BACKGROUND Supracondylar humeral fractures(SCHF)are the second most common fractures in childhood and can lead to short-and long-term complications.Despite their prevalence,the anatomical factors that predispose child...BACKGROUND Supracondylar humeral fractures(SCHF)are the second most common fractures in childhood and can lead to short-and long-term complications.Despite their prevalence,the anatomical factors that predispose children to SCHF remain unclear.This study aimed to determine whether there are significant morpho-logical differences in the elbow by comparing the radiographic angular measure-ments of the contralateral elbows of patients with SCHF to those of patients with distal radius fractures(DRF)and a healthy control group.We sought to explore if these morphological variations contribute to the occurrence of SCHF.Radiographs of 78 SCHF patients were analyzed for angular measurements of the contralateral elbow.Two control groups were used:98 healthy children and 40 patients with DRF.Angular measurements included Baumann angle(BA),hu-meroulnar angle(HUA),humerus metaphysis-diaphysis angle(HMDA),humerus shaft-condylar angle(HSCA),and lateral capitellohumeral angle.Only BA,HUA,and HMDA were measured in the DRF group.Statistical analysis was performed to compare differences among groups.RESULTS Significant differences were found in elbow measurements between SCHF and control groups(P<0.05).However,the mean values for all groups fell within the ranges described in the literature.CONCLUSION While statistically significant differences were found in elbow morphology between SCHF patients and controls,these differences don't translate into clinically meaningful morphological deviations.展开更多
Elbow dislocations are rare injuries in children due to the resistance of the capsuloligamentous structures. Anterior dislocation is very rare and its combination with an olecranon fracture is unusual. The authors rep...Elbow dislocations are rare injuries in children due to the resistance of the capsuloligamentous structures. Anterior dislocation is very rare and its combination with an olecranon fracture is unusual. The authors report a case of this lesion in a 7-year-old child managed nonoperatively.展开更多
Gas-liquid flow(GLF),especially slug and annular flows in oil and gas gathering and transportation pipelines,become particularly complex inside elbows and can easily exacerbate pipeline corrosion and damage.In thisstu...Gas-liquid flow(GLF),especially slug and annular flows in oil and gas gathering and transportation pipelines,become particularly complex inside elbows and can easily exacerbate pipeline corrosion and damage.In thisstudy,FLUENT was used to conduct 3D simulations of slug and annular flow in elbows for different velocitiesto assess the ensuing changes in terms of pressure.In particular,the multifluid VOF(Volume of Fraction)modelwas chosen.The results indicate that under both slug and annular flow conditions,the pressure inside the elbow islower than the outside.As the superficial velocity of liquid and gas increase,the pressure and liquid flow velocityat different positions of the elbow also increase,while the secondary flow weakens.Under annular flow conditions,the liquid film on the outer side of the elbow is thicker than that on the inner side,and the liquid velocityin the main liquid film zone is the lowest.展开更多
Aimed at the S-elbow composed of two elbows with different radii, this article proposes a winding pattern design method combined with patch winding method and traditional winding method. It proposes an optimal combina...Aimed at the S-elbow composed of two elbows with different radii, this article proposes a winding pattern design method combined with patch winding method and traditional winding method. It proposes an optimal combination of calculating the tangential point amount and skip point amount to make the pattern distribution even and keep the minimal adjusting angle. The S-elbow overall winding pattem plan and simulation module are designed to verify the combined winding pattern design method and the calculation algorithm of the tangential point amount and skip point amount. From the pattern distribution and the simula- tion effect analysis, it shows that this combined winding pattern design method is a good solution to the S-elbow combined winding pattern design. Aimed at the S-elbow winding pattern based on the patch winding method, it carries out the precision error analysis and points out the correspondence between the error and mesh size. Generally speaking, the bigger the mesh size is, the quicker the program calculation speed is; the smaller the mesh size is, the smaller the winding pattern error is.展开更多
AIM:To evaluate the effect of different elbow and forearm positions on radiocapitellar alignment.METHODS:Fifty-one healthy volunteers were recruited and bilateral elbow radiographs were taken to form a radiologic data...AIM:To evaluate the effect of different elbow and forearm positions on radiocapitellar alignment.METHODS:Fifty-one healthy volunteers were recruited and bilateral elbow radiographs were taken to form a radiologic database.Lateral elbow radiographs were taken with the elbow in five different positions:Maximal extension and forearm in neutral,maximal flexion and forearm in neutral,elbow at 90° and forearm in neutral,elbow at 90° and forearm in supination and elbow at 90° and forearm in pronation.A goniometer was used to verify the accuracy of the elbow's position for the radiographs at a 90° angle.The radiocapitellar ratio(RCR)measurements were then taken on the collected radiographs using the Slice Omatic software.An orthopedic resident performed the radiographic measurements on the 102 elbows,for a total of 510 lateral elbow radiographic measures.ANOVA paired t-tests and Pearson coefficients were used to assess the differences and correlations between the RCR in each position.RESULTS:Mean RCR values were-2% ± 7%(maximal extension),-5% ± 9%(maximal flexion),and for elbow at 90° and forearm in neutral-2% ± 5%,supination 1% ± 6% and pronation 1% ± 5%.ANOVA analyses demonstrated significant differences between the RCRin different elbow and forearm positions.Paired t-tests confirmed significant differences between the RCR at maximal flexion and flexion at 90°,and maximal extension and flexion.The Pearson coefficient showed significant correlations between the RCR with the elbow at 90°-maximal flexion;the forearm in neutralsupination;the forearm in neutral-pronation.CONCLUSION:Overall,95% of the RCR values are included in the normal range(obtained at 90° of flexion)and a value outside this range,in any position,should raise suspicion for instability.展开更多
Prof. FANG Jian-qiao is good at clinical and basic study on acupuncture analgesia. The therapeutic efficacy in treating tennis elbow of Prof. Fang is significant,＂needling painful point＂ on the basis of clarifying c...Prof. FANG Jian-qiao is good at clinical and basic study on acupuncture analgesia. The therapeutic efficacy in treating tennis elbow of Prof. Fang is significant,＂needling painful point＂ on the basis of clarifying causes and pathogenesis of this disease in TCM and western medicine,treat this disease by using encircling needling in combina on with warm needling moxibus on,and it is convenient,safe and eff ec ve. The encircling needling in combina on with warm needling moxibus on has obvious advantages in trea ng external humeral epicondyli s.展开更多
A loop system was used to investigate the effect of flow velocity on corrosion behavior of AZ91 D magnesium alloy at an elbow of loop system based on array electrode technology by polarization, computational fluid dyn...A loop system was used to investigate the effect of flow velocity on corrosion behavior of AZ91 D magnesium alloy at an elbow of loop system based on array electrode technology by polarization, computational fluid dynamics(CFD) simulation and surface analysis. The experimental results showed that the corrosion rate increased with increasing flow velocity, and a critical flow velocity could exist in the corrosion of AZ91 D magnesium alloy. When flow velocity exceeded the critical flow velocity, fluid hydrodynamics was dominant in the corrosion of AZ91 D magnesium alloy. On the contrary, the electrochemical factors were dominant.展开更多
Since 1991, the author has treated 32 cases of tennis elbow by the three-needle therapy on the elbow with satisfactory therapeutic results. The report is presented as follows. Clinical Data Of the 32 cases, 21 were ma...Since 1991, the author has treated 32 cases of tennis elbow by the three-needle therapy on the elbow with satisfactory therapeutic results. The report is presented as follows. Clinical Data Of the 32 cases, 21 were male and 11 female, with the age ranging from 32 to 64 years, and the duration of illness from 28 days to 1 year.展开更多
AIM:To evaluate short-to medium term outcome of total elbow arthroplasty(TEA)in complex fractures of the distal humerus.METHODS:A consecutive series of 24 complex distal humerus fractures operated with TEA in the peri...AIM:To evaluate short-to medium term outcome of total elbow arthroplasty(TEA)in complex fractures of the distal humerus.METHODS:A consecutive series of 24 complex distal humerus fractures operated with TEA in the period2006-2012 was evaluated with the Mayo Elbow Performance score(MEPS),plain radiographs,complications and overall satisfaction.The indications for surgery were 1:AO type B3 or C3 or Sheffield type 3 fracture and age above 65 or 2:fracture and severe rheumatoid arthritis.Mean follow-up time was 21 mo.RESULTS:Twenty patients were followed up.Four patients,of which 3 had died,were lost to follow up.According to the AO classification there were 17 C3,1B2 and 2 A2 fractures.Mean follow-up was 21 months(range 4-54).Mean MEPS was 94(range 65-100).Mean flexion was 114 degrees(range 80-140).According to MEPS there were 15 excellent,4 good and 1 fair result.Patient satisfaction:8 excellent,10 good,2 fair and 1poor.There were two revisions due to infection treated successfully with revision and three months of antibiotics.In two patients the locking split had loosened.One was referred to re-insertion and one chose yearly con-trols.Two patients had persistent dysaesthesia of their5th finger,but were able to discriminate between sharp and blunt.CONCLUSION:Our study suggests that TEA in complex fractures of the distal humerus in elderly patients can result in acceptable short-to medium term outcome.展开更多
With the increase in mining depth, mine heat harm has appeared to be more prominent. The mine heat harm could be resolvedor reduced by ice refrigeration. Thus, ice transportation through pipeline becomes a critical pr...With the increase in mining depth, mine heat harm has appeared to be more prominent. The mine heat harm could be resolvedor reduced by ice refrigeration. Thus, ice transportation through pipeline becomes a critical problem; typically flowresistance occurs in the elbow. In the present study, according to the analysis of the surface morphology of fish scale, abiomimetic functional surface structure for the interior wall of elbow is designed. Based on the theory of liquid-solid two phaseflow, a CFD numerical simulation of ice-water mixture flowing through the elbow is carried out using finite element method.Conventional experiments of pressure drop and flow resistance for both bionic and common elbows are conducted to test theeffect of the bionic elbow on flow resistance reduction. It is found that with the increase in the ice mass fraction in the ice-watermixture, the effect of bionic elbow on resistance reduction becomes more obvious.展开更多
The medial ulnar collateral ligament complex of the elbow, which is comprised of the anterior bundle [AB, more formally referred to as the medial ulnar collateral ligament(MUCL)], posterior(PB), and transverse ligamen...The medial ulnar collateral ligament complex of the elbow, which is comprised of the anterior bundle [AB, more formally referred to as the medial ulnar collateral ligament(MUCL)], posterior(PB), and transverse ligament, is commonly injured in overhead throwing athletes. Attenuation or rupture of the ligament results in valgus instability with variable clinical presentations. The AB or MUCL is the strongest component of the ligamentous complex and the primary restraint to valgus stress. It is also composed of two separate bands(anterior and posterior) that provide reciprocal function with the anterior band tight in extension, and the posterior band tight in flexion. In individuals who fail co-mprehensive non-operative treatment, surgical repair or reconstruction of the MUCL is commonly required to restore elbow function and stability. A comprehensive understanding of the anatomy and biomechanical properties of the MUCL is imperative to optimize reconstructive efforts, and to enhance clinical and radiographic outcomes. Our understanding of the native anatomy and biomechanics of the MUCL has evolved over time. The precise locations of the origin and insertion footprint centers guide surgeons in proper graft placement with relation to bony anatomic landmarks. In recent studies, the ulnar insertion of the MUCL is described as larger than previously thought, with the center of the footprint at varying distances relative to the ulnar ridge, joint line, or sublime tubercle. The purpose of this review is to consolidate and summarize the existing literature regarding the native anatomy, biomechanical, and clinical significance of the entire medial ulnar collateral ligament complex, including the MUCL(AB), PB, and transverse ligament.展开更多
Lateral epicondylitis is a relatively common clinical prob lem, easily recognized on palpation of the lateral protu berance on the elbow. Despite the "itis" suffix, it is no an inflammatory process. Therapeu...Lateral epicondylitis is a relatively common clinical prob lem, easily recognized on palpation of the lateral protu berance on the elbow. Despite the "itis" suffix, it is no an inflammatory process. Therapeutic approaches with topical non-steroidal anti-inflammatory drugs, cortico steroids and anesthetics have limited benefit, as would be expected if inflammation is not involved. Other ap proaches have included provision of healing cytokine from blood products or stem cells, based on the recog nition that this repetitive effort-derived disorder repre sents injury. Noting calcification/ossification of tendon attachments to the lateral epicondyle(enthesitis), dry needling, radiofrequency, shock wave treatments and surgical approaches have also been pursued. Physi ologic approaches, including manipulation, therapeuti ultrasound, phonophoresis, iontophoresis, acupuncture and exposure of the area to low level laser light, ha also had limited success. This contrasts with the benefi of a simple mechanical intervention, reducing the stres on the attachment area. This is based on displacemen of the stress by use of a thin(3/4-1 inch) band applied just distal to the epicondyle. Thin bands are required as thick bands(e.g., 2-3 inch wide) simply reduce mus cle strength, without significantly reducing stress. Thi approach appears to be associated with a failure rateless than 1%, assuming the afflicted individual modifies the activity that repeatedly stresses the epicondylar attachments.展开更多
The effect of a guide vane installed at the elbow on flow-induced noise and vibration is investigated in the range of Reynolds numbers from 1.70×10^5 to 6.81×10^5, and the position of guide vane is determine...The effect of a guide vane installed at the elbow on flow-induced noise and vibration is investigated in the range of Reynolds numbers from 1.70×10^5 to 6.81×10^5, and the position of guide vane is determined by publications. The turbulent flow in the piping elbow is simulated with large eddy simulation （LES）. Following this, a hybrid method of combining LES and Lighthill＇s acoustic analogy theory is used to simulate the hydrodynamic noise and sound sources are solved as volume sources in code Actran. In addition, the flow-induced vibration of the piping elbow is investigated based on a fluid-structure interaction （FSI） code. The LES results indicate that the range of vortex zone in the elbow without the guide vane is larger than the case with the guide vane, and the guide vane is effective in reducing flow-induced noise and vibration in the 90° piping elbow at different Reynolds numbers.展开更多
During the production period of shale gas, proppant particles and rock debris are produced together,which will seriously erode the elbows of gathering pipelines. In response to this problem, this paper takes the elbow...During the production period of shale gas, proppant particles and rock debris are produced together,which will seriously erode the elbows of gathering pipelines. In response to this problem, this paper takes the elbow of the gathering pipeline in the Changning Shale Gas Field as an example to test the erosion rate and material removal mechanism of the test piece at different angles of the elbow through experiments and compares the four erosion models with the experimental results. Through analysis, it is found that the best prediction model for quartz sand-carbon steel erosion is the Oka model. Based on the Oka model, FLUENT software was used to simulate and analyze the law of erosion of the elbow of the gas gathering pipeline under different gas flow velocities, gas gathering pressure, particle size, length of L1,and bending directions of the elbow. And a spiral pipeline structure is proposed to reduce the erosion rate of the elbow under the same working conditions. The results show that this structure can reduce erosion by 34%.展开更多
In this work,computational fuid dynamics(CFD)is used to study elbow erosion due to a gas-solid two-phase fow.In particular,the direct simulation Monte Carlo(DSMC)method is used to study the impact of inter-particle co...In this work,computational fuid dynamics(CFD)is used to study elbow erosion due to a gas-solid two-phase fow.In particular,the direct simulation Monte Carlo(DSMC)method is used to study the impact of inter-particle collision on the erosion behavior.The two-way coupled Euler-Lagrange method is used to solve the gas-solid fow,and the DSMC method is used to consider the collision behavior between particles.The efects of key factors,such as the particle concentration distribution and inter-particle collision,on the erosion ratio are evaluated and discussed.The efectiveness of the method is verifed from experimental data.The results show that the inter-particle collision signifcantly infuences the particle movement path and erosion ratio.When the inter-particle collision is considered,the maximum erosion position is ofset.The erosion model proposed by Oka et al.,who used the DSMC method,agrees best with the experimental data,and the average percentage error decreases from 39.2 to 27.4%.展开更多
Objective： To compare differences of acupotomy loosing combined with medication treatment, electroacupuncture combined with medication treatment and simple medication treatment in effects on rheumatoid arthritis pati...Objective： To compare differences of acupotomy loosing combined with medication treatment, electroacupuncture combined with medication treatment and simple medication treatment in effects on rheumatoid arthritis patients with elbow joint stiffness and investigate the anti-inflammatory mechanism of the acupotomy loosing.Methods： A total of 60 cases of rheumatoid arthritis（RA） patients with elbow joint stiffness were randomly assigned into the group receiving acupotomy loosing（group A）, group with electroacupuncture（group B） and the one undergoing medication treatment（group C） with 20 cases for each group. Based on the medication treatment, all patients underwent continuous oral administration with Methotrexate（MTX）, Leflunomide（LEF） and Bitongding capsules for 3 weeks. And no other treatments were given to group C. In addition to medications treatment, the electroacupuncture was performed in group B. The acupoints of Tianzhu（天柱 BL 10）,DAzhui（大椎 GV 14）; Fengchi（风池 GB 20）,Quchi（曲池 LI 11）,Quze（曲泽 PC 3）,Chize（尺泽 LU 5）, Shousanli（手三里 LI 10）, Xiaohai（小海 SI 8）, Shaohai（少海 HT 3）, Tianjing（天井 TE 10）,Qinglengyuan（清冷渊 TE 11） and Hegu（合谷 LI 4） in the affected side were selected. A pair of electrodes were connected to LI 11 and LI 10, and another pair of electrodes were connected to PC 3 and LU 5, and the continuous wave with frequency of 2 Hz was designed, the needle retention for 30 min was performed, and the acupuncture was performed for 6 times per week with 3 weeks for one course,and there was one course totally. Besides the medication treatment, group A underwent the acupotomy loosing therapy. The tender point in lateral elbow joint, etc. were taken as the treatment point, and 6-8 treatment points being taken for each time, and longitudinal dredging and transverse exfoliation were conducted for 2-3 times with the acupotomy. The treatment was given for one time per week with three weeks for one course, and there was one course totally. The changes of maximum angle of active extension position, maximum angle of active flexion position and range of motion were observed, and levels of IL-6, IL-10 and TNF-a in affected synovial fluid of elbow joint were tested before the treatment and 2 weeks after the treatment in the groups.Results： ① Compared with those before treatment, the maximum angle of active extension position were smaller, the maximum angle of active flexion position were larger and the range of motion were wider of the affected elbow joints of the patients in the 3 groups on the 2 weeks after the treatment.There were statistical significances for the differences（All P 0.05）. Two weeks after the treatment,as compared with those in group C, the affected elbow joint for patients in the group B and group A was smaller in maximum angle of active extension position, larger in maximum angle of active flexion position and wider in range of motion and there were statistical significances for the differences（All P 0.05）. Comparing with those in the group B, the affected elbow joint for patients in the group A was smaller in maximum angle of active extension position, larger in maximum angle of active flexion position and wider in range of motion and there were the statistical significances for the differences（All P 0.05）. ② Compared with those before treatment, the levels of TNF-a and IL-6 were lower and the level of IL-10 was higher of the 3 groups on the 2 weeks after the treatment. There were the statistical significances for the differences（All P 0.05）. For 2 weeks after the treatment, compared with those in the group C, group B and group A were lower in levels of TNF-α and IL-6 and higher in level of IL-10 and there were the statistical significances for the differences（All P 0.05）. As compared with those in the group B, group A was lower in levels of TNF-a and IL-6 and higher in level of IL-10 and there were the statistical significances for the differences（All P 0.05）.Conclusions： The combination of acupotomy loosing can improve the maximum angle of active extension position, maximum angle of active flexion position and range of motion in affected elbow joint for RA patients with elbow joint stiffness, whose efficacy was superior to single basic treatment and electroacupuncture combined with basic treatment. Meanwhile, the levels of proinflammatory cytokines,such as TNF-α and IL-6 can be decreased, and the level of anti-inflammatory cytokines, such as IL-10 can be increased, playing a role in regulating the imbalance between proinflammatory cytokines and anti-inflammatory cytokines in RA patients, which may be one of mechanisms regarding treating RA and improving the range of motion for stiff joints.展开更多
Direct coaptation of contralateral C7 to the upper trunk could avoid the interposition of nerve grafts. We have successfully shortened the gap and graft lengths, and even achieved direct coaptation. However, direct re...Direct coaptation of contralateral C7 to the upper trunk could avoid the interposition of nerve grafts. We have successfully shortened the gap and graft lengths, and even achieved direct coaptation. However, direct repair can only be performed in some selected cases, and partial procedures still require autografts, which are the gold standard for repairing neurologic defects. As symptoms often occur after autografting, human acellular nerve allografts have been used to avoid concomitant symptoms. This study investigated the quality of shoulder abduction and elbow flexion following direct repair and acellular allografting to evaluate issues requiring attention for brachial plexus injury repair. Fifty-one brachial plexus injury patients in the surgical database were eligible for this retrospective study. Patients were divided into two groups according to different surgical methods. Direct repair was performed in 27 patients, while acellular nerve allografts were used to bridge the gap between the contralateral C7 nerve root and upper trunk in 24 patients. The length of the harvested contralateral C7 nerve root was measured intraoperatively. Deltoid and biceps muscle strength, and degrees of shoulder abduction and elbow flexion were examined according to the British Medical Research Council scoring system;meaningful recovery was defined as M3–M5. Lengths of anterior and posterior divisions of the contralateral C7 in the direct repair group were 7.64 ± 0.69 mm and 7.55 ± 0.69 mm, respectively, and in the acellular nerve allografts group were 6.46 ± 0.58 mm and 6.43 ± 0.59 mm, respectively. After a minimum of 4-year follow-up, meaningful recoveries of deltoid and biceps muscles in the direct repair group were 88.89% and 85.19%, respectively, while they were 70.83% and 66.67% in the acellular nerve allografts group. Time to C5/C6 reinnervation was shorter in the direct repair group compared with the acellular nerve allografts group. Direct repair facilitated the restoration of shoulder abduction and elbow flexion. Thus, if direct coaptation is not possible, use of acellular nerve allografts is a suitable option. This study was approved by the Medical Ethical Committee of the First Affiliated Hospital of Sun Yat-sen University, China (Application ID:[2017] 290) on November 14, 2017.展开更多
The elbow joint is a complex joint, which, when impaired in function, leads to severe disability. In some cases however, an arthroplasty might be an appropriate treatment. In the past four decades, large steps havebee...The elbow joint is a complex joint, which, when impaired in function, leads to severe disability. In some cases however, an arthroplasty might be an appropriate treatment. In the past four decades, large steps havebeen taken to optimize this treatment in order to achieve better post-operative outcomes. To understand these progresses and to discover aspects for upcoming improvements, we present a review on the past developments, the present state of affairs and future developments which may improve patient care further.展开更多
BACKGROUND Joint stiffness after elbow surgery is not a rare complication,and is always accompanied by deformity.The causes of joint stiffness are multiple in different patients,and divided into intrinsic and extrinsi...BACKGROUND Joint stiffness after elbow surgery is not a rare complication,and is always accompanied by deformity.The causes of joint stiffness are multiple in different patients,and divided into intrinsic and extrinsic causes.Herein,we report an unusual case of posttraumatic elbow stiffness due to multiple and rare causes.CASE SUMMARY A 19-year-old male was hospitalized with the loss of motion of the left elbow for over ten years.Left limb computed tomography revealed left elbow stiffness with bony block and connection.The patient underwent surgery,and the etiology of joint stiffness was found to be a rare combination of common and uncommon causes.During an 18-mo follow-up period,the patient’s left elbow had normal motion and he was symptom-free.CONCLUSION However,this case combined with multiple and rare causes highlights that the patient with scar physique is likely to be accompanied with more severe soft tissue,nerve contracture,and heterotypic ossification,even during recurrence.展开更多
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 reve...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.展开更多
文摘BACKGROUND Supracondylar humeral fractures(SCHF)are the second most common fractures in childhood and can lead to short-and long-term complications.Despite their prevalence,the anatomical factors that predispose children to SCHF remain unclear.This study aimed to determine whether there are significant morpho-logical differences in the elbow by comparing the radiographic angular measure-ments of the contralateral elbows of patients with SCHF to those of patients with distal radius fractures(DRF)and a healthy control group.We sought to explore if these morphological variations contribute to the occurrence of SCHF.Radiographs of 78 SCHF patients were analyzed for angular measurements of the contralateral elbow.Two control groups were used:98 healthy children and 40 patients with DRF.Angular measurements included Baumann angle(BA),hu-meroulnar angle(HUA),humerus metaphysis-diaphysis angle(HMDA),humerus shaft-condylar angle(HSCA),and lateral capitellohumeral angle.Only BA,HUA,and HMDA were measured in the DRF group.Statistical analysis was performed to compare differences among groups.RESULTS Significant differences were found in elbow measurements between SCHF and control groups(P<0.05).However,the mean values for all groups fell within the ranges described in the literature.CONCLUSION While statistically significant differences were found in elbow morphology between SCHF patients and controls,these differences don't translate into clinically meaningful morphological deviations.
文摘Elbow dislocations are rare injuries in children due to the resistance of the capsuloligamentous structures. Anterior dislocation is very rare and its combination with an olecranon fracture is unusual. The authors report a case of this lesion in a 7-year-old child managed nonoperatively.
基金supported by the Ministry of Industry and Information Technology High Tech Ship Special Project(Grant No.CBG3N21-2-6).
文摘Gas-liquid flow(GLF),especially slug and annular flows in oil and gas gathering and transportation pipelines,become particularly complex inside elbows and can easily exacerbate pipeline corrosion and damage.In thisstudy,FLUENT was used to conduct 3D simulations of slug and annular flow in elbows for different velocitiesto assess the ensuing changes in terms of pressure.In particular,the multifluid VOF(Volume of Fraction)modelwas chosen.The results indicate that under both slug and annular flow conditions,the pressure inside the elbow islower than the outside.As the superficial velocity of liquid and gas increase,the pressure and liquid flow velocityat different positions of the elbow also increase,while the secondary flow weakens.Under annular flow conditions,the liquid film on the outer side of the elbow is thicker than that on the inner side,and the liquid velocityin the main liquid film zone is the lowest.
基金National Natural Science Foundation of China (50905088)Science and Technoloy Major Project (2009ZX04004-102)
文摘Aimed at the S-elbow composed of two elbows with different radii, this article proposes a winding pattern design method combined with patch winding method and traditional winding method. It proposes an optimal combination of calculating the tangential point amount and skip point amount to make the pattern distribution even and keep the minimal adjusting angle. The S-elbow overall winding pattem plan and simulation module are designed to verify the combined winding pattern design method and the calculation algorithm of the tangential point amount and skip point amount. From the pattern distribution and the simula- tion effect analysis, it shows that this combined winding pattern design method is a good solution to the S-elbow combined winding pattern design. Aimed at the S-elbow winding pattern based on the patch winding method, it carries out the precision error analysis and points out the correspondence between the error and mesh size. Generally speaking, the bigger the mesh size is, the quicker the program calculation speed is; the smaller the mesh size is, the smaller the winding pattern error is.
基金Supported by Fondation de Recherche et d’éducation en Orthopédie de Montréal
文摘AIM:To evaluate the effect of different elbow and forearm positions on radiocapitellar alignment.METHODS:Fifty-one healthy volunteers were recruited and bilateral elbow radiographs were taken to form a radiologic database.Lateral elbow radiographs were taken with the elbow in five different positions:Maximal extension and forearm in neutral,maximal flexion and forearm in neutral,elbow at 90° and forearm in neutral,elbow at 90° and forearm in supination and elbow at 90° and forearm in pronation.A goniometer was used to verify the accuracy of the elbow's position for the radiographs at a 90° angle.The radiocapitellar ratio(RCR)measurements were then taken on the collected radiographs using the Slice Omatic software.An orthopedic resident performed the radiographic measurements on the 102 elbows,for a total of 510 lateral elbow radiographic measures.ANOVA paired t-tests and Pearson coefficients were used to assess the differences and correlations between the RCR in each position.RESULTS:Mean RCR values were-2% ± 7%(maximal extension),-5% ± 9%(maximal flexion),and for elbow at 90° and forearm in neutral-2% ± 5%,supination 1% ± 6% and pronation 1% ± 5%.ANOVA analyses demonstrated significant differences between the RCRin different elbow and forearm positions.Paired t-tests confirmed significant differences between the RCR at maximal flexion and flexion at 90°,and maximal extension and flexion.The Pearson coefficient showed significant correlations between the RCR with the elbow at 90°-maximal flexion;the forearm in neutralsupination;the forearm in neutral-pronation.CONCLUSION:Overall,95% of the RCR values are included in the normal range(obtained at 90° of flexion)and a value outside this range,in any position,should raise suspicion for instability.
基金Supported by a construc on project of inheritance studio of TCM of old Chinese medicine experts:GZS 2012014a na onal construc on project of inheritance studio of TCM of old Chinese medicine experts in 2013
文摘Prof. FANG Jian-qiao is good at clinical and basic study on acupuncture analgesia. The therapeutic efficacy in treating tennis elbow of Prof. Fang is significant,＂needling painful point＂ on the basis of clarifying causes and pathogenesis of this disease in TCM and western medicine,treat this disease by using encircling needling in combina on with warm needling moxibus on,and it is convenient,safe and eff ec ve. The encircling needling in combina on with warm needling moxibus on has obvious advantages in trea ng external humeral epicondyli s.
基金Project(51401151)supported by the National Natural Science Foundation of ChinaProjects(2015T80792,2012M511207)supported by the Postdoctoral Science Foundation of China
文摘A loop system was used to investigate the effect of flow velocity on corrosion behavior of AZ91 D magnesium alloy at an elbow of loop system based on array electrode technology by polarization, computational fluid dynamics(CFD) simulation and surface analysis. The experimental results showed that the corrosion rate increased with increasing flow velocity, and a critical flow velocity could exist in the corrosion of AZ91 D magnesium alloy. When flow velocity exceeded the critical flow velocity, fluid hydrodynamics was dominant in the corrosion of AZ91 D magnesium alloy. On the contrary, the electrochemical factors were dominant.
文摘Since 1991, the author has treated 32 cases of tennis elbow by the three-needle therapy on the elbow with satisfactory therapeutic results. The report is presented as follows. Clinical Data Of the 32 cases, 21 were male and 11 female, with the age ranging from 32 to 64 years, and the duration of illness from 28 days to 1 year.
文摘AIM:To evaluate short-to medium term outcome of total elbow arthroplasty(TEA)in complex fractures of the distal humerus.METHODS:A consecutive series of 24 complex distal humerus fractures operated with TEA in the period2006-2012 was evaluated with the Mayo Elbow Performance score(MEPS),plain radiographs,complications and overall satisfaction.The indications for surgery were 1:AO type B3 or C3 or Sheffield type 3 fracture and age above 65 or 2:fracture and severe rheumatoid arthritis.Mean follow-up time was 21 mo.RESULTS:Twenty patients were followed up.Four patients,of which 3 had died,were lost to follow up.According to the AO classification there were 17 C3,1B2 and 2 A2 fractures.Mean follow-up was 21 months(range 4-54).Mean MEPS was 94(range 65-100).Mean flexion was 114 degrees(range 80-140).According to MEPS there were 15 excellent,4 good and 1 fair result.Patient satisfaction:8 excellent,10 good,2 fair and 1poor.There were two revisions due to infection treated successfully with revision and three months of antibiotics.In two patients the locking split had loosened.One was referred to re-insertion and one chose yearly con-trols.Two patients had persistent dysaesthesia of their5th finger,but were able to discriminate between sharp and blunt.CONCLUSION:Our study suggests that TEA in complex fractures of the distal humerus in elderly patients can result in acceptable short-to medium term outcome.
基金supported bv the National Natural Science Foundation of China(Grant No.50975164)the Science and Technology Planning Project of Shandong Proyince(Grant No.J09LD05)the Foundation of Key LaboratOry of Mine Hazard Prevention and Control (Grant No.MDPC0810)
文摘With the increase in mining depth, mine heat harm has appeared to be more prominent. The mine heat harm could be resolvedor reduced by ice refrigeration. Thus, ice transportation through pipeline becomes a critical problem; typically flowresistance occurs in the elbow. In the present study, according to the analysis of the surface morphology of fish scale, abiomimetic functional surface structure for the interior wall of elbow is designed. Based on the theory of liquid-solid two phaseflow, a CFD numerical simulation of ice-water mixture flowing through the elbow is carried out using finite element method.Conventional experiments of pressure drop and flow resistance for both bionic and common elbows are conducted to test theeffect of the bionic elbow on flow resistance reduction. It is found that with the increase in the ice mass fraction in the ice-watermixture, the effect of bionic elbow on resistance reduction becomes more obvious.
文摘The medial ulnar collateral ligament complex of the elbow, which is comprised of the anterior bundle [AB, more formally referred to as the medial ulnar collateral ligament(MUCL)], posterior(PB), and transverse ligament, is commonly injured in overhead throwing athletes. Attenuation or rupture of the ligament results in valgus instability with variable clinical presentations. The AB or MUCL is the strongest component of the ligamentous complex and the primary restraint to valgus stress. It is also composed of two separate bands(anterior and posterior) that provide reciprocal function with the anterior band tight in extension, and the posterior band tight in flexion. In individuals who fail co-mprehensive non-operative treatment, surgical repair or reconstruction of the MUCL is commonly required to restore elbow function and stability. A comprehensive understanding of the anatomy and biomechanical properties of the MUCL is imperative to optimize reconstructive efforts, and to enhance clinical and radiographic outcomes. Our understanding of the native anatomy and biomechanics of the MUCL has evolved over time. The precise locations of the origin and insertion footprint centers guide surgeons in proper graft placement with relation to bony anatomic landmarks. In recent studies, the ulnar insertion of the MUCL is described as larger than previously thought, with the center of the footprint at varying distances relative to the ulnar ridge, joint line, or sublime tubercle. The purpose of this review is to consolidate and summarize the existing literature regarding the native anatomy, biomechanical, and clinical significance of the entire medial ulnar collateral ligament complex, including the MUCL(AB), PB, and transverse ligament.
文摘Lateral epicondylitis is a relatively common clinical prob lem, easily recognized on palpation of the lateral protu berance on the elbow. Despite the "itis" suffix, it is no an inflammatory process. Therapeutic approaches with topical non-steroidal anti-inflammatory drugs, cortico steroids and anesthetics have limited benefit, as would be expected if inflammation is not involved. Other ap proaches have included provision of healing cytokine from blood products or stem cells, based on the recog nition that this repetitive effort-derived disorder repre sents injury. Noting calcification/ossification of tendon attachments to the lateral epicondyle(enthesitis), dry needling, radiofrequency, shock wave treatments and surgical approaches have also been pursued. Physi ologic approaches, including manipulation, therapeuti ultrasound, phonophoresis, iontophoresis, acupuncture and exposure of the area to low level laser light, ha also had limited success. This contrasts with the benefi of a simple mechanical intervention, reducing the stres on the attachment area. This is based on displacemen of the stress by use of a thin(3/4-1 inch) band applied just distal to the epicondyle. Thin bands are required as thick bands(e.g., 2-3 inch wide) simply reduce mus cle strength, without significantly reducing stress. Thi approach appears to be associated with a failure rateless than 1%, assuming the afflicted individual modifies the activity that repeatedly stresses the epicondylar attachments.
基金Supported by the Independent Innovation Foundation for National Defense of Huazhong University of Science and Technology(No.01-18-140019)
文摘The effect of a guide vane installed at the elbow on flow-induced noise and vibration is investigated in the range of Reynolds numbers from 1.70×10^5 to 6.81×10^5, and the position of guide vane is determined by publications. The turbulent flow in the piping elbow is simulated with large eddy simulation （LES）. Following this, a hybrid method of combining LES and Lighthill＇s acoustic analogy theory is used to simulate the hydrodynamic noise and sound sources are solved as volume sources in code Actran. In addition, the flow-induced vibration of the piping elbow is investigated based on a fluid-structure interaction （FSI） code. The LES results indicate that the range of vortex zone in the elbow without the guide vane is larger than the case with the guide vane, and the guide vane is effective in reducing flow-induced noise and vibration in the 90° piping elbow at different Reynolds numbers.
基金supported by the Petrochina's “14th Five-Year plan” Project(2021DJ2804)Sichuan Natural Science Foundation(2023NSFSC0422)。
文摘During the production period of shale gas, proppant particles and rock debris are produced together,which will seriously erode the elbows of gathering pipelines. In response to this problem, this paper takes the elbow of the gathering pipeline in the Changning Shale Gas Field as an example to test the erosion rate and material removal mechanism of the test piece at different angles of the elbow through experiments and compares the four erosion models with the experimental results. Through analysis, it is found that the best prediction model for quartz sand-carbon steel erosion is the Oka model. Based on the Oka model, FLUENT software was used to simulate and analyze the law of erosion of the elbow of the gas gathering pipeline under different gas flow velocities, gas gathering pressure, particle size, length of L1,and bending directions of the elbow. And a spiral pipeline structure is proposed to reduce the erosion rate of the elbow under the same working conditions. The results show that this structure can reduce erosion by 34%.
基金The authors acknowledge the fnancial support by the National Natural Science Foundation of China(No.51874340)by the Shandong Provincial Natural Science Foundation,China(No.ZR2018MEE004).
文摘In this work,computational fuid dynamics(CFD)is used to study elbow erosion due to a gas-solid two-phase fow.In particular,the direct simulation Monte Carlo(DSMC)method is used to study the impact of inter-particle collision on the erosion behavior.The two-way coupled Euler-Lagrange method is used to solve the gas-solid fow,and the DSMC method is used to consider the collision behavior between particles.The efects of key factors,such as the particle concentration distribution and inter-particle collision,on the erosion ratio are evaluated and discussed.The efectiveness of the method is verifed from experimental data.The results show that the inter-particle collision signifcantly infuences the particle movement path and erosion ratio.When the inter-particle collision is considered,the maximum erosion position is ofset.The erosion model proposed by Oka et al.,who used the DSMC method,agrees best with the experimental data,and the average percentage error decreases from 39.2 to 27.4%.
基金Supported by 2014 Wuhan clinical medical research project:WZ14C01~~
文摘Objective： To compare differences of acupotomy loosing combined with medication treatment, electroacupuncture combined with medication treatment and simple medication treatment in effects on rheumatoid arthritis patients with elbow joint stiffness and investigate the anti-inflammatory mechanism of the acupotomy loosing.Methods： A total of 60 cases of rheumatoid arthritis（RA） patients with elbow joint stiffness were randomly assigned into the group receiving acupotomy loosing（group A）, group with electroacupuncture（group B） and the one undergoing medication treatment（group C） with 20 cases for each group. Based on the medication treatment, all patients underwent continuous oral administration with Methotrexate（MTX）, Leflunomide（LEF） and Bitongding capsules for 3 weeks. And no other treatments were given to group C. In addition to medications treatment, the electroacupuncture was performed in group B. The acupoints of Tianzhu（天柱 BL 10）,DAzhui（大椎 GV 14）; Fengchi（风池 GB 20）,Quchi（曲池 LI 11）,Quze（曲泽 PC 3）,Chize（尺泽 LU 5）, Shousanli（手三里 LI 10）, Xiaohai（小海 SI 8）, Shaohai（少海 HT 3）, Tianjing（天井 TE 10）,Qinglengyuan（清冷渊 TE 11） and Hegu（合谷 LI 4） in the affected side were selected. A pair of electrodes were connected to LI 11 and LI 10, and another pair of electrodes were connected to PC 3 and LU 5, and the continuous wave with frequency of 2 Hz was designed, the needle retention for 30 min was performed, and the acupuncture was performed for 6 times per week with 3 weeks for one course,and there was one course totally. Besides the medication treatment, group A underwent the acupotomy loosing therapy. The tender point in lateral elbow joint, etc. were taken as the treatment point, and 6-8 treatment points being taken for each time, and longitudinal dredging and transverse exfoliation were conducted for 2-3 times with the acupotomy. The treatment was given for one time per week with three weeks for one course, and there was one course totally. The changes of maximum angle of active extension position, maximum angle of active flexion position and range of motion were observed, and levels of IL-6, IL-10 and TNF-a in affected synovial fluid of elbow joint were tested before the treatment and 2 weeks after the treatment in the groups.Results： ① Compared with those before treatment, the maximum angle of active extension position were smaller, the maximum angle of active flexion position were larger and the range of motion were wider of the affected elbow joints of the patients in the 3 groups on the 2 weeks after the treatment.There were statistical significances for the differences（All P 0.05）. Two weeks after the treatment,as compared with those in group C, the affected elbow joint for patients in the group B and group A was smaller in maximum angle of active extension position, larger in maximum angle of active flexion position and wider in range of motion and there were statistical significances for the differences（All P 0.05）. Comparing with those in the group B, the affected elbow joint for patients in the group A was smaller in maximum angle of active extension position, larger in maximum angle of active flexion position and wider in range of motion and there were the statistical significances for the differences（All P 0.05）. ② Compared with those before treatment, the levels of TNF-a and IL-6 were lower and the level of IL-10 was higher of the 3 groups on the 2 weeks after the treatment. There were the statistical significances for the differences（All P 0.05）. For 2 weeks after the treatment, compared with those in the group C, group B and group A were lower in levels of TNF-α and IL-6 and higher in level of IL-10 and there were the statistical significances for the differences（All P 0.05）. As compared with those in the group B, group A was lower in levels of TNF-a and IL-6 and higher in level of IL-10 and there were the statistical significances for the differences（All P 0.05）.Conclusions： The combination of acupotomy loosing can improve the maximum angle of active extension position, maximum angle of active flexion position and range of motion in affected elbow joint for RA patients with elbow joint stiffness, whose efficacy was superior to single basic treatment and electroacupuncture combined with basic treatment. Meanwhile, the levels of proinflammatory cytokines,such as TNF-α and IL-6 can be decreased, and the level of anti-inflammatory cytokines, such as IL-10 can be increased, playing a role in regulating the imbalance between proinflammatory cytokines and anti-inflammatory cytokines in RA patients, which may be one of mechanisms regarding treating RA and improving the range of motion for stiff joints.
基金supported by the National Natural Science Foundation of China,No.81572130(to LQG)and 81601057(to JTY)the National Key Research and Development Plan of China,No.2016YFC1101603(to XLL)the Natural Science Foundation of Guangdong Province of China,No.2015A030310350(to JTY)
文摘Direct coaptation of contralateral C7 to the upper trunk could avoid the interposition of nerve grafts. We have successfully shortened the gap and graft lengths, and even achieved direct coaptation. However, direct repair can only be performed in some selected cases, and partial procedures still require autografts, which are the gold standard for repairing neurologic defects. As symptoms often occur after autografting, human acellular nerve allografts have been used to avoid concomitant symptoms. This study investigated the quality of shoulder abduction and elbow flexion following direct repair and acellular allografting to evaluate issues requiring attention for brachial plexus injury repair. Fifty-one brachial plexus injury patients in the surgical database were eligible for this retrospective study. Patients were divided into two groups according to different surgical methods. Direct repair was performed in 27 patients, while acellular nerve allografts were used to bridge the gap between the contralateral C7 nerve root and upper trunk in 24 patients. The length of the harvested contralateral C7 nerve root was measured intraoperatively. Deltoid and biceps muscle strength, and degrees of shoulder abduction and elbow flexion were examined according to the British Medical Research Council scoring system;meaningful recovery was defined as M3–M5. Lengths of anterior and posterior divisions of the contralateral C7 in the direct repair group were 7.64 ± 0.69 mm and 7.55 ± 0.69 mm, respectively, and in the acellular nerve allografts group were 6.46 ± 0.58 mm and 6.43 ± 0.59 mm, respectively. After a minimum of 4-year follow-up, meaningful recoveries of deltoid and biceps muscles in the direct repair group were 88.89% and 85.19%, respectively, while they were 70.83% and 66.67% in the acellular nerve allografts group. Time to C5/C6 reinnervation was shorter in the direct repair group compared with the acellular nerve allografts group. Direct repair facilitated the restoration of shoulder abduction and elbow flexion. Thus, if direct coaptation is not possible, use of acellular nerve allografts is a suitable option. This study was approved by the Medical Ethical Committee of the First Affiliated Hospital of Sun Yat-sen University, China (Application ID:[2017] 290) on November 14, 2017.
文摘The elbow joint is a complex joint, which, when impaired in function, leads to severe disability. In some cases however, an arthroplasty might be an appropriate treatment. In the past four decades, large steps havebeen taken to optimize this treatment in order to achieve better post-operative outcomes. To understand these progresses and to discover aspects for upcoming improvements, we present a review on the past developments, the present state of affairs and future developments which may improve patient care further.
文摘BACKGROUND Joint stiffness after elbow surgery is not a rare complication,and is always accompanied by deformity.The causes of joint stiffness are multiple in different patients,and divided into intrinsic and extrinsic causes.Herein,we report an unusual case of posttraumatic elbow stiffness due to multiple and rare causes.CASE SUMMARY A 19-year-old male was hospitalized with the loss of motion of the left elbow for over ten years.Left limb computed tomography revealed left elbow stiffness with bony block and connection.The patient underwent surgery,and the etiology of joint stiffness was found to be a rare combination of common and uncommon causes.During an 18-mo follow-up period,the patient’s left elbow had normal motion and he was symptom-free.CONCLUSION However,this case combined with multiple and rare causes highlights that the patient with scar physique is likely to be accompanied with more severe soft tissue,nerve contracture,and heterotypic ossification,even during recurrence.
文摘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.
