Elbow Dislocations: A Review Ranging from Soft Tissue Injuries to Complex Elbow Fracture Dislocations

Englert, Carsten; Zellner, Johannes; Koller, Michael; Nerlich, Michael; Lenich, Andreas

doi:10.1155/2013/951397

Cited by 29 publications

(13 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Its ability to guide decision-making is well documented in the literature, particularly with ligament-based injuries around the knee, such as anterior cruciate ligament reconstruction and collateral ligament injuries, and stability of dislocated joints including the hip, shoulder, and elbow. [19][20][21] EUA provides the treating surgeon with information regarding joint stability that may not be evident from examination in clinic or from imaging modalities. While examination in the clinic setting is essential, the findings in instability cases are often obscured by patient apprehension.…”

Section: Discussionmentioning

confidence: 99%

Examination under Anesthesia in Patients with Recurrent Patellar Dislocation: Prognostic Study

2018

View full text Add to dashboard Cite

Surgical management of patellar instability is a matter of wide debate. While some authors believe that isolated medial patellofemoral ligament (MPFL) reconstruction is sufficient, others advocate procedures to treat the underlying pathology, namely, patella alta and trochlear dysplasia. Radiological studies have been traditionally used as a determinant of these pathologies and to determine the need for an additional procedure. The value of examination under anesthesia (EUA) in formulating a treatment plan remains unknown. Our aim is to assess the prognostic value of EUA in assessing patients presenting for surgical treatment of recurrent patellar dislocations. We retrospectively reviewed the outcome after surgical treatment of 23 patients who had undergone isolated MPFL reconstruction for recurrent patella dislocation by a single surgeon in our tertiary center. All data were completed at the time of index surgery. Primary outcome was recurrent instability requiring revision surgery. The mean age of the 23 patients undergoing MPFL reconstruction was 17.4 years of age. The median trochlea tuberosity-trochlear groove (TT-TG) distance was 15 mm with a median Caton-Deschamps ratio of 1.3. Of the 23 patients who underwent MPFL reconstruction, 9 failed (39%). Median time to failure was 10.5 months. All patients who failed MPFL reconstruction had a dislocating patella on EUA at >30 degrees of flexion. Radiological assessment of the knee to assess its morphology is essential for preoperative surgical planning for patients with recurrent patellar instability. Cutoff values to determine the need for surgical procedures require a consistent method of imaging and are prone to flaws in measurement. However, we demonstrated that EUA provides valuable additional information toward an appropriate surgical approach.Based on our small cohort, we suggest that patients in whom patella remains dislocated past 30 degrees of knee flexion on EUA are unlikely to benefit from isolated MPFL reconstruction.

show abstract

Section: Discussionmentioning

confidence: 99%

Examination under Anesthesia in Patients with Recurrent Patellar Dislocation: Prognostic Study

2018

View full text Add to dashboard Cite

show abstract

“…3,41 An anterior elbow dislocation, although a less commonly occurring simple dislocation, always involves a fracture of the olecranon. 99,100 Divergent dislocations, in which the ulna dislocates medially and the radius dislocates laterally, are very rare but present with the least stable patterns due to the extensive soft tissue disruption. 101 A traumatic dislocation of the proximal radioulnar joint typically results in significant joint pain and dysfunction, even though gross deformity may be absent upon examination.…”

Section: Considerations Of Individual Jointsmentioning

confidence: 99%

National Athletic Trainers' Association Position Statement: Immediate Management of Appendicular Joint Dislocations

Rozzi

Anderson

Doberstein

et al. 2018

Journal of Athletic Training

View full text Add to dashboard Cite

Objective To provide certified athletic trainers (ATs) with recommendations and guidelines for the immediate management of patients with joint dislocations. Background One of the primary responsibilities of ATs is to provide immediate injury care for active individuals. Although ATs are confronted with managing patients who have many kinds of injuries, the onsite management of a joint dislocation presents challenges in evaluation and immediate treatment. The critical concern in managing a dislocation is deciding when a joint can be reduced onsite and when the patient should be splinted and transported for reduction to be performed in the hospital or medical setting. Factors that influence the decision-making process include the following: whether the AT possesses a documented protocol that is supported by his or her supervising physician(s), employer documents, and respective state regulations; the AT's qualifications and experience; the dislocated joint; whether the dislocation is first time or recurrent; the patient's age and general health; and whether associated injuries are present. Recommendations These guidelines are intended to provide considerations for the initial care of specific joint dislocations. They are not intended to represent the standard of care and should not be interpreted as a standard of care for therapeutic or legal discussion.

show abstract

“…Simple posterolateral elbow dislocations (SPLED) are usually stable after reduction and have been treated nonoperatively, followed by controlled mobilization, with favorable results [ 5 , 6 ]. However, several investigators have emphasized that these injuries are not entirely benign [ 1 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Common Extensor Complex Is a Predictor to Determine the Stability in Simple Posterolateral Elbow Dislocation: Analysis of MR Images of Stable vs. Unstable Dislocation

Cho

Kim

et al. 2020

JCM

View full text Add to dashboard Cite

Simple posterolateral elbow dislocations (SPLED) may be treated nonoperatively using closed reduction, followed by controlled mobilization. However, the extent of soft tissue injuries might affect the choice of treatment, rehabilitation approach, and prognosis. The purpose of this study is to compare the characteristics of soft tissue injuries between patients with unstable and stable SPLED using MRI findings. Thirty MRIs of elbows with SPLED (unstable group (n = 15); stable group (n = 15)) were randomly reviewed by two experienced musculoskeletal radiologists. Soft tissue injuries were characterized as an intact, partial tear or complete tear for the: medial collateral ligament (MCL) complex, common flexor complex, lateral collateral ligament (LCL) complex, common extensor complex, anterior capsule, and posterior capsule. Moderate to substantial interobserver reliability and substantial to perfect intraobserver reliability were observed for medial and lateral complexes in SPLED. The proportion of soft-tissue injuries of the common extensor complex were significantly different between the unstable (four partial tears and 11 complete tears) and stable groups (11 partial tears and four complete tears). In conclusion, based on MRI findings, the degree of common extensor complex injuries may be a predictor of stability and help inform treatment decisions for SPLED.

show abstract

Elbow Dislocations: A Review Ranging from Soft Tissue Injuries to Complex Elbow Fracture Dislocations

Cited by 29 publications

References 63 publications

Examination under Anesthesia in Patients with Recurrent Patellar Dislocation: Prognostic Study

Examination under Anesthesia in Patients with Recurrent Patellar Dislocation: Prognostic Study

National Athletic Trainers' Association Position Statement: Immediate Management of Appendicular Joint Dislocations

Common Extensor Complex Is a Predictor to Determine the Stability in Simple Posterolateral Elbow Dislocation: Analysis of MR Images of Stable vs. Unstable Dislocation

Contact Info

Product

Resources

About