ABSTRACT
BACKGROUND: Incompetence of the ulnar collateral ligament (UCL) of the elbow is career-threatening for high-performance throwing athletes. Although multiple reconstructions have been described, a procedure that combines a larger graft with improved fixation may demonstrate more favorable loading characteristics than current techniques. HYPOTHESIS: Ulnar collateral ligament reconstructions utilizing a semitendinosus graft and interference knot fixation will be biomechanically superior to previously reported techniques. STUDY DESIGN: Controlled laboratory study. METHODS: Thirty cadaveric elbows were stripped of all medial soft tissue superficial to the UCL. The proximal humeri were mounted on a materials testing system with the elbows flexed 90 degrees . The intact UCL was loaded to failure at 4.5 deg/s. The torsional failure moment, torsional stiffness, and mode of failure were recorded. Three groups of 10 specimens were created. Group 1 underwent reconstruction using a palmaris tendon graft secured with interference knot fixation. Group 2 reconstructions utilized a palmaris graft and the docking technique. Group 3 specimens were reconstructed using a semitendinosus graft and interference knot fixation. All specimens were loaded to failure and the same parameters recorded. RESULTS: The torsional failure moments for group 1 (13.28 N x m) and group 2 (12.81 N x m) reconstructions were significantly (P < .05) inferior to that of their respective native values (21.3 N x m and 23.5 N x m). Semitendinosus reconstructions (20.5 N.m) were not significantly different (P = .24) from their native UCLs (23.0 N.m). All reconstructions were torsionally less stiff (P < .001) than the native UCL. There were no statistically significant differences in stiffness between the groups (P = .4). CONCLUSION: Ulnar collateral ligament reconstruction utilizing semitendinosus graft and interference knot fixation restores the torsional strength of the intact UCL. CLINICAL RELEVANCE: Reconstructions using semitendinosus grafts may allow for accelerated rehabilitation and earlier return to competition.
Subject(s)
Biomechanical Phenomena , Collateral Ligaments/surgery , Elbow Joint/surgery , Orthopedic Procedures/methods , Transplants , Cadaver , Humans , Joint Instability , TorqueSubject(s)
Compartment Syndromes/diagnosis , Compartment Syndromes/etiology , Leg Injuries/pathology , Warfarin/adverse effects , Aged , Aged, 80 and over , Compartment Syndromes/surgery , Debridement , Fasciotomy , Fatal Outcome , Female , Hematoma/complications , Hematoma/pathology , Hematoma/surgery , Humans , Leg Injuries/complications , Leg Injuries/surgery , Male , Middle Aged , Muscle, Skeletal/blood supply , Muscle, Skeletal/pathology , Muscle, Skeletal/surgery , Trauma Severity Indices , Treatment OutcomeABSTRACT
GOAL: To understand nocardiaI infections to better manage patients with the condition. OBJECTIVES: 1. Identify the organisms causing nocardial infections in humans. 2. Describe the presenting symptoms of nocardial infections. 3. Explain the treatment of nocardial infections.
