For purposes of simplicity, we focus here on the larger body of. 9 (20 ratings) Dr. Knee ligament injuries can be caused by trauma, such as a car accident. This causes pain and a loss of flexibility in the joint. Implantable medical devices have gained more attention as an alternative approach. Appointment wasn't rushed. This is a small bump on the bone near the elbow joint. , a knife injury). Rotator cuff repair. Meanwhile, tissue. Primary surgical repair is the gold standard modality of care; however, it is highly dependent on the extent of injuries. Dr. Ligaments and tendons are dense connective tissue that connect bone to bone and bone to muscle, respectively. Tendons attach muscle to bone. Abstract. 5 million people suffer from a serious Achilles tendon injury each year, and some 200,000 experience ACL (anterior cruciate ligament) damage in the knee. The ligament has been stretched to the point where it becomes loose—often referred to as a partial tear of the ligament. He works in San Mateo, CA and 5 other locations and specializes in Family Medicine. Tendons contain 60 to 80 percent collagen type I, while ligaments contain around 95 percent. The positive effect of NOS inhibition on tendon repair demonstrates that nitric oxide (NO) negatively regulates tissue recovery . Timmerman has been found during an automated background check to be clear of any malpractice history and holds one or more active medical licenses. 1,2,3 It has been reported that tendon injuries account for. 2 Advances in repair processes and biomaterials for tendon and ligament rupture If a tendon or ligament breaks, the repair process is relatively slow compared with other musculoskeletal tissues. The triquetrum (T), lunate (L), and scaphoid (S) are the carpal bones of the proximal row. It is the balance of these multifactorial risk factors which will determine if the injury presents. Treatment of Tendon Injuries. These are signs of De Quervain's tenosynovitis: You may feel pain over the thumb side of the wrist. Foot bones. Tendon injury can be divided into two types, chronic and acute. Ligaments are fairly similar to tendons in both structure and physiology; however, ligaments and tendons differ in function. Ligament damage often happens from a sports injury. Posted by The Horse Staff. 1002/bdrc. Regenerative Medicine for Tendon and Ligament Repair Healing of tendons and ligaments is more difficult than healing of tissue in other parts of the body. Shoulder tendons and muscles respond to Graston treatments, allowing for faster healing and. A torn ligament or tendon in the foot is an injury that can limit daily activity. Tendon cell fate in repair. Dr. Murray MM, Spindler KP, Ballard P, et al. To better understand the role of the coracoclavicular ligament, it is necessary to understand the anatomy of the. Tendon development and repair are two closely related but still not fully understood processes. Flexor tendon lacerations are common hand injuries and may have debilitating sequelae. Studies on the application of MSC-EVs for the enhancement of ligament and tendon-to-bone junction repair are limited. If the tendon is degenerated, the surgeon may remove the damaged part of the tendon and repair the rest of the tendon with stitches. Once injured,. Previous studies have shown that many different types of adult stem cells, such as BMSCs, adipose-derived stem cells (ADSCs), and periodontal ligament stem cells. Carroll RE, Match RM. In recent years, with the extensive development of sports, the incidence of Anterior cruciate ligament (ACL) injury increases year by year (Best et al. Activity limitations. Ligaments are fibrous connective tissues that span between bony surfaces acting to stabilize joints. 99Ligaments connect two or more bones together and help stabilize joints. In addition, Dr. The structure of the four zones, (1) tendon, (2) fibrocartilage, (3. One is a white ligament,. For example, collagen content of Achilles tendons from postnatal day (P)4 mice is less than 3% of the dry weight [], and in 1 week old sheep, cells account for nearly 33% of the tendon. Beginning in the 1970s, this timeline focused on two common orthopedic soft tissue problems, anterior cruciate ligament ruptures in the knee and supraspinatus tendon injuries in the. A ligament is fibrous tissue that connects 2 or more bones together. Next we examine the process of tendon to bone healing. joint stability and protection, force attenuators, protective reflexes, position sense (pacinian corpuscles) Load relaxation. Common tendon repair surgeries include: Foot and ankle tendon repair including reattaching a ruptured Achilles tendon. The four main ligaments in the knee connect the femur (thighbone) to the tibia (shin bone), and include the following: Anterior cruciate ligament (ACL). Cellular cues. S (Pennisi, 2002). Each type of injury or degeneration can cause substantial pain and the loss of tendon function. Sutter network surgeons offer a number of different tendon and ligament repair surgeries, such as: Achilles tendon repair. transmission of forces from muscle to bone (reducing work of muscle) Function of ligament. Overstretching, tearing, rupture, or bruising are the most typical physical injuries that can occur. Whatever your needs, our experts work with you to create personalized care plans and provide comprehensive support throughout your treatment. Hip and knee surgeon Dr Roger Brighton offer his services in Darlinghurst, Australia. Grade 2. Damage to the tendons and ligaments can effectively be considered sterile inflammation, a process characterized by DAMP-induced IL-1β release 144. 6 (rupture of tendon, nontraumatic) - 727. A ligament is fibrous tissue that connects 2 or more bones together. See full list on upmc. Tissue engineering strategies to improve tendon repair healing include the use of scaffolds, growth factors, cell seeding, or a combination of these approaches []. On average, hand injuries count for 14% to 30% of all treated patients in emergency care. At the most basic level, tendons connect muscle to bone, and ligaments connect bone to bone. Conventional MRI and MR arthrography are the imaging modalities. Flexor tendon injuries typically occur from a cut on the palm side of your fingers, hand, wrist, or forearm. Sutter network surgeons offer a number of different tendon and ligament repair surgeries, such as: Achilles tendon repair. Swelling. Tendons are fibrous cords, similar to a rope, and are made of collagen. If the arch is flexible, the surgeon may choose to repair these ligaments (especially the spring ligament) as part of your flatfoot surgery. Vet J. Whatever your needs, our experts work with you to create personalized care plans and provide comprehensive support throughout your treatment. Project has been submitted: Tendon injuries are common, impacting athletes, laborers, and everyday individuals alike. The enthesis, where the tissue attaches to the bone, is categorized into four zones. Muscles Ligaments Tendons J. Ankle sprain is a very common injury and can range from mild to severe. 7. Abstract. PMC4041869. Injured fetal sheep tendon that was transplanted into an adult environment was found to retain a regenerative healing pattern after injury. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. None of the rats were immobilized postoperatively. Avulsion of the flexor profundus tendon insertion. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. A potential disadvantage of tendon/ligament repair in clinical trials is that this method requires tearing down the intact tendon/ligament tissue, which may result in a length-tension mismatch in the repaired cuff and alter the normal orientation, and shape . The minimally invasive Percutaneous Achilles Repair System (PARS) technique can be used to treat quadriceps, patellar, and Achilles tendon ruptures. Ligament/tendon and cartilage injuries are clinically common diseases that perplex most clinicians. e. Ligament/tendon and cartilage injuries are clinically common diseases that perplex most clinicians. ACL reconstruction. Although ADSCs have been effective in tendon-bone healing in many studies, the exact mechanism remains unclear. An inversion injury to the ankle may thus not only produce ligament damage to the anterior talofibular and calcaneofibular ligaments but also injury. Much of the research has examined that when the damaged area receives near-infrared light with a length of 600–1,000 nm and a radiation value of 3–10 J/cm 2, it normally promotes tendon repair to a large extent. Significant dysfunction and disability may result from suboptimal healing of tendon and ligament injuries. 1. The elbow is a complex joint whose stability is imparted by osseous and soft-tissue constraints. The American Academy of Orthopaedic Surgeons estimates about 2. This means it hasn’t torn completely through. In this review, we look at. Sometimes a tendon graft is needed to hold the injured joint together. 5 million people suffer from a serious Achilles tendon injury each year, and some 200,000 experience ACL (anterior cruciate ligament) damage in the knee. The American Academy of Orthopaedic Surgeons estimates about 2. Small tendon tears can make it difficult to walk and participate in other daily activities. Understanding the development and function of the enthesis organ has implications for surgical repair, particularly in regards to healing and the regulation of tendon to bone engraftment. The wound healing. Differences in Treatment Sprain and Strain Prevention Tendons and ligaments are connective tissues that help support muscles and bones. 2. Understanding the development and function of the enthesis organ has implications for surgical repair, particularly in regards to healing and the regulation of tendon to bone engraftment. Cadaver tendons also may be used to connect the tendon edges, depending on the severity of the injury. And these three kinds of tendon and ligament are particularly important for the body to. 15 Fascicles are sur-Introduction . Ligaments are strong, flexible fibers that hold bones together. Valley Bone & Joint Clinic. It’s also called hip flexor tendonitis, or tendonitis of the hip. Our goal is to get you back in the. The orthopedic surgery service at the Foster Hospital for Small Animals is overseen by our board-certified faculty, who specialize in treating all types of orthopedic trauma (fractures, luxations) and neurologic trauma (fractures and prolapsed intervertebral discs). Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. In the case of tendon injuries requiring operative therapy, the use of LLLT is typically placed after surgical treatment. Tightly bound water molecules bridge the strands of the helix [], stabilising the. Rotator cuff repair. They usually occur due to extreme force to a joint, such as with a fall or another high-impact event. These cords are called. The remaining 5–10% consists of chondrocytes, synovial cells (outer sheath), capillary endothelial cells, and arteriolar smooth muscle cells . Recovery can take up to 12 weeks. This is the main symptom. , 2011). , pain, muscle atrophy, and tendonitis) may still limit the clinical application of TSPCs in regenerating tendon tissue in vivo. 1 Introduction. Tendon graft healing in a bone tunnel requires bone ingrowth into the tendon. Extensive research continues to further understand the complex healing pathways that are involved when these structures are damaged. Improvement of graft healing to bone is crucial for facilitating an early and aggressive rehabilitation and ensuring rapid return to pre-injury levels activity. Bruising. Email: Info@OldTownStrings. The main function of the peroneal tendons is to. Whatever your needs, our experts work with you to create personalized care plans and provide comprehensive support throughout your treatment. He is affiliated with Lawrence and Memorial Hospital. They cross each other to create an X. The American Academy of Orthopaedic Surgeons estimates about 2. J Trauma. Whatever your needs, our experts work with you to create personalized care plans and provide comprehensive support throughout your treatment. An evaluation of the quadriceps tendon revealed a partial tear of 50% of the deep portion near the insertion site at the superior pole of the knee. If a knee ligament is torn, additional treatment might include: Muscle-strengthening exercises. 5. 1). 62 (nontraumatic rupture of tendons of biceps; long head)A tendon is a band of tissue that connects a muscle to a bone. Your body contains thousands of tendons. Methods of repair focus on reapposition of tendon or ligament ends, resistance to gap formation during the repair phase of healing, and production of a repair with adequate stiffness and strength to resist recurrence following return to preinjury activities. Your surgeon will make an incision over the elbow. The division of tendons into fibrils ensures that minor damage does not necessarily spread to the entire tendon, and also provides a high total structural strength . 5 million people suffer from a serious Achilles tendon injury each year, and some 200,000 experience ACL (anterior cruciate ligament) damage in the knee. 5 million people suffer from a serious Achilles tendon injury each year, and some 200,000 experience ACL (anterior cruciate ligament) damage in the knee. Weakness or instability. The American Academy of Orthopaedic Surgeons estimates about 2. From the same test, the mechanical properties of the ligament or tendon substance, represented by the stress-strain curve, can also be obtained Woo et al. The natural healing process of tendon injury is complex. F. ACL reconstruction. Most surgeons treat these injuries surgically to lessen the risk of long-term disability and morbidity. Pain relievers. Injuries of the accessory ligament of the deep digital flexor tendon in the equine hindlimb: a problem of middle-age. The American Academy of Orthopaedic Surgeons estimates about 2. See More. The condition causes pain and tenderness just outside a joint. The biceps muscle is located in the front of your upper arm. A grade 2 (moderate) MCL tear generally takes four to six weeks to heal with treatment. 5 mm in diameter tendon looped upon itself. Human doctors have cruciate ligament (which stabilizes the knee joint) surgical repair down to an exact science these days, which involves taking a nearby tendon and attaching it to the knee where. Sequence variants of the tenascin C (TNC) gene. 2. These are the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the lateral collateral ligament (LCL), and the medial collateral ligament (MCL). The American Academy of Orthopaedic Surgeons estimates about 2. Tested on patellar tendon models in rats, the synthetic scaffold has been developed with a stress resistance and water volume similar to real tendons and ligaments, allowing for the. Tendon/ligament structure and function. ly forceps are then for ced through the. The enthesis displays gradients in tissue organization, composition and mechanical. Unfortunately, the fibrovascular scar formed during. They may include: Pain, especially when you bear weight on the affected foot. 09 N) than in. When using lemongrass, do not apply to open cuts or wounds as it will irritate the raw skin. 23 Historically, transosseous tunnels were used in open rotator cuff repair, with sutures placed and tied through bone tunnels from the cuff footprint to the lateral aspect of the. Tendon disorders are frequent, and are responsible for much morbidity both in sport and the workplace. This is independent of subcutaneous swelling. The American Academy of Orthopaedic Surgeons estimates about 2. 60 (nontraumatic rupture of M66. The attachment of tendons and ligaments to bone is termed the enthesis, whilst the attachment of tendon to muscle is termed the myotendinous junction. Course notes ASE/EM 605, University of Cincinatti. The donor tendon is inserted through the drilled holes in a pattern like that of the original ligament complex. Both the cases and controls may harbour genetic and non-genetic elements, which may confer an increased or decreased risk to sustaining a potential tendon or ligament injury. 21041. The surgery to correct a torn knee ligament involves replacing the ligament with a piece of healthy tendon. 2017; 7:11–18. 3. doi: 10. Aftercare Outlook What is tendon repair surgery? Tendon repair is surgery done to treat a torn or otherwise damaged tendon. Christopher Hutchins, MD is an orthopedic surgery specialist in Groton, CT and has over 28 years of experience in the medical field. 4. Anatomical and biomechanical knowledge of the supporting structures that provide stability to the medial and lateral elbow is essential to correctly interpret the pathological findings. Request an Appointment Find a Doctor. PCL was also done arthroscopically 29889. 2013 Sep;99 (3):203-222. The aim of this study was to evaluate the effects of HILT on injured tendon and ligament repair in horses. Acromioplasty, removal of the coracoacromial ligament and repair of the rotator cuff tendon, usually results in near full rotator cuff strength. RenuTend™ is a targeted stem cell treatment with proven efficacy and repeatable results. For a long time, chronic painful tendons have. Steven Carlow, MD. 1 The Broström technique is the most popular procedure for repairing the ruptured ATFL. 2%) of the 118 cases of peroneal tendon displacement had been identified in the radiology reports. It typically takes place as an outpatient procedure. Learn more about our services in Vallejo and how we partner with you to create personalized care. Most tendinitis can be treated with rest, physical therapy. Procedures vary depending on your diagnosis and the ligaments and tendons that need repair. Graston Technique helps break up scar tissue, eliminate pain, and restore proper shoulder muscle function. The point at which the tendon forms attachment to the muscle is also known as the myotendinous junction. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. Damaged tendon and ligament can severely affect the normal body movement and might lead to many. About 16. . Overstrain injuries occur in two main ways. -Actions: Actual Tendon & Ligament repair & knitting, removes stasis from damaged areas, promote circulation. The American Academy of Orthopaedic Surgeons estimates about 2. This is done with a tendon taken from another place in your foot. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. More than one ligament or the fibrous cartilage in your knee also is injured; The injury is causing your knee to buckle during everyday activities; During ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon — tissue similar to a ligament that connects muscle to bone. More recently, studies have suggested that there is also, at least in part, a genetic component to the Achilles tendon, rotator cuff and anterior cruciate ligament injuries. 3 Teaching Points Ligaments are elastic bands of tissue that connect bones to each other and provide stability and strength to the joint. For ligaments and tendons undergoing larger deformations, a single integral finite strain (SIFS) theory has been implemented and used for the patellar tendon and ACL . 5 million people suffer from a serious Achilles tendon injury each year, and some 200,000 experience ACL (anterior cruciate ligament) damage in the knee. Suspensory injuries are common and generally serious. Not surprisingly, playing tennis or other racquet sports can cause this condition. The system of ligaments in the vertebral column, combined with the tendons and muscles, provides a natural brace to help protect the spine from. In most rotator cuff tears, the tendon is torn away from the bone. The mature athlete faces challenges associated with age-dependent changes in the rotator cuff, Achilles tendon, lateral humeral epicondylar tendons, quadriceps tendon, and patellar tendon. He is affiliated with medical facilities Lawrence and Memorial Hospital and Westerly Hospital. Your biceps tendons attach the biceps muscle to bones in the shoulder and elbow. A partial tear, however, may need only a trimming or smoothing procedure called a debridement. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. 5 million people suffer from a serious Achilles tendon injury each year, and some 200,000 experience ACL (anterior cruciate ligament) damage in the knee. 5 Its importance is for nutrition of the central part of the tendon. Gap formation results. 5 million people suffer from a serious Achilles tendon injury each year, and some 200,000 experience ACL (anterior cruciate ligament) damage in the knee. Tears or ruptures to tendons and ligaments can: Cause extreme pain. For. There are two types of enthesis; fibrous and fibrocartilagi-nous. A complete tear of the quadriceps tendon is a disabling injury. The fascicles combine to form tendon tissues. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. 19. In general, surgical intervention is necessary to restore stability to the injured knee, and to prevent meniscal damage. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. Tendon and ligament damage caused by injury or overuse or associated with aging and arthritis is a common clinical problem because damaged tissues heal very slowly and rarely recover completely (). Orthopedic Surgery. Among different tendon and ligament, Achilles tendon (Raikin et al. Tendinopathy is a disease entity which can cause significant pain and functional limitations for individuals and collectively places a tremendous burden on society through high healthcare costs (Hopkins et al. An overview of approaches for repair of tendon injuries. Learn more about our services in Soquel and how we partner with you to create personalized care. 410-955-5000 Maryland; 855-695-4872 Outside of Maryland +1-410-502-7683 International; Find a Doctor. the tendon crimp, decreases the number of fascicles, and increases the thickness of the endotenon. Torn or stretched ligaments are also called sprains. 1990. Flexor tendons can also be injured when a finger or thumb is violently pulled away from you while you are attempting to grasp something, such as the jersey of an opposing player in sports. Recovery can take up to 12 weeks. This injury is nearly certain to result in a complete tear of the quadriceps tendons. Achilles tendon rupture is a frequent injury with an increasing incidence. On staff at Laura A. Rotator cuff repair. com. In chronic tendinopathy, tendons experience morphological changes and can present with. Stitching up the incision. In this procedure, surgeons insert a tiny camera (arthroscope) and tools through small incisions to reattach the torn tendon to the bone. Richard Alan Young, MD. Tendons and ligaments connect muscles to bone or bone to bone, respectively, which enable locomotion, and the interface where tendon or ligament attaches to bone is known as the enthesis [1,2]. J. The management of peroneus tendon tear is surgical repair using lateral approach. 1970;10(12):1109-1118. Initially, 1 to 5 days post-injury, an inflammatory response occurs in which. (812) 920-0408. Tendon and ligament injuries remain a clinical challenge. A large tear of the patellar tendon is a disabling injury. But research has shown benefits for musculoskeletal injuries, such as injuries of tendons and ligaments, muscle injuries, nerve injuries, bone fractures, tendinopathies like tennis. This could potentially be Tendonitis in elbow. However, the outcome of biological graft healing is not satisfactory with graft failure. En-theses are critical as they allow for the proper transmission of contractile forces from the muscle belly to the respective skeletal attachment, while. Arthroscopic repair or reconstruction of the lateral ankle ligaments is a promising new technique with results similar to those of open surgery. 1 The Broström technique is the most popular procedure for repairing the ruptured ATFL. Tendinosis refers to hardening, thickening, and scarring of the tendons. Tendons are specialised, heterogeneous connective tissues, which represent a significant healthcare challenge after injury. Starting with procollagen that weaves together to form collagen molecules, which are then packaged into fibrils, and subsequently fibers, fascicles, and. This paper details mechanisms of ligament and tendon healing, as well as attempts to apply stem cells to ligament and tendon healing. Ligaments. 2 However, because the repair's strength depends on ATFL remnant quality, postoperative results may be poor when much time has passed after an. Facilitation of healing of tendons and ligaments. 18-11. The repaired Achilles tendons were removed with excision of the calcaneal and femoral condyle insertions. A previous total knee replacement extensor mechanism repair site had healed and been undamaged. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. Whatever your needs, our experts work with you to create personalized care plans and provide comprehensive support throughout your treatment. Both of these issues have a particular type of cell called Fibroblast that forms the structural framework for connective tissues. Joints are formed where two. In recent years, its incidence is increasing. Achilles tendonitis can be exceptionally painful and slow to improve. Because of the lack of blood vessels and nerves, their self-repairing abilities are rather poor. The control rats received no medication after primary tendon repair. While an open cut may cause a tendon laceration. The use of quantitative histology on a resorbable stent for tendon or ligament repair is far these two areas will give more insight into the from being a clinical actuality. 12. And while surgery is, unfortunately, often the only treatment offered, the truth is, most tendon and ligament tears aren’t really extreme enough to require invasive orthopedic. They usually occur due to extreme force to a joint, such as with a fall or another high-impact event. Doctors define tendon and ligament tears or ruptures as injuries to the soft tissues that connect muscles and joints. Inadequate cell numbers and donor site morbidity (i. During a tendon or ligament repair, your orthopedic surgeon makes an incision on your skin over the injured tendon or ligament and carefully sews the damaged or torn ends together. For hand surgery, regional anaesthetic is injected into the base of the neck or the top of the shoulder to numb the whole arm. 6. Symptoms. Rotator cuff repair. ASSymptoms. These cords are called tendons. Advancements in arthroscopy have permitted adequate visualization and exposure of the hamstring footprint, thus allowing for an anatomic repair with increased protection of the. An estimated 300,000 tendon and ligament repair surgeries are performed annually in the U. The donor tendon is harvested from either the forearm or below the knee. What is a posterior tibialis tendon repair? To prevent further collapse of the arch, a repair must be performed. 1. Elbow Tendon and Ligament Repair. Tendons and ligaments share many similar features in structure and function. Ankle ligaments are like cords that connect the foot bones with the lower leg bones. The bicipital aponeurosis, or lac-ertus fibrosis, is the continuation of the fascia of the distal biceps muscle; it courses from the distal biceps tendon to blend with the deep fascia of the forearm. g. When applying to assist with tendon and ligament repair, you only need a few drops in your formulation to get the maximum benefit. 21041. currently undergoing prolotherapy for medial elbow pain (tendon injury) in both arms caused by repetive use as well as in right SI joint (ligament injury) caused by a heavy squat with bad form because of poor mobility / flexibility (which I am ardently. 00:55. Chronic ankle pain often finds its cause in laxity of one of the ankle ligaments. 2 This can mean the end of a career for many horses. 1 Structure and Function. (860) 449-1413. Appointment scheduling. Even although only 2% of the patients are hospitalized, hand injuries, especially tendon lesions, play a key role in. Degenerative tears (tendonosis) —Sporadic pain (occurring from time to time) on the outside of. Their main function is to transfer muscle generated force to the bony skeleton, facilitating movement around a joint, and as such they are relatively passive, inelastic structures, able to resist high forces. Dr. TS: Distention of the digital flexor tendon sheath (DFTS) (tenosynovitis) on a scale of 0 to 5. The current management options fail to restore the preinjury. In other words, a tendon serves to move the bone to which it is attached. Graston breaks up scar tissue, eliminate pain, and the treatments are safe, effective, and non surgical. In 2011, a cohort of 23 patients were reviewed at minimum 1-year follow-up who underwent open surgical repair for full-thickness proximal hamstring ruptures of varying acuity. Tendon and ligament injuries — sprains, strains, ruptures and tears — occur frequently. 1. The flexor tendon cross-sectional area increases with age, exercise, and injury. S (Pennisi, 2002). g. Dr. Then, we review commonly encountered complications: those associated with decreased range of motion (impingement, arthrofibrosis, intraarticular bodies, ganglion cysts) and those associated with laxity (graft tearing, graft stretching). It is one of the important joints of the upper limb and is involved in basic movements such as flexion and extension of the upper limb.