Shoulder/Elbow – Pubmed Results

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CONCLUSION: Complex cubitus varus involving multiple skeletal segments may not be correctable with single-level osteotomy. Double-level osteotomy allows anatomical realignment while preserving elbow joint orientation, reliably achieved using three-dimensional patient-specific techniques.

CONCLUSIONS: This study suggests that scapular dyskinesis influences the activity of the infraspinatus and lower trapezius muscles during Chakrasana and Pincha Mayurasana poses. The data highlight the importance of targeted neuromuscular interventions to address muscular imbalances in the shoulder complex, especially in populations exposed to overhead and inverted movements, such as yoga practitioners.

CONCLUSIONS: The movement through the elbow and shoulder is distributed differently during different styles of push-ups. The wrist and elbow can be relatively protected from ligament injury when push-ups are performed on a neutral wrist.

Robotic-assisted surgery has gained prominence in orthopedic practice due to its precision, enhanced visualization, and minimally invasive nature. While robotic applications for orthopedic surgery are well established in arthroplasties, their use in soft-tissue surgery remains limited. This study presents the indications, technique, and clinical outcomes of robotic-assisted latissimus dorsi tendon transfers for shoulder reconstruction. The robotic approach allows accurate identification of the...

This study aimed to conduct a retrospective review of pediatric patients with concomitant ipsilateral lateral humeral condyle fractures and further evaluate treatment approaches and patient outcomes. Inclusion criteria: age 4 to 14 years with the diagnosis of ipsilateral lateral humeral condyle and ulnar olecranon fractures, no history of fractures, and follow-up of at least 24 months. Excluded patients: patients with open fractures, history of elbow joint surgery, and associated neurovascular...

CONCLUSION: This study demonstrates the feasibility of reconstructing the full shoulder anatomy using a hybrid 3D US mosaicking approach. The proposed workflow improves alignment accuracy and anatomical visualisation compared with pose estimation alone and provides a practical reference framework for future large-scale and automated, real-time musculoskeletal US reconstruction.

CONCLUSIONS: Individually tailored PEST delivered via a DT system is a viable, cost-effective, and safe alternative to conventional outpatient clinic-based training following arthroscopic release for posttraumatic elbow stiffness. These findings support its integration into routine postsurgical care, particularly for patients facing barriers to traditional therapy.

CONCLUSIONS: Individuals with T2DM showed impairments in proprioception and functional stability, suggesting shoulder involvement. These findings highlight the need for greater clinical attention, while rehabilitation implications should be interpreted with caution.

Work-related musculoskeletal disorders are common, especially among women performing repetitive overhead tasks. In a randomized 2 × 2 crossover study with 14 female participants, we investigated the effects of a passive upper-body exoskeleton during an overhead precision task, involving the tightening of 20 bolts into a sensor-based workstation, while muscle activation, task performance, and usability were assessed. The results showed significant reduced M. Trapezius muscle activations during...

Intraoperative nerve injuries during orthopaedic shoulder procedures can cause pain, paresthesia, and muscle weakness. Iatrogenic nerve injuries are often transient or subclinical, and it is believed that many neurologic injuries go undiagnosed. Several risk factors predispose patients to intraoperative nerve injury, including local tissue stiffness, revision surgery, low body mass index, medications, and decreased range of motion. Apart from patient-specific risk factors, there are direct and...

CONCLUSION: The median nerve neurotmesis after elbow dislocation without an associated fracture is rare. This case highlights the importance of careful neurologic examination in children sustaining simple elbow dislocations and surgical exploration if there is evidence of severe injury.

CONCLUSION: Fracture treatment should consider the clinical relevance of pre-existing but functional musculoskeletal abnormalities.

CONCLUSION: In this small exploratory cohort of modular press-fit pyrocarbon RHA, radial neck osteolysis ≥ 3 mm was rare and no association was found between osteolysis depth and functional outcomes. These findings do not support the use of an isolated 3 mm osteolysis threshold as a clinical warning sign in this implant at short-to-midterm follow-up.

Distal humeral arthroplasty (DHA), also termed elbow hemiarthroplasty, replaces the distal humeral articular surface while preserving the native ulnar and radial articular surfaces. Compared with total elbow arthroplasty (TEA), DHA has distinct characteristics, resulting in different surgical indications and clinical outcomes. The prefix "hemi-" may be misleading, as DHA should not be regarded as half--the humeral part of TEA.

CONCLUSIONS: No statistically significant differences in clinical outcomes were detected between defect/distance and contact arthrodesis; however, equivalence cannot be concluded from this underpowered exploratory cohort. Elbow arthrodesis remains a salvage procedure with substantial complication risk. Individualized fusion angle selection, local bone stock, infection status, and patient-specific occupational demands should be considered carefully during preoperative counseling and surgical...

CONCLUSION: These findings suggest that rotator cuff tears are associated with maladaptive reductions in supraspinatus muscle stiffness during acute exercise, potentially impairing functional capacity and necessitating longer recovery periods. In contrast, asymptomatic participants maintain supraspinatus stiffness despite weakness, underscoring differential adaptation to low-intensity exercise.

CONCLUSION: In this case series, ligament-based surgical treatment of PLRI with associated posterior capitellar lesions was associated with generally favorable patient-reported outcomes. These findings highlight the need for larger, standardized studies to clarify the clinical relevance and treatment thresholds of posterior capitellar lesions. Standardized protocols are needed for defect size assessment and evidence-based guidelines for managing posterior capitellar lesions remain necessary to...

CONCLUSION: Complications following RHA result in impaired functional outcomes that persist even after the prosthesis is removed. These findings support the importance of careful primary implantation and avoidance of overstuffing; however, removal of a failed RHA should be regarded as a salvage procedure with limited potential to restore long-term elbow function.

CONCLUSION: Dominant side fracture was not an independent predictor of conservative management change, undergoing surgical management or clinical outcomes in pediatric lateral condyle fractures. Fracture displacement and higher Weiss classification were the strongest predictors of surgical intervention, while non-FOOSH mechanisms and elevated BMI were associated with higher risks of loss of reduction and change of conservative management, respectively.

Passive arm-support exoskeletons (ASEs) can reduce shoulder stress during overhead work. However, the effects of ASEs are task- and device-specific, and current human-subjects evaluation protocols are time-consuming and resource-intensive. Musculoskeletal modeling could simplify ASE evaluation, such as by estimating muscle activation in place of measuring electromyographic (EMG) data. We assessed shoulder muscle activities estimated using a commercial biomechanical modeling system during dynamic...

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....

CONCLUSIONS: A flexible 15°-90° arthroscope significantly increased anterior visualization of the capitellum compared with a conventional 30° arthroscope in this cadaveric model. Whether this anatomical visualization gain translates into clinical diagnostic or therapeutic benefit requires further investigation.

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...

Shoulder disorders have been associated with repetitive overhead work and manual lifting. Passive exoskeletons may reduce exposure to physical risk factors associated with shoulder injuries. This repeated-measures study evaluated the initial static, pseudo-static, cognitive, and dynamic fit of three passive shoulder exoskeletons compared to a no-exoskeleton condition. Twenty-four participants (sex-balanced) performed range of motion tasks, simulated manufacturing activities, and a cognitive...

BACKGROUND: Alterations in shoulder muscle thickness and strength are believed to be associated with rotator cuff (RC) tendinopathy. Previous studies have mainly focused on measuring the supraspinatus tendon thickness in relevant patients with shoulder pain. This study examined differences in shoulder muscle thickness and RC strength in the symptomatic and asymptomatic shoulders of patients with RC tendinopathy.

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...

CONCLUSIONS: The EBT is a simple clinical tool which identifies a distinct subgroup of brachial plexus birth injury patients with C7 nerve injury, which limits shoulder abduction secondary to subscapularis weakness and altered biceps dynamics. Recognition of this clinical sign is crucial as this can influence the treatment.

CONCLUSION: Lateral armrest support demonstrated biomechanical advantages in healthy young adults, including improved spinal alignment, reduced shoulder girdle loading, and greater vital capacity compared with unsupported sitting. These findings provide preliminary mechanistic insight and may inform future investigations in clinical populations; however, direct extrapolation to individuals with respiratory or neurological impairment requires further study.

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...

CONCLUSION: Intravenous, topical, or combined TXA administration showed no significant difference in reducing postoperative blood loss after OEA. However, both combined and topical TXA significantly reduced postoperative drainage volume compared to intravenous administration.

Exploring the risk factors for postoperative rebound pain (RP) in patients undergoing shoulder arthroscopy under brachial plexus nerve block combined with general anesthesia. This study is a prospective observational study. Clinical data of patients were used as predictors for intergroup comparisons. Univariate analysis identified statistically significant influencing factors, which were then subjected to multivariate binary logistic regression analysis. This process ultimately identified...

Objective Almost 70 years ago, Osborne described a fibrous band, Osborne’s ligament, stretching between the humeral and ulnar heads of the flexor carpi ulnaris, which forms the cubital tunnel’s roof. Prior to this account, this ligament had received limited attention in the anatomical literature and had been poorly studied. Therefore, the present anatomical study was performed to better elucidate this structure. Methods thirty adult anatomical donors (60 sides) underwent dissection of the medial...

The reproducibility of radiographic parameters used to assess pediatric supracondylar fracture reduction, including Baumann angle, lateral capitellohumeral angle (LCHA), carrying angle, and anterior humeral line (AHL) crossing the capitellum, was evaluated. Two observers undertook a total of 2368 measures on 148 elbow radiographs from 107 patients aged 0-12 years. The observers, who were blinded to their own measurements and each other's measurements, performed the measurements twice with a...

PURPOSE OF REVIEW: Shoulder arthroplasty is often associated with significant postoperative pain, making effective analgesia a crucial part of surgery day. The interscalene brachial plexus nerve block (ISB) is the gold standard for regional anesthesia in otherwise healthy patients. However, its use is limited by a high incidence of ipsilateral phrenic nerve paralysis, which may result in respiratory compromise, particularly in patients with chronic obstructive pulmonary disease (COPD), reduced...

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.

The incidence of advanced osteomyelitis following arthroscopic shoulder surgery is rare, with few documented cases. As the need for shoulder interventions in elderly populations increases, managing these complex infections poses a significant surgical challenge. This report details the case of an 85-year-old woman who presented with fever and a fistulating portal site infection of the right shoulder. Diagnostic workup confirmed methicillin-resistant Staphylococcus aureus (MRSA). She was...

Post-traumatic elbow stiffness is a common complication limiting range of motion and function. Open surgical release is invasive and may not improve patient outcomes. Manipulation under anesthesia (MUA) is a less invasive way to break adhesions and restore motion, though high-level comparative evidence is lacking. This study evaluated whether early MUA plus rehabilitation improves elbow motion, pain, and function compared to rehabilitation alone in patients with postoperative elbow stiffness....

BACKGROUND: Anterior shoulder instability may impact daily physical activities, particularly those requiring movements above shoulder level, and is typically treated with stabilizing surgery. However, quantification of the shoulder function during activities of daily living, both before and after a shoulder stabilizing surgery, is unknown. The aim was to evaluate daily shoulder activity in patients with anterior shoulder instability before and after stabilizing surgery using inertial measurement...

CONCLUSION: We propose that in a group with experience in musculoskeletal ultrasound (MSKUS) examining patients from a mixed referral base, the rate of recommendation for additional MRI should be less than 9%.

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...

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.

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...