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In the study of elastoplastic members subjected to bending moments, understanding the loading and unloading phases is crucial for assessing material behavior and structural integrity. During the loading phase, as the bending moment increases, the material initially responds elastically, adhering to Hooke's Law, where stress is directly proportional to strain. When the load exceeds the yield strength, plastic deformation occurs, resulting in permanent strain and deformation that remains even...
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In materials that exhibit elastic and plastic behavior, known as elastoplastic materials, residual stresses can accumulate when these materials experience plastic deformation. This deformation arises from either high levels of shearing stress or significant strains. Residual stresses are internal stresses that persist within a material after removing the external force causing deformation. This phenomenon is demonstrated when observing the behavior of a shaft under torque; notably, the...
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Hidden instability in posttraumatic stiff elbows.

Stephanie Geyer1, Jesse Seilern Und Aspang2, Michael Geyer3

  • 1Department for Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany. stephanie.geyer@tum.de.

European Journal of Orthopaedic Surgery & Traumatology : Orthopedie Traumatologie
|January 8, 2021
PubMed
Summary
This summary is machine-generated.

Hidden elbow instability is common in post-traumatic stiffness, detectable via arthroscopic testing. Surgical stabilization improves range of motion but requires further investigation due to heterogenic results.

Keywords:
Arthroscopic instability testing of the elbowComplex instability of the elbowElbow arthrolysisElbow ligament stabilizationPosttraumatic elbow instabilityPosttraumatic elbow stiffness

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Traumatology

Background:

  • Post-traumatic elbow stiffness can be linked to underlying instability.
  • Detecting this instability in stiff elbows is clinically challenging.
  • Simultaneous surgical treatment for stiffness and instability has not been previously evaluated.

Purpose of the Study:

  • To investigate the existence of a post-traumatic "stiff and unstable elbow" syndrome.
  • To determine if arthroscopic instability testing can detect coexisting instability.
  • To report midterm outcomes of arthrolysis combined with ligament stabilization for stiff and unstable elbows.

Main Methods:

  • 55 patients with post-traumatic elbow stiffness underwent arthroscopic arthrolysis.
  • Instability was graded during surgery; grades II-III received ligament stabilization.
  • Patient-reported outcomes (PREE, OES) and Mayo-elbow-performance-score (MEPS) were assessed postoperatively.

Main Results:

  • 40% of patients (22/55) exhibited detectable elbow instability during arthroscopy.
  • Postoperative range of motion improved significantly (95° to 110°, p=0.045).
  • Midterm follow-up showed mixed results, with 20% requiring revision surgery.

Conclusions:

  • Intraoperative arthroscopic diagnostics effectively identify post-traumatic instability.
  • Concurrent ligament stabilization is indicated for unstable stiff elbows.
  • The stiff and unstable elbow is a complex condition requiring further research due to heterogenic outcomes.