Structural injuries correlate with radiographic signs of instability on MRI after simple elbow dislocations View Full Text


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Article Info

DATE

2021-07-15

AUTHORS

Philip-Christian Nolte, Dirk Maier, Ferdinand Christian Wagner, Alexander Ellwein, Rony-Orijit DeyHazra, Thorsten Guehring, Konstantin Müller, Paul-Alfred Grützner, Marc Schnetzke

ABSTRACT

BackgroundThere is a paucity of literature demonstrating which factors are associated with signs of elbow instability on magnetic resonance imaging (MRI) following simple elbow dislocations (SED).ObjectivesThis study aimed to evaluate demographic variables and MRI datasets to identify factors associated with elbow instability following SEDs.Materials and methodsThis retrospective multicenter MRI study included patients who had sustained SED and presented within 21 days of trauma. Measurements included ulnohumeral angle, drop sign, and radiocapitellar and ulnohumeral incongruity. The coronoid tip (Regan Morrey type I), lateral collateral ligament (LCL), common extensor origin (CEO), medial collateral ligament (MCL,) and common flexor origin (CFO) were assessed for injuries. Simple and multiple logistic regression analyses were performed to identify factors associated with signs of elbow instability (e.g., ulnohumeral incongruity > 1 mm) on MRI.ResultsA total of 147 patients (68 women, 79 men) with a mean age of 42.9 years (range, 17–85) were included. Of those, 62 patients (42.2%) demonstrated radiocapitellar (> 2 mm) and 36 patients (25.5%) demonstrated ulnohumeral incongruity (> 1 mm); 17 patients (11.6%) had a drop sign (≥ 4 mm). All patients with elbow instability on MRI had injury to the CEO and/or CFO. In multiple logistic regression, an ulnohumeral angle of ≤ 45° (p = 0.005; OR: 4.95), injury to the CEO (p < 0.001; OR: 10.45), CFO (p < 0.001; OR: 8.38), and coronoid tip (p = 0.002; OR: 5.32) were significantly associated with signs of elbow instability on MRI.ConclusionInjury to the CEO, CFO, and coronoid tip as well as an ulnohumeral angle of ≤ 45° are associated with signs of elbow instability on MRI following SEDs. If the CEO or CFO is injured, the odds for instability on MRI are increased by a factor of 10 and 8, respectively. More... »

PAGES

203-209

References to SciGraph publications

  • 2017-02-20. Interobserver and intraobserver agreement of ligamentous injuries on conventional MRI after simple elbow dislocation in BMC MUSCULOSKELETAL DISORDERS
  • 2019-04-03. The elbow: review of anatomy and common collateral ligament complex pathology using MRI in INSIGHTS INTO IMAGING
  • 2016-09-06. Chronische Bandinstabilitäten des Ellenbogengelenks in DER ORTHOPÄDE
  • 2016-04-04. Unstable simple elbow dislocations: medium-term results after non-surgical and surgical treatment in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2009-04-02. Simple elbow dislocations: a systematic review of the literature in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 2020-08-17. MRI in acute simple elbow dislocations: correlation of preoperative imaging and intraoperative findings of collateral ligaments and associated soft tissue injuries in MUSCULOSKELETAL SURGERY
  • 2020-11-16. Acute elbow dislocation: comparison between magnetic resonance imaging and intra-operative finding of ligament injury in INTERNATIONAL ORTHOPAEDICS
  • 2008-08-02. Surgical management of unstable elbow dislocation without intra-articular fracture in INTERNATIONAL ORTHOPAEDICS
  • 2015-08-20. Initial joint stability affects the outcome after conservative treatment of simple elbow dislocations: a retrospective study in JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
  • 2020-08-11. Injury patterns following simple elbow dislocation: radiological analysis implies existence of a pure valgus dislocation mechanism in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
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