise is an important component of rehabilitation programs. Recently, it is reported that strengthening exercise with low-intensity resistance training (20-30% of 1 Repetition Maximum) combined with the application of blood flow restriction potentially increases muscle strength and induces muscle hypertrophy as well.Objective: This study aims to compare the increase in muscle strength and hypertrophy among the muscles trained with high-intensity resistance training (HIRT), low-intensity resistance training combined with the application of blood flow restriction using a sphygmomanometer cuff (LIRT+BFR) and low-intensity resistance training (LIRT) alone. Method: The subjects (n=18) are randomly and equally divided into three groups, those are the groups getting the strengthening exercise for left Biceps Brachii muscle with HIRT (70% of 1 RM), LIRT (30% of 1 RM)+BFR and LIRT (30% of 1 RM). Before starting and after getting the resistance training for five weeks, each subject is measured for the left arm circumference. Results: HIRT and LIRT+BFR produce an increase of the left arm circumference significantly greater than LIRT. However, there is no significant difference in the increase of left arm circumference between the HIRT and LIRT+BFR. There is a significant difference in the increase of the peak torque of left flexion elbow joint among the three groups, either at 60o/s or 120o/s or 180o/s angular velocity. At 60o/s angular velocity, LIRT+BFR produces the greatest increasing of the left elbow peak torque among the three groups. At both 120o/s and 180o/s angular velocity, there is no significant difference in the increase of the peak torque of flexion left elbow joint between HIRT and either LIRT+BFR or LIRT. However, at both 120o/s and 180o/s angular velocity, there is a significant difference in the increase of the peak torque of flexion left elbow joint between LIRT+BFR and LIRT.Conclusion: the strengthening exercise for Biceps Brachii muscle with LIRT+BFR induces the Biceps Brachii muscle hypertrophy and increases the muscle strength more than strengthening exercise with LIRT alone. Compared to the HIRT, LIRT+BFR induces an equal muscle hypertrophy and increases more muscle strength for the trained Biceps Brachii muscle.

ARTHROSCOPIC METHOD OF THE RADIAL HEAD FRACTURE OSTEOSYNTHESIS (СASE REPORT)

Radial head fractures constitute about 3% of all fractures and 30% within the group of elbow joint injuries. Conventional open surgical treatment is accompanied by an extensive soft tissue incision and sometimes by capsule release for adequate visualization. Arthroscopic methods feature relatively insignificant soft tissue trauma, allow to reduce pain syndrome in postoperative period and to accelerate rehabilitation. Besides, arthroscopy improves surgical view in cases of intraarticular fractures and facilitates a better anatomical reduction of articular surface. The authors demonstrate a clinical case of a patient with closed fractures of radial head and ulna coronoid process with displacement of left elbow joint fragments where arthroscopic surgery provided for good anatomical and functional results.

개인보호장비 착용이 심폐소생술에 미치는 영향: 119 구급대원을 중심으로

Purpose : This study examined the effect of wearing personal protective equipment (PPE) on cardiopulmonary resuscitation (CPR), positive airway pressure, and the posture of emergency medical technicians (EMTs) when conducting CPR. Methods : Twenty 119 EMTs performed 30:2 CPR on a manikin for 4 min. Im aging data were digitized with Kwon3D XP (version 4.0). Data were collected by analyzing the m otion when starting in one cycle, such as pressing to the maximum and in the final position (relaxed), an d were analyzed with SPSS 18.0. Results : The angle of the elbow joints was significantly reduced ( p＜.05). The trunk angle was statistically significantly ( p＜.01, p＜.001) increased. The angular velocities of the shoulder joint and left elbow joint were reduced ( p＞.05). The angular velocity of the trunk was significantly redu ced in the starting and maximum compression postures. The hand-escape time was increased. The average compression depth was increased but not significantly ( p＞.05). The positive airway pressure was reduced (p＞.05).Conclusion : The angle of the elbow joints and the angular velocity of the trunk were reduced, and the angle of the trunk was increased. The success of CPR and positive airway pressure was reduced. Keywords : Personal protective equipment, Cardiopulmonary resuscitation, Emergency medical technician, Postural analysis

Acute Disseminated Melioidosis Presenting with Septic Arthritis and Diffuse Pulmonary Consolidation in an Otherwise Healthy Adult: A Case Report

Background: Melioidosis is an infectious disease caused by Burkholderia pseudomallei. It is most prevalent in South-East Asia, northern Australia, and the Indian subcontinent. Septic arthritis is a rare manifestation of melioidosis. Melioidosis is usually found in patients with diabetes, heavy alcohol use, or chronic lung disease. Case: We report a case of melioidosis in an otherwise healthy 44-year-old male, who presented with acute painful left knee swelling, high-grade fever associated with chills, rigors and night sweats, and a productive cough. Examination revealed active synovitis with effusion involving his left knee, ankle and elbow joints and scattered crackles over both lung fields. Chest X-ray showed diffuse pulmonary consolidation. Abdominal ultrasound showed splenic micro-abscesses. The diagnosis was made based on a positive blood culture for Burkholderia pseudomallei. He was started on appropriate antibiotics and responded well, becoming afebrile after 48 hours, while his joint effusions disappeared after one week. Conclusion: Septic arthritis only occurs in 4% of patients with melioidosis. When there is diffuse pulmonary involvement, melioidosis may mimic disseminated tuberculosis, sepsis syndromes, and systemic vasculitis syndromes. This case is relevant for medical literature as melioidosis is emerging and is expanding its territories worldwide. It should be considered early in the differential diagnoses in endemic areas so that treatment can be started early to reduce its high mortality and morbidity.

Intraoperative radial nerve injury during coronary artery surgery – report of two cases

BackgroundPeripheral nerve injury and brachial plexopathy are known, though rare complications of coronary artery surgery. The ulnar nerve is most frequently affected, whereas radial nerve lesions are much less common accounting for only 3% of such intraoperative injuries.Case presentationsTwo 52- and 50-year-old men underwent coronary artery surgery. On the first postoperative day they both complained of wrist drop on the left. Neurological examination revealed a paresis of the wrist and finger extensor muscles (0/5), and the brachioradialis (4/5) with hypoaesthesia on the radial aspect of the dorsum of the left hand. Both biceps and triceps reflexes were normoactive, whereas the brachioradialis reflex was diminished on the left. Muscles innervated from the median and ulnar nerve, as well as all muscles above the elbow were unaffected. Electrophysiological studies were performed 3 weeks later, when muscle power of the affected muscles had already begun to improve. Nerve conduction studies and needle electromyography revealed a partial conduction block of the radial nerve along the spiral groove, motor axonal loss distal to the site of the lesion and moderate impairment in recruitment with fibrillation potentials in radial innervated muscles below the elbow and normal findings in triceps and deltoid. Electrophysiology data pointed towards a radial nerve injury in the spiral groove. We assume external compression as the causative factor. The only apparatus attached to the patients' left upper arm was the sternal retractor, used for dissection of the internal mammary artery. Both patients were overweight and lying on the operating table for a considerable time might have caused the compression of their left upper arm on the self retractor's supporting column which was fixed to the table rail 5 cm above the left elbow joint, in the site where the radial nerve is directly apposed to the humerus.ConclusionAlthough very uncommon, external compression due to the use of a self retractor during coronary artery surgery can affect – especially in obese subjects – the radial nerve within the spiral groove leading to paresis and should therefore be included in the list of possible mechanisms of radial nerve injury.

Streptobacillus hongkongensis sp. nov., isolated from patients with quinsy and septic arthritis, and emended descriptions of the genus Streptobacillus and Streptobacillus moniliformis.

Two bacterial strains, HKU33(T) and HKU34, were isolated in Hong Kong from the pus aspirated from the right peritonsillar abscess of a patient with quinsy and the left elbow joint fluid of another patient with tophaceous gout and left elbow septic arthritis, respectively. The bacteria were Gram-stain-negative, non-motile, non-spore-forming, non-haemolytic pleomorphic bacilli. They grew best on Columbia agar with 5 % defibrinated sheep blood in an anaerobic environment or aerobic environment with 5 % CO2. They also grew on chocolate agar but not on MacConkey agar. They were catalase- and cytochrome oxidase-negative. They showed a unique profile of enzyme activities distinguishable from their closely related species. Phylogenetic analysis of the complete 16S rRNA gene, and partial groEL, gyrB and recA gene sequences showed the two isolates formed a distinct branch within the family Leptotrichiaceae, being related most closely to Streptobacillus moniliformis. Hierarchical cluster analysis of mass spectra of whole-cell protein contents showed that strains HKU33(T) and HKU34 were closely related to each other, but were distinct from Streptobacillus moniliformis, Sneathia sanguinegens and 'Leptotrichia amnionii'. The DNA G+C content of strain HKU33(T) was 26.0±2.1 mol% (mean±sd; n = 3). DNA-DNA hybridization demonstrated ≤45.02 % DNA relatedness between the two isolates and Streptobacillus moniliformis CCUG 13453(T). A novel species, Streptobacillus hongkongensis sp. nov., is proposed to accommodate strains HKU33(T) and HKU34, with HKU33(T) ( = JCM 18691(T) = NCTC 13659(T) = DSM 26322(T)) designated the type strain. Emended descriptions of the genus Streptobacillus and Streptobacillus moniliformis are also given.

Ultrasound Detection of Salmonella Septic Arthritis in a Rheumatoid Arthritis Patient on Anti-TNF Treatment.

We report a case of Salmonella septic arthritis detected by ultrasound in a 40-year-old man with rheumatoid arthritis while he was on anti–tumor necrosis factor-α monoclonal antibody certolizumab. An aspirate of his left elbow joint showed Salmonella enteritidis infection that was sensitive to ceftraixone. This was preceded by a brief episode of loose stools following a visit to the Far East. He was treated with antibiotics and made a good recovery. There have only been a few case reports of Salmonella septic arthritis in a rheumatoid arthritis patient on anti–tumor necrosis factor treatment but none previously in association with certolizumab.

Tuberculous Tenosynovitis of the Elbow: A Case Report

A 29-year-old man visited our clinic owing to a persistent swelling in the anterior part of the left elbow joint that began one year ago. Through magnetic resonance imaging (MRI), we observed tenosynovitis with multiple rice bodies, and so we performed an excisional biopsy and tenosynovectomy. Through pathology and culture tests, we identified tuberculosis in the tissue biopsy that we harvested intraoperatively. Following the anti-tuberculosis medication relieved the patient's symptoms without recurrence. Since tuberculosis of the elbow occurs only rarely, and the symptoms mimic those of rheumatoid synovitis or of non-specific chronic synovitis, early diagnosis and appropriate treatment are often delayed. The authors report this rare case of tuberculous tenosynovitis of the elbow with a review of the relevant literature.

A Case of Recurrent Tumoral Calcinosis in a Young Female

ABSTRACT Tumoral calcinosis, a rare benign clinical condition resembling a neoplasm is characterized by calcium and phosphate deposits, usually located around large joints. It can be primary or secondary to renal failure and hyperparathyroidism. This report describes a rare case of tumoral calcinosis in a 13 years old girl presenting as a huge lump around left shoulder and elbow joint with discharging sinus over left infraclavicular region. How to cite this article Kumar A, Singh P, Dobhal H. A Case of Recurrent Tumoral Calcinosis in a Young Female. World J Endoc Surg 2013;5(1):18-20.

Ipsilateral Dislocation of Shoulder and Elbow Joints

Ipsilateral dislocations of the shoulder and elbow joints are very rare. In English literature, only eight cases have been reported. It is imperative to remember the shoulder dislocation as it is easily missed at the initial presentation of a combined elbow and shoulder dislocation. A 40 year old female patient presented with sustained ipsilateral dislocations of her left shoulder and elbow joint after falling over her cat. The elbow was reduced first, followed by the shoulder. Maintaining a high index of suspicion is fundamental in ensuring that a second dislocation is not missed when a patient presents with either a shoulder or elbow dislocation. She made a very good recovery of the function of her left upper limb within three months.

Biepicondylar fracture dislocation of the elbow joint concomitant with ulnar nerve injury

In this article, we present a case of humeral biepicondylar fracture dislocation concomitant with ulnar nerve injury in a seventeen year-old male patient. Physical examination of our patient in the emergency room revealed a painful, edematous and deformed-looking left elbow joint. Hypoesthesia of the little finger was also diagnosed on the left hand. Radiological assessment ended up with a posterior fracture dislocation of the elbow joint accompanied by intra-articular loose bodies. Open reduction-Internal fixation of the fracture dislocation and ulnar nerve exploration were performed under general anesthesia at the same session as surgical treatment of our patient. Physical therapy and rehabilitation protocol was implemented at the end of two weeks post-operatively. Union of the fracture lines, as well as the olecranon osteotomy site, was achieved at the end of four months post-operatively. Ulnar nerve function was fully restored without any sensory or motor loss. Range of motion at the elbow joint was 20-120 degrees at the latest follow-up.

8세 남아에서 골종양을 닮은 주관절 색소 융모 결절성 활액막염 - 증례 보고 -

Pigmented villonodular synovitis (PVNS) is a rare benign proliferative disorder that results in villous hyperplasia and nodule formation in the synovium, tendon sheath and bursa. That most commonly affects the knee and the hip joint in adult. PVNS of the hand, the wrist, the shoulder and the elbow is rare and that of the elbow in children is particularly rarer. An eight-year-old boy had his left elbow pain and a lesion like benign bone tumor in the left fossa olecrani on plain x-ray. During the operation, abnormal synovial hyperplasia in his left elbow joint led us to diagnose PVNS. Therefore, open curettage of the lesion and radical synovectomy was performed. The specimen of the synovectomized tissue revealed PVNS. The left elbow pain subsided after the operation and the child restored a full range of motion of his left elbow. We reported this rare case of PVNS in a child`s elbow joint mimicking the bone tumor together with a review of the literature.

MATHEMATICAL MODEL OF THE ARMS DURING KAYAKING USING GORDON'S METHOD

The aim of this study was to develop a mathematical model of the arms during kayaking. Gordon's method has been used to develop the model. This model comprises of six kinematic chains of the arms that represent the right shoulder joint, right elbow joint, right wrist joint, left wrist joint, left elbow joint and left shoulder joint. The joints comprise of right upper arm, right lower arm, right hand-paddle, left hand-paddle, left lower arm and left upper arms.

Vanishing bone disease (Gorham′s disease) - A rare occurrence of unknown etiology

A 20-year-old male patient presented with painful swelling around left elbow joint. Radiographic examination revealed osteolytic lesion with pathological fracture of lower end of humerus and upper radius. Upper end of ulna was completely absent along with bony erosion. Histopathology of the bony tissue revealed hemangioma-like lesion composed of vascular channels lined by benign endothelium replacing bone. The diagnosis of Gorham's massive osteolysis was made. Gorham's disease is a benign self-limiting condition affecting any age, may involve any part of the skeleton and is characterized by replacement of bone by hemangiomatous tissue resulting in formation of lesions exhibiting massive osteolysis, which may be to the extent of disappearance of the affected bone in radiograph. This nonhereditary case was not associated with nephropathy, which is often a coexistent condition. The case is being reported for its rarity.

A Case of Rheumatoid Arthritis Improved from Steinbrocker Classification Class IV to Class II after Multi-Joint Surgery

We report the case of a patient with rheumatoid arthritis (RA) who showed a reduction in disease severity (from class IV to class II) after multi-joint surgery. The patient was a 61-year-old man with a history of RA, type-2 diabetes, chronic obstructive pulmonary disease, and nephrotic syndrome. He had been undergoing treatment for RA for the past 10 years, but his condition could not be appropriately controlled. In addition to generalized edema, marked destruction of the left elbow joint and knees was observed, and he was unable to move in bed (Steinbrocker classification: stage IV, class IV). In March 2009, he developed suppurative arthritis of the left elbow (methicillin-sensitive Staphylococcus aureus [MSSA] infection) and was referred to our institution, where the infection subsided after cleaning of the wound and administration of antibiotics. In March 2010, he underwent artificial joint replacement arthroplasty of the left elbow, followed by replacement arthroplasty of the right knee in July that year and of the left knee in November. As of December 2011, the patient showed no signs of inflammatory reactions and was able to walk using crutches (Steinbrocker classification: stage IV, class II). Recent advancements in pharmacotherapy have made it possible to control the advancement of joint destruction in RA. However, in this patient, because of the advanced stage of joint destruction, surgical methods were required to aid the patient in recovering his ability to walk.

Concurrent Palmar Lunate Dislocation and Posterior Elbow Dislocation: A Case Report

We report a rare case of concurrent palmar lunate dislocation of the left wrist combined with a posterior dislocation of the left elbow joint in a 40-year-old man. He sustained both injuries after falling onto his outstretched left hand. The elbow was reduced by the closed method. The wrist was treated with open reduction with carpal tunnel decompression and fixation with a Kirschner wire through the volar approach. Both the scapholunate and radioscaphocapitate ligaments were also repaired. At month 3, the patient had no pain in his elbow and minimal pain in his wrist on heavy lifting and had resumed his work as a porter.

Relationship of selected kinematics variables with the performance of back court spike in volleyball

The purpose of this study was to examine the relationship of selected kinematic variables with the performance of back court spike in volleyball. The subjects (5 M, age 20–24 years)...

Rapidly progressive destructive arthritis in psoriatic arthritis sine psoriasis: do bone resorption marker levels predict outcome of bone destruction in psoriatic arthritis?

(2011). Rapidly progressive destructive arthritis in psoriatic arthritis sine psoriasis: do bone resorption marker levels predict outcome of bone destruction in psoriatic arthritis? Modern Rheumatology: Vol. 21, No. 1, pp. 106-108.

Osteochondrosis of the elbow joint in finishing pigs from three herds: Associations among different types of joint changes and between osteochondrosis and growth rate

Osteochondrosis (OC) is a degenerative condition of the cartilage seen in growing animals. The objective of the study was to investigate (1) the prevalence of macroscopically visible OC in the elbow of finishing pigs, (2) the relationship between changes in the surface of the articular cartilage and changes in the underlying cartilage and bone and the synovial membrane, and (3) the association between growth rate and the occurrence of OC in the elbow. The study used 9696 finishing pigs from three herds. After slaughter, the left elbow joint of each pig was examined, and macroscopically visible lesions in the articular cartilage, subchondral bone and synovial membrane were recorded. The highest prevalences of OC lesions were found in the humeral condyle with thickening of the articular cartilage (53%), irregularity of the articular cartilage (32%), lesions in the subchondral bone (26%), fissures under the cartilage (21%) and osteochondrosis dissecans (OCD) (14%). Irregularity of the articular cartilage was strongly associated with fissures under the cartilage and lesions in the subchondral bone (OR 13.7 and 5.8, respectively). Irregularity of the articular cartilage and OCD were associated with villous proliferation of the synovial membrane. For each additional 100 g of average daily gain in the weaner period or in the finishing period, the risk of irregularity in the articular cartilage and OCD increased by approximately 20% (ORs ranging between 1.14 and 1.20 for both weaners and finishers).

Articular Gout and Suspected Pseudogout in a Basilisk Lizard (Basilicus plumifrons)

A 9-yr-old male Basilisk lizard (Basilicus plumifrons) with a history of painful and limited mobility for approximately 4 mo, which had seemed to be more pronounced in the front limbs, was presented for necropsy. The animal had exhibited moderate weight loss and anorexia before euthanasia. Postmortem examination revealed yellow-to-white, soft-to-semifirm nodules within the periarticular fascia and musculature of the left and right shoulder joints, hip joints, and stifle joints. Several other joints, including the left and right tarsi, left and right elbow joints, and the left carpus had calcified, white material present on the articular surfaces. Histopathologic evaluation of representative sections of all organs and the joints confirmed tophaceous articular gout and articular pseudogout. The differentiation between articular gout and pseudogout was based on histologic appearance, histochemical staining for calcium, and birefringence under polarized light.