Simple elbow dislocation

Robinson, Paula; Griffiths, Emmet; Watts, Adam C.

doi:10.1177/1758573217694163

Cited by 72 publications

(47 citation statements)

References 57 publications

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“…2 Type 2 injuries involved the medial side of the osteochondral lesions, which consisted of varus posteromedial rotational force in forearm pronation. 3,4,12,17,19 The medial facet of the anteromedial facet of the coronoid and posterior trochlea was involved in the type 2 pattern. However, considering initial plain radiography, there was some discrepancy between the MRI type and the direction of dislocations on radiographs, particularly between type 2 and posteromedial dislocations (Table 4).…”

Section: Discussionmentioning

confidence: 99%

Distribution of Osteochondral Lesions in Patients With Simple Elbow Dislocations Based on MRI Analysis

Kim

Kholinne

Kwak

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: The clinical relationship between osteochondral lesions and long-term outcomes and patterns in the elbow joint has not yet been established. A sole evaluation from plain standard radiography may underestimate the severity of bony lesions in patients with simple dislocations. It has been suggested that the mechanism of a posterior elbow dislocation could be inferred from the pattern of bony contusions and osteochondral lesions visible on magnetic resonance imaging (MRI) in patients with simple elbow dislocations. Purpose/Hypothesis: The purpose of this study was to describe the incidence and distribution of osteochondral lesions based on MRI findings in patients with simple elbow dislocations. We hypothesized that (1) osteochondral lesions are consistently found in patients with simple elbow dislocations and (2) the distribution and severity of osteochondral lesions may explain the mechanism of the simple elbow dislocation. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of 43 patients with simple elbow dislocations was performed in tertiary-level hospitals from January 2010 to August 2019. Two orthopaedic surgeons separately assessed the initial plain radiographs and MRI scans. Osteochondral lesions were evaluated and categorized based on whether they were located (1) on the lateral side (posterolateral capitellum and radial head; type 1) or (2) on the medial side (posterior trochlea and anteromedial facet of the coronoid; type 2). The severity of the osteochondral lesions was assessed according to the Anderson classification. Results: Of the 43 patients, 21 (48.8%) presented with osteochondral lesions on MRI. The type 1 pattern of osteochondral lesions was the most frequently observed on MRI in patients with simple elbow dislocations (69.8% of cases), and these were confirmed by simple radiography. Posterolateral capitellum osteochondral lesions were found in 13 patients. Among them, 10 (76.9%) were advanced-stage lesions (stages III and IV according to the Anderson classification). Conclusion: Osteochondral lesions were found on MRI after simple elbow dislocations at a rate of 48.8%. Osteochondral lesions in the posterolateral capitellum were associated with an advanced stage. Clinically, these findings may help surgeons in the diagnosis of osteochondral lesions and in determining how to manage patients with the progression of arthritic changes.

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Section: Discussionmentioning

confidence: 99%

Distribution of Osteochondral Lesions in Patients With Simple Elbow Dislocations Based on MRI Analysis

Kim

Kholinne

Kwak

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…The elbow joint owes its stability to the ulno-trochlear articulation and collateral ligament complexes which are its primary static stabilisers; the radial head, joint capsule, common flexor and extensor origin which are the secondary static stabilisers and anconeus, triceps and brachialis muscles which act as the dynamic stabilisers 3 5. Dislocations of the elbow joint can be posterior, posteromedial, posterolateral, pure medial or lateral and anterior 3…”

Section: Discussionmentioning

confidence: 99%

“…Widening of over 1.5 mm at the radio-capitellar joint on varus stress testing is considered as subtle varus instability. Mild and moderate instability are determined by angular displacement of <10 0 (mild) or >10 0 (moderate) on stress testing 1 3. If the joint re-dislocates, it signifies severe instability.…”

Section: Discussionmentioning

confidence: 99%

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Anterior elbow dislocation without fracture in an adult: a rare injury pattern

et al. 2019

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Anterior elbow dislocation without periarticular fracture (simple dislocation) is an extremely rare injury and is usually caused by distraction or torsional forces. It is important to look for associated ligamentous and musculotendinous injuries in this pattern. We report an elderly patient who sustained simple anterior dislocation of the elbow and in whom successful closed reduction could be achieved. Reduction by closed method is possible if we know the exact mechanism of elbow injury. Despite the presence of medial collateral ligament injury, he was managed non-operatively and had full functional recovery. Checking for joint stability and collateral ligaments after reduction and getting additional radiological investigations help in better treatment planning. Early protected active mobilisation should be initiated to achieve better functional results.

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“…Junge und aktive Patienten mit hohem funktionellem Anspruch, bei denen das Ziel eine rasche Wiederherstellung des vollen Bewegungsumfangs (und nicht nur des funktionellen Bogens) ist, können von einer großzügigeren Indikation zur operativen Behandlung profitieren. Als Orientierung zur Entscheidungsfindung haben wir einen Behandlungsalgorithmus basierend auf den Befunden der dynamischen Durchleuchtung und den klinischen Ergebnissen erstellt [11,12,16]…”

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