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Handheld Osteotomes Facilitate Arthroscopic Treatment of Elbow Valgus Extension Overload.

ABSTRACT: Arthroscopic elbow surgery can be difficult due to the highly congruent nature of the joint and the surrounding neurovascular and ligamentous structures at risk. In a patient with valgus extension overload, posterior medial olecranon osteophytes must be removed safely to restore range of motion and alleviate pain. Arthroscopic burrs and shavers create significant debris, therefore limiting visualization, and their use has inherent risks to the surrounding structures that need to be preserved. Small, handheld osteotomes can facilitate the safe and efficient removal of these posterior medial osteophytes while preserving normal bone and articular cartilage.

SUBMITTER: O'Connell RS

PROVIDER: S-EPMC7093706 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Handheld Osteotomes Facilitate Arthroscopic Treatment of Elbow Valgus Extension Overload.

O'Connell Robert S RS Field Larry D LD

Arthroscopy techniques 20200225 3

Arthroscopic elbow surgery can be difficult due to the highly congruent nature of the joint and the surrounding neurovascular and ligamentous structures at risk. In a patient with valgus extension overload, posterior medial olecranon osteophytes must be removed safely to restore range of motion and alleviate pain. Arthroscopic burrs and shavers create significant debris, therefore limiting visualization, and their use has inherent risks to the surrounding structures that need to be preserved. Sm ...[more]

PMID: 32226747

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Project description:Injury to the medial collateral ligament of the elbow (MCL) can be a career-threatening injury for an overhead athlete without appropriate diagnosis and treatment. It has been considered separately from other athletic injuries due to the unique constellation of pathology that results from repetitive overhead throwing. The past decade has witnessed tremendous gains in understanding of the complex interplay between the dynamic and static stabilizers of the athlete's elbow. Likewise, the necessity to treat these problems in a minimally invasive manner has driven the development of sophisticated techniques and instrumentation for elbow arthroscopy. MCL injuries, ulnar neuritis, valgus extension overload with osteophyte formation and posteromedial impingement, flexor pronator strain, medial epicondyle pathology, and osteochondritis dissecans (OCD) of the capitellum have all been described as sequelae of the overhead throwing motion. In addition, loose body formation, bony spur formation, and capsular contracture can all be present in conjunction with these problems or as isolated entities. Not all pathology in the thrower's elbow is amenable to arthroscopic treatment; however, the clinician must be familiar with all of these problems in order to form a comprehensive differential diagnosis for an athlete presenting with elbow pain, and he or she must be comfortable with the variety of open and arthroscopic treatments available to best serve the patient. An understanding of the anatomy and biomechanics of the thrower's elbow is critical to the care of this population. The preoperative evaluation should focus on a thorough history and physical examination, as well as on specific diagnostic imaging modalities. Arthroscopic setup, including anesthesia, patient positioning, and portal choices will be discussed. Operative techniques in the anterior and posterior compartments will be reviewed, as well as postoperative rehabilitation and surgical results. Lastly, complications will be reviewed.

Dataset Information

Handheld Osteotomes Facilitate Arthroscopic Treatment of Elbow Valgus Extension Overload.

Publications

Handheld Osteotomes Facilitate Arthroscopic Treatment of Elbow Valgus Extension Overload.

Similar Datasets

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