88 | wetenschapsdag 2023 Sessie 3a: Holl(t)en of Stilstaan x4 Auteurs C.M. Lameijer G.J. Streekstra J.G.G. Dobbe A. Arets P. Boomsma M. Boeijenga Abstract titel In-vitro analysis of elbow instability using 4D-CT imaging Background Simple elbow dislocations are not uncommon injuries in the Emergency Department (ED) as it is the second most frequently dislocated joint. Despite the absence of significant fractures, elbow instability is challenging to treat as it might result in long term impairment including persistent instability. Physical examination and static imaging modalities such as CT or MRI are insufficient to reliably diagnose clinically significant ligamentous or capsular injuries of the elbow. Dynamic CT imaging can lead to early diagnosis and prevent possible impaired function. Literature is scarce on the clinical use and outcomes of 4D-CT for elbow pathology, more specifically on ligamentous injuries. Moreover, there is no literature available on the follow-up of simple elbow dislocations and predictors for posttraumatic instability. This cadaver study will be the first study to investigate in-vitro elbow kinematics and instability patterns by applying stress tests with dynamic braces using 4D-CT. By investigating and describing instability patterns and ligamentous injuries, we can provide new insights on dynamic elbow pathology and possibly improve current treatment algorithms. Methods For this in-vitro observational study, we will use three cadaver upper extremities. To obtain baseline data analysing elbow kinematics, one ‘healthy’ cadaver arms will be exposed to flexion/hyperextension, varus/valgus and posterolateral rotational stress using three different dynamic braces. Subsequently, specific instability patterns will be implemented on the cadaver elbows by releasing the medial collateral ligament, the posterolateral ligament (LuCL) and the complete lateral collateral ligament in laboratory setting. In addition, anterior and posterior capsular release will be tested to explore their role in instability. All the above mentioned instability patterns will be investigated by scanning the cadaver elbow in dynamic braces, simulating different stress tests. Motion analysis following 4D-CT scan images will provide quantitative data to ultimately answer the research questions of this study.
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