Shoulder/Elbow – Pubmed Results

Osteochondritis dissecans of the capitellum is an uncommon but notable cause of elbow pain in the young athlete. Although the exact pathogenesis of this condition is not completely understood, repetitive microtrauma, such as in throwing athletes or gymnasts, can predispose these groups to developing osteochondral lesions. Patients may present with laterally based elbow pain, swelling, or loss of range of motion. Initial screening radiographs can often detect these lesions, with MRI key to...

CONCLUSIONS: Superior trunk block offers superior early postoperative analgesia and better overall recovery, while erector spinae plane block minimizes diaphragmatic impairment. However, the erector spinae plane block may represent an option only in carefully selected patients at high respiratory risk, acknowledging its significantly poorer early analgesic profile.

The medial ulnar collateral ligament (UCL) of the elbow is a vital structure for the overhead throwing motion. Injuries to this ligament are becoming increasingly common and specifically in youth baseball players. Significant work has been done to provide pitch count guidelines to monitor workload and prevent UCL injuries. Yet despite these efforts, injuries to the ulnar collateral ligament continue to occur at an alarming rate, leading to lost playing time and impacting player development....

BACKGROUND: Musculoskeletal disorders represent a significant global health burden, frequently leading to chronic pain, functional impairment and disability. Conventional treatment modalities, including rehabilitation, pharmacotherapy and surgical intervention, are often associated with suboptimal outcomes and prolonged recovery. Adipose-derived stem cells (ADSCs) have gained considerable attention due to their regenerative capacity, accessibility and immunomodulatory properties. Preclinical...

CONCLUSION: The MEV(9) (0) of 0.25% ropivacaine required to achieve surgical anesthesia for ultrasound-guided STB under dexmedetomidine sedation is 9.1 mL.

Aiming to reduce muscle fatigue and prevent occupational injuries caused by prolonged lifting in insulator replacement operations, this study presents the design of an upper-limb exoskeleton. Firstly, this study performs kinematic analysis and phase segmentation of the lifting motion in the insulator replacement operation. Based on the analysis, in terms of mechanical structure, the proposed upper-limb exoskeleton adopts a unilateral three-degree-of-freedom shoulder mechanism that biomimics the...

High-grade disruptions to the acromioclavicular joint (ACJ) significantly impair scapular function, which may compromise the subacromial space and increase the risk of impingement related pathology. Research has traditionally focused on the minimum distance between the humeral head and undersurface of the acromion, which may not accurately address the space above the supraspinatus footprint. This study aimed to quantify the subacromial space between the anterior acromion and the supraspinatus...

CONCLUSION: This short- to mid-term follow-up shows good functional results after osteosynthetic reconstruction in coronal shear fractures despite high complication and revision rates. However, increasing Dubberley classification, posterior comminution and the presence of complications show inferior outcome scores. This study shows that osteosynthetic reconstruction can be an option even in comminuted coronal shear fractures. Nevertheless, patient factors need to be considered and an individual...

Muscle-based procedures have been the mainstay of surgical treatment of spastic upper limb deformities, in particular when muscle contractures are a main contributor to the deformity. The type of muscle-based procedures that are utilized to correct a spastic deformity is dependent upon the presence of volitional motor activation and the magnitude of muscle contracture. These procedures can markedly improve patient's quality of life and enhance upper limb function. However, comprehensive...

Functional Electrical Stimulation (FES) is a rehabilitation technique that helps restore or improve motor function by activating muscles through the distribution of electrical signals to nerves or muscles. However, because of the nonlinear and time-varying characteristics of muscle feedback to external electrical stimulation, achieving highly accurate real-time control is difficult. To precisely control the angles of the elbow joint and wrist joints of the upper limb simultaneously, this study...

While the relationship between radial head fractures (RHF) and coronoid process fractures (CPF) is biomechanically established, the exact frequency of CPF in RHF patients without focus on elbow dislocations is underexplored. To better estimate the likelihood of CPF, the analysis of typical fracture constellations is useful. The aim of this study was therefore to analyze the correlation between RHF severity and the presence and type of CPF. This retrospective study analyzed 356 RHF patients,...

CONCLUSIONS: TUBC fracture-dislocations represent a high-risk subgroup of trans-ulnar elbow injuries. Stable fixation of the coronoid base appears critical for achieving favorable outcomes. The Mayo classification provides clinically relevant stratification and prognostic insight for these complex injuries.

CONCLUSION: Functional outcomes were largely comparable between Tight-Rope and screw fixation techniques. These findings align with emerging evidence questioning the routine necessity of coronoid fixation and underscore the importance of individualized surgical decision-making.

The swim bench is an isokinetic ergometer designed to replicate the underwater pull of the freestyle stroke for swimming training. However, limited literature addresses the biomechanical fidelity of the swim bench and specific changes to a swimmer's kinematics with the addition of a torso rotation setting. The aim of this study was to assess the influence of swim bench rotation settings on freestyle stroke kinematics and evaluate the differences with pre-existing in-water kinematic data. Few...

As humans and other animals age, passive and active muscle properties change markedly, with reduced peak tension, peak strain rate, activation and deactivation rate, and increased parallel stiffness. It is thought that these alterations modify locomotor performance, but establishing causal links is difficult when many parameters vary at once. We developed a simplified model of an elbow joint with two antagonistic Hill-type muscles, and varied the associated muscle parameters combinatorially over...

CONCLUSIONS: IR was preferentially weakened in FW, which is thought to be due to the preferential impairment of an "active" movement. In contrast, IR was not easily weakened in SW. The shoulder rotation test is a promising new test for discriminating between FW and SW of the upper limbs.

Stroke affects the sensorimotor control of the upper extremity, limiting functional movements which require coordination between the shoulder and distal joints. StartReact has been used to investigate motor planning, independent of motor initiation and execution, but it is unclear if observed deficits in motor planning at the shoulder are due to task requirements or stroke-related impairments. Our aim was to decouple these factors by studying motor planning of shoulder movement in participants...

CONCLUSION: In this cohort, 14.0% of all patients had a postoperative complication. GW3 fractures treated with K-wires were found to have significantly more complications than GW2 fractures. Also, the rate of loss of reduction was significantly higher in the GW3 group.

This study aimed to compare the accuracy of machine learning classification for three commonly prescribed shoulder exercises in people with and without rotator cuff tendinopathy. Eighteen participants with rotator cuff tendinopathy (mean age 54.2, SD 13.2; 50% female), followed by eighteen matched controls completed a laboratory-based shoulder strength testing protocol. Three exercises were performed (shoulder press, lateral raise and bent over row) while wearing three inertial measurement (IMU)...

Comprehensive evaluation of the shoulder function relies on accurate tracking of humerothoracic and scapulothoracic motion. This study presents a posterior marker configuration comprising three custom 3D-printed clusters (trunk, scapula, upper arm) for use with infrared optoelectronic motion capture systems. The protocol includes a static, unilateral estimation of the glenohumeral joint center (GH). Eight healthy adults performed cycles of abduction/adduction, flexion/extension, horizontal...

The fracture of the coronoid process can compromise elbow stability. The surgical treatment aims to achieve adequate reduction and stability of the fragment. This article describes how arthroscopic assistance and the use of screws and sutures achieve fragment fixation. Our main objective is to describe the effectiveness of arthroscopy in obtaining reduction and fixation of isolated coronoid process fractures. This technique allows for optimal fragment stability and early rehabilitation.

CONCLUSION: The IDO-Isometer demonstrated excellent reliability for measuring isometric external rotation at 90° shoulder abduction. Given its lower cost and ease of use, it may represent a valuable alternative to the HHD in both clinical and research settings.

Dynamometric shoulder strength testing is crucial in clinical, research, and sports settings. Reliable and valid protocols are required to track changes in muscle strength over time. Therefore, this study aims to compare the reliability and validity of portable dynamometer protocols, provide an overview of available protocols and their methodological quality, and develop a checklist to guide the planning and reporting of reliability studies. A systematic search of PubMed, Cochrane Library, Web...

CONCLUSIONS: In summary, this study highlights significant sex-based disparities in isokinetic shoulder strength among WBAs, with male athletes demonstrating superior shoulder strength across multiple parameters. These findings underscore the necessity for sex-specific training and rehabilitation programs to optimize athletic performance and injury prevention in wheelchair basketball.

Dysfunctional elbow osteoarthritis poses a therapeutic dilemma in young patients with high activity levels and corresponding demands on elbow mobility. In selected cases, interposition arthroplasty of the elbow remains a viable salvage option and alternative to primary prosthetic replacement. The primary objective of this study was to evaluate the effects of interposition arthroplasty on elbow joint contact mechanics, comparing Achilles tendon (AT) and fascia lata (FL) grafts. Ten fresh-frozen...

Cubitusvarus deformity is the most common delayed complication of paediatric supracondylar humerus fractures. To evaluate the outcome of cubitusvarus deformity treated by Modified French Osteotomy and fixation with reconstruction plate we have done this observational study. A total 22 patients with post-traumatic cubitusvarus deformity were included in this study. Out of 22 patients; left side was involved in 18 cases and the right side in four. The average age at the time of osteotomy was 14.41...

The 'terrible triad' injury of the elbow is defined as a dislocation of the elbow with concomitant fractures of the radial head and coronoid process. The term was based on reports of poor outcomes following this pattern of injury. However, the 'terrible triad' concept has meant that some very complex elbow fracture-dislocations are considered alongside more benign injuries, leading to problems with our understanding and interpretation of the literature. This annotation explores how our knowledge...

CONCLUSIONS: This study demonstrates the effectiveness of a protocol measuring linear and rotational accelerations of a dummy's head during high-speed rugby tackles where a real player's shoulder hit the dummy's head and the dummy's head hit the floor. Trialing the protocol showed high impact accelerations experienced when receiving a tackle did not reduce with headgear. The experimental methodology and tools developed provide the basis for more complete testing of head biomechanics in tackles.

This retrospective propensity score-matched cohort study examined whether Platelet-Rich Plasma (PRP) use was associated with improved wound healing and functional recovery after shoulder surgery. We analyzed records from Changsha Hospital of Traditional Chinese Medicine (January 2018-December 2023) and included 170 patients undergoing rotator cuff repair (n = 100), shoulder replacement (n = 40), or subacromial decompression (n = 30). Within each surgery type, patients receiving PRP (treatment...

Upper extremity impairments often lead to reduced joint range of motion (ROM), making reliable assessment essential for rehabilitation planning. This study investigated the within-day and between-day reliability of the Microsoft Kinect V2 depth camera for active upper extremity ROM assessment in 30 healthy adults. Ten predefined shoulder and elbow movements were recorded, and joint angles were computed using a custom vector-based algorithm. Within-day reliability ranged from moderate to...

Facioscapulohumeral dystrophy (FSHD) causes progressive muscle weakness, limits function and may lead to altered muscle co-contraction patterns to accomplish task performance and joint stability. In this study we examined time-changes in co-contraction of scapular and humeral muscles in persons with FSHD vs. healthy controls during reaching. Participants with FSHD (N = 12, 56.0 ± 14.5 yrs) and age-matched healthy controls (N = 12, 55.8 ± 13.1 yrs) performed ipsilateral and contralateral reaching...

Shoulder spasticity is a common consequence of upper motor neuron lesions and may be associated with soft tissue contractures, limiting functional recovery. While both cryoneurolysis and tendon lengthening procedures are used individually in refractory cases, their combined effect has not been clearly established. It is consequently necessary to assess the efficacy of combining cryoneurolysis and percutaneous pectoral tenotomy in reducing shoulder spasticity and improving passive range of motion...

Reverse total shoulder arthroplasty (rTSA) has become a standard treatment for symptomatic massive rotator cuff tears (MRCT). While clinical outcomes are generally satisfactory, significant variability in functional recovery raises questions about the extent of inter-individual neuromuscular adaptations and motor restoration. This study aimed to assess the neuromuscular impact of rTSA by analysing superficial shoulder muscle activity and synergies. Asymptomatic shoulders (n = 20) and symptomatic...

CONCLUSION: Arm- and shoulder function remained impaired 2 years after breast surgery, except for grip strength. The reconstruction versus non-reconstruction groups showed minor differences. These findings highlight the importance of counseling and early referral to physiotherapy when postoperative complaints arise.

Elbow valgus torque is often used as a proxy for ulnar collateral ligament injury risk in baseball, yet evidence supporting it as a prospective predictor remains weak. Limited data ranges and reliance on single-session biomechanics restrict its usefulness and inflate noise. Further, assumptions about anthropometric data, simplified joint models, and potential motion-capture inaccuracies can obscure the true loading experienced by the elbow. Because torque is tightly linked to fastball velocity...

Arthroscopy has evolved significantly with advancements in instrumentation and surgical techniques. The introduction of needle arthroscopy represents a promising minimally invasive alternative and, has for the wrist proven to offer a reduced soft tissue trauma with still maintained diagnostic and therapeutic efficacy. The purpose of this study was to evaluate the safety and visualization capabilities of needle arthroscopy of the elbow using cadaveric specimens. Six fresh-frozen cadaveric elbows...

CONCLUSIONS: BA is an important parameter for evaluating reduction. SCA and LCHA were found to be unsuccessful in evaluating reduction. Additionally, evaluating the teardrop figure after reduction and in follow-ups is important in terms of assessing reduction quality and monitoring healing.

BackgroundPrevious studies reported that medial shoulder balance (MSB) with neck tilt correlated radiologically with T1 tilt, first rib angle (FRA), and cervical axis (CA), whereas lateral shoulder balance (LSB) correlated radiologically with clavicle angle (Cla-A), coracoid height difference (CHD), clavicle-rib intersection distance (CRID), and radiographic shoulder height (RSH). Nevertheless, there is a scarcity of literature correlating both the clinical and radiological shoulder balance...

Varus posteromedial rotatory instability (VPMRI) is one of the types of complex elbow instability, which was initially proposed by O 'Driscoll in 2003. Its typical clinical manifestations are anteromedial coronoid fracture (AMCF), injury of lateral collateral ligament complex (LCL), widening of the lateral humeroradial space, and subluxation of the coronoid process relative to the medial edge of the humeral trochlea. However, it presents diagnostic challenges due to its low incidence, complex...

INTRODUCTION: Open elbow arthrolysis effectively treats post-traumatic elbow stiffness, but severe postoperative pain during early rehabilitation impedes recovery. Continuous brachial plexus blocks, though effective, face limitations such as catheter displacement and infection risks. Liposomal bupivacaine, an ultra-long-acting local anaesthetic, offers prolonged analgesia and may circumvent these challenges. This study aims to compare the analgesic efficacy of a single-dose liposomal bupivacaine...

Stroke-induced abnormal upper extremity (UE) joint coupling limits independent joint control and impairs functional arm use. While previous studies have predominantly evaluated UE joint coupling within the plane of motion (in-plane) and its effect on functional task performance, minimizing unnecessary joint movements outside the plane of motion (out-of-plane) across all UE degrees of freedom (DOFs) is essential for coordinated movements. To address this limitation, we developed an experimental...

CONCLUSIONS: Greater elbow valgus torque during pitching is not a significant risk factor for medial elbow injury in young pitchers. Older age and higher pitch count per day were associated with the occurrence of medial elbow injuries in elementary school-aged pitchers.

This study aimed to compare acute muscle damage responses of the elbow flexors following eccentric quasi-isometric (EQI) and eccentric (ECC) exercise. Thirty healthy young men were randomly assigned to EQI or ECC (n = 15/group). Participants performed five sets of dumbbell elbow flexion to volitional failure. Maximal voluntary isometric contraction (MVC), elbow joint range of motion (ROM), upper arm circumference (CIR), pressure pain threshold (PPT), plasma creatine kinase (CK), and myoglobin...

Shoulder calcific tendinopathy is a common condition affecting adults and is has a higher incidence in women. This condition is due to a multifactorial process and is characterized by the deposition of hydroxyapatite crystals in the rotator cuff tendons. The disease shows a phenotypic transformation of tenocytes into chondrocyte-like cells, likely caused by metabolic and inflammatory changes and mechanical stress. Risk factors promoting this pathology include hyperlipidemia, advanced age,...

BACKGROUND Pleomorphic lipoma is a rare benign adipocytic tumor that can closely mimic, radiologically and histologically, malignant soft tissue neoplasms, particularly atypical lipomatous tumor or liposarcoma. Despite is benign nature, pleomorphic lipoma poses a diagnostic challenge because of its significant histologic overlap with malignant entities. Accurate diagnosis is essential to prevent unnecessary wide surgical resections or overtreatment. Recognition of its distinctive clinical,...

CONCLUSION: TEA using CM prosthesis in Chinese patients can achieve favorable functional outcomes regardless of RA status, with a high 5-year prosthesis survival rate. However, a larger sample size and a longer follow-up period are still required.

CONCLUSION: Fractures located proximal to the olecranon fossa are more unstable and technically demanding, resulting in longer operation times and more intraoperative pinning attempts. Among high-level fractures, oblique types are especially prone to technical challenges and increased revision rates, highlighting the importance of fracture morphology in surgical planning.

CONCLUSION: Reconstruction can be supplemented with IJS which aids in keeping the elbow concentrically reduced throughout arc of motion. There is no consensus on the optimal location of the LUCL graft proximally on the distal humerus when the axis of rotation is occupied by the IJS central pin. This case series describes techniques to reconstruct the LUCL as close to the isometric point as possible with IJS placement.

Powerlifting, including the bench press, has shown an increasing participation rate, especially among women. While rotator cuff injuries are prevalent in lifters, there is limited knowledge on how biological sex impacts shoulder biomechanics during the bench press. This study evaluated the impact of biological sex and fatigue on subacromial space parameters, specifically the acromiohumeral distance and supraspinatus occupation ratio, during the bench press. We hypothesized that the occupation...

Robotic systems assess joint dynamics objectively by perturbing the limb and estimating properties such as impedance. Position perturbations constrain the limb to a target trajectory, reducing variability in task execution but obstructing voluntary motion. Force perturbations allow voluntary movement but elicit orientation-dependent responses, increasing the number of trials needed for accurate estimates. To overcome these limitations, we combined the flexibility of admittance control with the...