Loss of motion following joint surgery is a common complication and has negative effects on individuals. The diminished motion autonomy of persons suffering from post-traumatic affections of the elbowjoint can be addressed by continuous passive motion, a treatment method entailing constant moving of the joint, however, without requiring any patient effort. The paper presents a novel type of rehabilitation equipment for the elbowjoint, using this technique. The novelty consists in the utilization of pneumatic muscles as actuators and in the two axes of motion. Pneumatic actuation presents benefits from compliance, meaning favourable response to commands, due to air compressibility, as well as from an excellent force-to-weight ratio.
Figure 1. A. Canine elbowjoint medial view, showing the medial collateral ligament (C), humerus (H), radius (R) and ulna (U) before olecranon osteotomy. B. Canine elbowjoint cranial view with oblique ligament (O) and the muscles around it (m. extensor carpi radialis and m. extensor digitorum comunis – ExM; m. biceps brachii and m. brachialis – BM). C. Canine elbowjoint (white arrow) in the testing apparatus (EMIC ® ) in tensile loading. D. Detail of the canine elbowjoint during the tensile test, showing the ligament rupture. Note the olecranon osteotomy (C – medial collateral ligament; O – oblique ligament; H – humerus; R – radius; U – ulna)
ABSTRACT: Golfers elbow is the soft tissue disorder seen in the elbowjoint along the medial side. It s and over use disorder of the forearm, wrist and fingers. Here is a study conducted by us to know the effect of intralesional steroid in cases suffering from golfers elbow. 9 cases of golfers elbow were managed with intralesional steroid between August 2014 and April 2015. And followed at 6, 12 weeks and results were evaluated using Nirschl grading system. We achieved grade 5 in two grade six in 5 and grade 7 in two. CONCLUSION: We conclude that golfer s elbow is the soft tissue disorder. Injecting Intralesional steroid will not give significant relief to the patients suffering from golfers elbow and it the procedure is usually associated with complications.
Although a relatively high proportion of patients had satisfac- tory functional outcomes, many patients experienced complica- tions, including ulnar neuropathy, elbowjoint stiffness, heterotopic ossification, and arthrosis. Indeed, overall, slightly less than one- third of patients required reoperation due to complication(s), typically due to instability or stiffness-related problems. There was no clear chronological trend in the occurrence of complications i.e., the rate of complications did not obviously decrease with time/presumable advances in management strategies/technology. This is despite the publication of an algorithm for the surgical management of TTIE and excellent review on the topic by Mathew et al. in 2009 . Interestingly, 3 studies did not report that any patients required reoperation for the management of complications [15,16,23]. Two of these studies [16,23], however, included a small number (#16) of patients. The other study, reported by Zeiders and Patel  involved 32 patients who were operated on following preoperative planning using three-dimen- sional computerized tomographic reconstruction and use of a treatment algorithm. Several patients in this study experienced heterotopic ossification; however, there was no mention of any complications requiring reoperation. This is unusual for a study involving a relatively (for this injury) large number of patients. In general, the continuing high rate of complications experienced by patients after surgical management of TTIE is concerning and
This paper is mainly based on research within FP7 project „Embodied Cognition in a Compliantly Engineered Robot“, with School of Electrical Engineering, University of Belgrade, as one of the partners. Within this project, an upper-half anthropomimetic robot with passive compliance, called ECCEROBOT, was designed. In this paper we consider a robot joint shown in Fig. 1, which represents an ECCEROBOT’s elbowjoint structure. It is a revolute joint driven by two antagonistically coupled dc motors – an electrical agonist-antagonist (AA) drive. The motors are equipped with gear-boxes which drive pulleys, which in turn wind up tendons attached to the forearm which produce the forearm motion. Each tendon is attached to a spring at one end, thus compliance is introduced. This system is an approximation of the human elbow: Motor “b” plays the role of the triceps muscle, and motor “a” plays the role of the brachialis.
he non-dominant upper limb of the subjects in the immo- bilization group was immobilized by means of a plaster cast, from the superior region of the biceps brachii to the wrist re- gion, for a period of 14 days at an orthopedics clinic. he elbowjoint was immobilized at an angle of 90° (180° = full extension), with the forearm at neutral position, whereas the shoulder and the radiocarpal joints and the ingers remained free in order to minimize the efects of immobilization on ADLs. he domi- nant upper limb served as a contralateral control, in addition to the control group.
Muscles working as agonists for elbow flexion (biceps brachii, brachialis and brachioradialis) have their optimal force production expected to occur at the elbowjoint angles of 110°, 100° and 50°, respectively (CHANG et al, 1999). Therefore, the angle of 90° where asymmetry was observed in our study can be considered inside the range where maximal elbow flexor torque production is observed (i.e., somewhere between 110° and 50° of elbow flexion) (KOO et al, 2002). It is interesting to observe, however, that maximal torque production was obtained at an elbowjoint angle of 90° for the preferred limb, whereas it occurred at a joint angle of 60° for the non-preferred limb (Figure 1). This suggests that torque is probably produced at a higher range of motion for the preferred limb, whereas the range of motion for torque production seems to be smaller for the preferred limb.
The joint cavity was then irrigated with betadine, and the bony margins were smoothed using bone file. Forceful mouth opening of about 25 mm was done using Heister's jaw opener at the time of surgery. Suction drain was placed, and the flap was sutured using 3-0 vicryl for deeper layers and skin was closed using 4-0 prolene. The width of the bone removal is considered crucial. It is recommended to create a gap of at least 1 cm to prevent reankylosis. It is also important to create a gap of equal dimension both laterally and medially, so that the possibility of reankylosis due to bone contact is avoided.
In our study, both the bony and soft tissue structures about the hip joint were clearly visualised on T1W images while the pathologies were well demarcated on FSE STIR images. FSE STIR proved to be the most useful sequence being able to detect presence or absence of abnormality in 100% of the cases. This is similar to what Khoury NJ et al 4 observed who
An active 64 year old lady with no previous history of trauma was referred for evaluation of persistent anterosuperior left shoulder pain for one year. The pain worsened when she tried to reach across the body or behind the back. She also experienced discomfort with rotational and overhead movements of the left shoulder. Physical examination revealed tenderness over the left acromioclavicular joint. Cross body adduction and active compression tests reproduced the symptoms at the acromioclavicular joint. Neer and Jobe impingement tests were positive. Plain radiographs revealed osteoarthritis of acromioclavicular joint with narrowing of joint space (Figure 1A). MRI of the shoulder joint on T2 weighted sequence revealed left acromioclavicular joint degenerative changes with proximal supraspinatus tendon impingement causing intrasubstance delamination tear (Figure 2). She was started with non-surgical treatment such as analgesia, rotator cuff and periscapular strengthening exercises. Initially, patient claimed that the pain resolved for a short period. Then, her symptoms recurred and worsened. Eventually, she was agreeable for concomitant arthroscopic distal clavicle resection and subacromial decompression surgery.
Besides gender, the study showed researches where young instrumentalists also has pain complaints. The virtuosity charged in music conservatories has a direct impact on the osteomyoarticular structures of young professionals. Stringed instruments, like the violin, can influence the formation of craniofacial bones and the onset of malocclusion. The support of the instru- ment and the asymmetric position of the jaw combined with the intense practice can cause changes in the face growth of a young person, imbalances strength of the face muscle, causing joint pain during mastication, a stiffness feeling, teeth clenching, protrusion, muscle tension and deviation of the jaw (37).
Sob outra perspectiva, Brodley (1990, p. 98-99) oferece uma posição um pouco mais cautelosa quanto às JV de P&D. Para ele, a colaboração entre companhias para a inovação, sobretudo quando se inclui a produção e a comercialização, pode criar riscos anticoncor- renciais, por isso a necessidade de estarem sujeitas às leis antitruste. Os mercados não são necessariamente competitivos com base na presença de uma única condição estrutural, como, por exemplo, a rápida mudança tecnológica. A conclusão a que o autor chega é que a colaboração entre empresas, seja na produção seja em P&D, deve certamente ser sujeita a uma análise de defesa da concorrência, embora as características especiais da inovação ensejem um tratamento diferenciado. Em consonância com Brodley (1990), Katz e Ordover (1990) airmam que as JV entre concorrentes para o desenvolvimento de atividades de P&D são importantes para o desenvolvimento tecnológico. Contudo, con- cluem que nem toda a cooperação é a priori capaz de gerar ganho de bem-estar líquido. Existe um grande debate na atualidade sobre a capacidade das JVs de P&D e das research joint ventures de gerarem eiciência, e promoverem inovações e benefícios aos consumidores. Um conjunto de estudos foi desenvolvido com o intuito de encontrar evidências empíricas de que JVs de P&D, especialmente em setores de alta tecnologia, aumentam o bem-estar e os benefícios para os consumidores (Cassiman e Veugelers, 2002; Hernan et al., 2003; Röller et al., 2007).
excision of heterotopic ossification, and might improve clinical results. Methods: A prospective randomized study was conducted at three medical centers. Patients with an intra-articular distal humeral fracture or a fracture-dislo- cation of the elbow with proximal radial and/or ulnar frac- tures were enrolled. Patients were randomized to receive either single-fraction radiation therapy of 700 cGy imme- diately postoperatively (within seventytwo hours) or nothing (the control group). Clinical and radiographic assessment was performed at six weeks, three months, and six months postoperatively. All adverse events and complications were documented prospectively. Results: This study was termi- nated prior to completion because of an unacceptably high number of adverse events reported in the treatment group. Data were available on forty-five of the forty-eight patients enrolled in this study. When the rate of complications was investigated, a significant difference was detected in the frequency of nonunion between the groups. Of the nine pa- tients who had a nonunion, eight were in the treatment group. The nonunion rate was 38 % (eight) of twenty-one patients in the treatment group, which was significantly different from the rate of 4 % (one) of twenty-four patients in the control group (p = 0.007). There were no significant differences between the groups with regard to the preva- lence of heterotopic ossification, postoperative range of motion, or Mayo Elbow Performance Score noted at the time of study termination. Conclusions: This study demon- strated that postoperative single-fraction radiation thera- py, when used acutely after elbow trauma for prophylaxis against heterotopic ossification, may play a role in in- creasing the rate of nonunion at the site of the fracture or an olecranon osteotomy. The clinical efficacy of radiation therapy could not be determined on the basis of the sample size. Further research is needed to determine the role of limited-field radiation for prophylaxis against heterotopic ossification after elbow trauma.
Figure 42 shows that the stress is higher at the edge representing 70% of the silicone RTV strength (2MPa). This is related to the presence of peel forces near the edge, caused by the significant rotation of the ceramic tile during the loading. A possible explanation for the lower joint strength with the silicone is adhesive insufficient cure. This silicone cures with the air moisture in 7 days. However, the large area and thick bondline makes difficult the diffusion of moisture in the adhesive. In addition, the silicone adhesive joints were found to have a more complex adhesive application method (in relation to the epoxy XN 1244) due to the tube application and high viscosity. This, along with adhesive storage concerns, explains the inconsistent results found during testing.
an immobile joint formed when t he gap bet ween t w o bones ossifies and t hey become, in effect , a single bone. Bony joint s can form by ossificat ion of eit her fi brous or cart ilaginous joint s. For exam ple, An infant is born w it h right and left frontal and mandibular bones, but t hese soon fuse seamlessly t o form single bones. In old age, som e cranial sut ures becom e oblit erat ed by ossificat ion, and t he adjacent cranial bones, such as t he parietal bones fuse. The epiphyses and diaphyses of t he long bones are j oined by car t i lagi no u s j o i nt s in chi l d ho o d an d adolescence, and t hese become synost osis in early adult hood. The attachment of t he first rib t o t he sternum also becomes a synost osis w it h age .
Most competition authorities acknowledge the potential procompetitive benefits that can result from joint ventures: collaboration may lead to efficiencies that lower prices, combine complementary or blocking technologies, spread risks, bring new products to market, or enable entry into a new market. On the other hand, some joint ventures lend themselves to the sort of collaborative activity antitrust laws prohibited: price-fixing, output restriction, market or customer allocation, or monopolization. In rare cases, based on the facts or a particular case, the authorities in different countries may disagree as to the fundamental goal of antitrust. (Is it to achieve lower prices, innovation, and higher quality for consumers, or to protect an existing industry structure? Are trade or employment policies, or other matters of public policy, to be taken into account?) Or they may differ on the approach to a particular case. (Will it be analyzed according to the U.S. merger guidelines, taking into account horizontal and vertical consolidation in defined relevant markets, and analyzing whether opportunities for unilateral price effects, express or tacit collusion or market foreclosure are enhanced? Or will the authorities look at a conglomerate merger or joint venture as an opportunity for strategic bundling of products and services that in the medium to long term could weaken or reduce competition?) Given this tension, several competition authorities have sought to construct sensitive and flexible – rather than formalistic – approaches to the regulation of collaborative activity between competitors. 29
Economic literature on groundwater management has traditionally been split into two areas: there are papers that evaluate diﬀerent schemes of dy- namic aquifer management, considering that pumping costs vary with stock but ignoring water quality. On the other hand, there are papers that consider contamination problems caused by specific pollutants. This paper presents two alternative models for joint quantity-quality management, and it shows that existing models are in fact special cases of these. The framework is dynamic and considers both the stock of water quantity and a stock mea- sure of water quality. Optimal taxes are derived, and shown to be diﬀerent from those in existing quantity-only or quality-only models. Implementation problems are briefly discussed.
Information from figures 6 and 8 leads us to conclude that the most developed nations are usually the ones who engage in IJVs, preferably into developing countries. It becomes beneficial to both nations to take part in these ventures, as usually the home country’s goal is to achieve some kind of competitive advantage, being it in terms of resources, location or costs, and the host nation can benefit from the spillovers of technology and knowledge that these firms bring, as well as the foreign capital that comes associated (Peng & Pleggenkuhle‐Miles, 2009). The case of China, per example, comes from the former president Deng Xiaoping economic reforms in the late 70’s and early 80’s, when China was still a fairly underdeveloped country and the state had control over all enterprises (Jasimuddin, Faulkner, & Liu, 2014). After these reforms, China allowed foreign capital into the country, but only in the form of joint ventures, in order to absorb and retain all of the knowledge and techniques that those firms from more industrialized countries brought; in
When it comes to joint operations, we have opted for finding the inverse element. Therefore, we will present a brief review of the RSA and ECC and point out those steps in algorithms in which it is necessary to calculate the inverse element.