Loose Elbow

A 25-year-old Caucasian man presents with itchy lesions on his scalp, chest, back, elbows, and knees. He says these lesions started about a month ago, and seem to be spreading. Upon examination, the lesions are well-demarcated and are reddish-violet in color—easily distinguished from normal skin. They appeared raised and are covered with loose scales. Removing the scales caused pinpoints of bleeding to show up. 

He leaned back on his elbows, legs spread, thumbs loosely joined. I ve taken a liking to Selden, Mrs. Aislabie. I think I ll wait here until such time as the money materializes. ... 

Between two different semi constraint and unconstraint elbow prosthesis, Semi constrained prosthesis has a polyethylene-metal loose-hinged device with intrinsic stability. Although this stability prevents bones unfavorable dislocation, but it permit to valgus-varus motion. As it is reported in literature, loosening and mechanical failure can be considered as the most complication for linked prosthesis [6,7]. 

The joint capsule surrounds all three articulations of the elbow joint and is thickened medially and laterally to form the collateral ligament complexes [2]. The joint capsule is loose anteriorly and especially posterior to allow full flexion and extension of the elbow [1]. It is most lax in 80 degrees of elbow flexion. Transverse and obliquely directed bands in the anterior capsule provide significant stability when taut in extension [4]. 

Sjoden GO, Lundberg A, Blomgren GA. Late results of the Souter-Strathclyde total elbow prosthesis in rheumatoid arthritis. 6/19 implants loose after 5 years. Acta Orthop Scand 1995 October 66(5) 391. ... 

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