force convection heat transfer of turbulent nano fluid flow in 90 and 60 degree ELBOW is simulated by using FLUENT. Single phase model has been implemented to study such a flow field and standard k-e model is employed. The considered nanofluids are mixtures of Al2O3 nanoparticles and water as the base fluid. Simulation effect of Reynolds number and nano concentration on Nusselt number and friction coefficient have been presented and discussed. The computed results are compared with previously published data for a base fluid (0% nano concentration) and good agreement between the results is observed. It is seen that by increasing Reynolds number and nano concentration, heat transfer increase and friction coefficient decrease. Heat transfer in 90 and 60 degree ELBOW is compared and result shows by increasing the angle, heat transfer will decrease.

Pulled ELBOW is one of the most common musculoskeletal injuries in children under four years of age. The lesion is caused by sudden traction on the wrist while the ELBOW is extended and forearm is pronated. In pronation, the lateral edge of the radial head which opposes the annular ligament is narrower and rounded at it's margin. The radial head is oval in shape and in pronation, the narrowest diameter of the radial head is in the anteroposterior plane. After longitudinal traction, a transverse tear in the annular ligament occurs, the anterior portion of the radial head escapes from under the annular ligament and subluxation occurs. Most authors recommend that the reduction can be achieved by supinating the forearm (reversing the mechanism). This outcome study without a control group, reviewed 29 cases of "pulled ELBOW" which referred to the hospital or a private clinic from Dec 2000 to Dec 2001. In this study, all subluxations were reduced by hyper pronation of the forearm while the ELBOW was in semiflexion (exaggerating the mechanism). The logic reason is that the anatomical situation of the radial head and annular ligament is in pronation.    

Background: Loss of motion is a well-known complication after ELBOW trauma and in severe cases, arthrolysis of ELBOW is the procedure of choice. The posterior approach might have some advantages especially in post-traumatic patients who have undergone the same surgical approach in the past.Objectives: The aim of this study was to evaluate the short-term outcomes of ELBOW arthrolysis through posterior approach. Moreover, we assessed the effect of operation on the patients’ quality of life.Patients and Methods: During a retrospective-cohort study, the medical records of 14 patients (12 men, two women) whose range of movement had been limited post-traumatically and had undergone ELBOW arthrolysis with posterior approach were reviewed. Before intervention, the patients had a flexion less than 100 degrees or an extension lag of 30 degrees or more. For evaluation of the final outcomes, they were invited to participate in our study and the final range of motion, visual analogue score (VAS), disability of arm, shoulder and hand (DASH), Mayo ELBOW score (MES) and short form health survey (SF-36) scores were measured in the patients.Results: Mean age of the participants was 28.7 years. The interval from initial injury and arthrolysis was 16 months and the patients were followed for 14 months. The mean range of motion in patients before surgery was 35.8 degrees, which was increased to a mean of 108.9 after the surgery, indicating a 73.1 degrees improvement. The means of VAS, DASH, Mayo ELBOW and SF-36 scores in the patients were 1.6, 34, 68 and 43, respectively. A significant inverse correlation was found between the preoperative range of motion and final range of motion.Conclusions: According to our results, ELBOW arthrolysis through posterior approach could be an effective technique with low complications. Since the final range of motion improved significantly, it might be a valuable method in promoting the patients’ quality of life.

Background: ELBOW stiffness is a debilitating condition with different etiologies including trauma, head injury, and burns, which seriously interferes with the patient’ s daily activities. Objectives: Here, we aimed to report the outcome of ELBOW release surgery in patients with ELBOW stiffness caused by different etiologies. Methods: In a retrospective study, the outcome of surgery was evaluated in 18 patients with ELBOW stiffness. The indication for surgery was the functional loss of ELBOW range of motion that failed at least six months of conservative management. ELBOW range of motion was evaluated before and after the surgery. Mayo ELBOW performance score (MEPS) was used to assess ELBOW function at the final follow-up session. Results: The mean follow-up period of the patients was 4. 5  2. 6 years, ranging from 2 to 10 years. The etiology of stiffness was trauma in 11 cases, central nervous system injury in six patients, and burns in one patient. The mean pre-operative supination, pronation, and flexion arc improved by 15. 3° , 20. 9° , and 62. 2° at the final follow-up evaluation, respectively (P = 0. 028, P = 0. 008, and P < 0. 001, respectively). The mean MEPS of the patients was 85 9. 1, ranging from 65 to 95. According to the MEPS scores, the functional outcome was excellent in 8 (44. 4%) patients, good in 7 (38. 9%) patients, and fair in 3 (16. 7%) patients. Conclusions: The release of stiff ELBOW could be regarded as an effective treatment that provides an acceptable gain in the range of motion and considerable improvement of ELBOW function.

This case is a 19-year-old soldier who suffered a combined ELBOW dislocation and posterior Monteggia fracture and dislocation (type II). The ulna fracture was managed by GRIP. The ELBOW dislocation was managed by closed reduction and immobilization in 90° flexion. The posteriorly dislocated radial head was kept reduced by a transarticular pin. After 6 months ELBOW and forearm motion was restricted and X-ray revealed heterotopic ossification around the radial head. In further follow up there was no improvement in his range of motion. Treatment of these combined ELBOW injuries remains challenging.

This is a report on simultaneous dislocation of the left shoulder and ELBOW resulting in a 16 years old boy. Bipolar dislocation of Luxatio Erecta and posterior dislocation of the ELBOW is extremely rare. After clinical examinations (attention to pain, swelling, and deformity of the shoulder and ELBOW joints and neurovascular examinations), the necessary radiography was performed for the patient at the level of his tolerance: AP of the shoulder and side imaging of the ELBOW. Closed reduction was carried out with emergency maneuvers, followed by physiotherapy. Good result was obtained in the 6 weeks follow-up the examination of the adjacent joints of a dislocated limb is an important issue and must be emphasized.

Because of some reasons local flaps are not suitable in the cases with upper extremity injuries. lattismus dorsi flaps are recommended in these cases. We present a twenty eight years old male with upper extremity trauma with type 3C left homerus fracture and destruction of triceps. Reconstruction made using lattismus dorsi flap and in a two month follow up we find a 30o Extention lag comparing to the right ELBOW while the patient had cosmetically satisfaction.