scholarly journals The Ulnar Collateral Ligament is Always Torn in the Posterolateral Elbow Dislocation: A Suggestion on the new Mechanism of Dislocation Using MRI Findings

1970 ◽  
Vol 14 (2) ◽  
pp. 193-198
Author(s):  
In Hyeok Rhyou ◽  
Ji Ho Lee ◽  
Kyung Jun Park ◽  
Hyun Suk Kang ◽  
Kang Wook Kim
Keyword(s):  
Magnetic Resonance Image ◽  
Elbow Dislocation ◽  
Lateral Collateral Ligament ◽  
Ulnar Collateral Ligament ◽  
The Novel ◽  
Collateral Ligament ◽  
Mri Findings ◽  
Surrounding Soft Tissue ◽  
Bone Contusion ◽  
The Status

PURPOSE: From the status of ulnar collateral ligament of elbow with magnetic resonance image which suffered with posterolateral dislocation. We would propose the novel mechanism of posterolateral elbow dislocation.MATERIALS AND METHODS: Between November 2005 and October 2009, we prospectively collected 12 cases of simple posterolateral elbow dislocation. The location of bone contusion and the status of collateral ligament were evaluated with MRI. Collateral ligament was divided in 2 subgroups (distraction type, stripping type). We also defined the disengagement as escaping of conoid process from trochlear notch totally.RESULTS: From 12 cases, we could found 11 cases of bone contusion in radial head or capitellum. Trochlea and conoid process were always intact without bone contusion. All ulnar collateral ligament ruptures were distraction type instead of all lateral collateral ligament ruptures were stripping type. Translations of all cases were shown those of the ulnar collateral ligament were longer than those of lateral collateral ligament (p<0.05).CONCLUSION: We carefully conclude that UCL and surrounding soft tissue has responsibility for the initiation of simple posterolateral elbow dislocation.

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

2020 ◽  
Vol 9 (10) ◽  
pp. 3094
Author(s):  
Chul-Hyun Cho ◽  
Beom-Soo Kim ◽  
Jaehyuck Yi ◽  
Hoseok Lee ◽  
Du-Han Kim
Keyword(s):  
Soft Tissue ◽  
Interobserver Reliability ◽  
Elbow Dislocation ◽  
Lateral Collateral Ligament ◽  
Soft Tissue Injuries ◽  
Collateral Ligament ◽  
Mri Findings ◽  
Partial Tears ◽  
Choice Of Treatment ◽  
Tissue Injuries

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.

scholarly journals Repair of a Divergent Elbow Dislocation with Distal Ulnar Fracture in a Dog Using TightRope and External Skeletal Fixation

VCOT Open ◽  
2021 ◽  
Vol 04 (01) ◽  
pp. e58-e64
Author(s):  
Marcos Garcia ◽  
Camille Bismuth ◽  
Claire Deroy-Bordenave
Keyword(s):  
Elbow Dislocation ◽  
Lateral Collateral Ligament ◽  
Normal Activity ◽  
Long Term Results ◽  
Collateral Ligament ◽  
Elbow Luxation ◽  
Ulnar Fracture ◽  
Fixation System

AbstractThe aim of this study was to report the outcome in a 6-year-old male English Setter dog that suffered a combination of divergent elbow dislocation and open distal ulnar fracture. This study is a case report. After surgical reduction in the elbow luxation, the dog was treated with the TightRope fixation system used as replacement of the lateral collateral ligament, a radioulnar positional screw, and external skeletal fixation. Removal of all implants was performed 3 months postoperatively. The 6-month follow-up visit found the dog without lameness, displaying normal activity, and with normal elbow range of motion and normal Campbell's test. Successful surgical management was achieved with good long-term results using TightRope, a positional screw, and an external skeletal fixator.

Reefing Procedure for Lateral Collateral Ligament Attenuation during Ligamentous Repair for Elbow Trauma

2012 ◽  
Vol 4 (4) ◽  
pp. 277-281
Author(s):  
Benjamin W. Sears ◽  
Grant E. Garrigues ◽  
Dan Witmer ◽  
Matthew L Ramsey
Keyword(s):  
Surgical Repair ◽  
Lateral Collateral Ligament ◽  
Ulnar Collateral Ligament ◽  
Current Procedural Terminology ◽  
Collateral Ligament ◽  
Elbow Trauma ◽  
Code Search ◽  
Lateral Ulnar Collateral Ligament ◽  
Humeral Condyle ◽  
A Current

Background Injury to the lateral soft tissue structures is common after complex elbow trauma and instability. Typically, this consists of lateral collateral ligamentous complex avulsion from the lateral distal humeral condyle. However, in some cases, attenuation of the ligament midsubstance may also occur, potentially resulting in residual ligamentous laxity after repair. Methods From 2007 to 2011, 37 patients were identified through a current procedural terminology code search as having undergone lateral ulnar collateral ligament (LUCL) repair during surgery for trauma to their elbow and were retrospectively reviewed. Results Attenuation of the ligament midsubstance was found in 19% (seven of 37) patients who underwent surgical repair of the LUCL for injuries to the elbow. In these patients, direct repair of the ligament with additional reefing of the ligament midsubstance was performed. Retrospective review of this population revealed no postsurgical instability or need for subsequent stabilizing procedures. Conclusions These findings demonstrate that, in select patients, repair with reefing of an attenuated LUCL ligament promotes stability to the elbow.

Magnetic Resonance Imaging Findings After Elbow Dislocation: A Descriptive Study

Hand ◽  
2020 ◽  
pp. 155894472094996
Author(s):  
Cory Demino ◽  
John R. Fowler
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Flexor Tendon ◽  
Elbow Dislocation ◽  
Ulnar Collateral Ligament ◽  
Magnetic Resonance Images ◽  
Joint Effusion ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Collateral Ligament

Background The elbow is one of the most commonly dislocated joints, and dislocation is usually accompanied with an assortment of soft tissue injuries. The purpose of this study was to retrospectively analyze and describe the patterns of ligamentous, tendinous, and muscular injuries in patients with an acute elbow dislocation and subsequent magnetic resonance image (MRI) evaluation. Methods From 2008 to 2020, 235 patients clinically diagnosed with an elbow dislocation were seen in the department, of which only 19 underwent an MRI of the affected elbow. Twelve patients met inclusion criteria, and MRIs were evaluated by both a radiologist and an upper extremity orthopedic surgeon. Magnetic resonance images were assessed for injury to the ulnar collateral ligament (UCL); radial collateral ligament (RCL); lateral ulnar collateral ligament (LUCL); common flexor and extensor tendons; biceps, brachialis, and triceps tendons; fracture; and joint effusion. Results Magnetic resonance imaging findings included the following: UCL was injured in 11 of 12 patients; RCL was injured in 9 of 12 patients; LUCL was injured in 9 of 12 patients; common flexor tendon was injured in 11 of 12 patients; and common extensor tendon was injured in 9 of 12 elbows. The biceps, brachialis, and triceps tendons showed injury in 1 of 12, 2 of 12, and 2 of 12 elbows, respectively. Four elbows had at least 1 fracture present, whereas 8 demonstrated an effusion. Conclusions In this series, injuries to the UCL and common flexor tendon were most common. Although ligamentous injuries are exceedingly common in elbow dislocations, large studies of MRI findings prove difficult due to MRI costs.

Development of 3D Finite Element Model of Human Elbow to Study Elbow Dislocation and Instability

2009 ◽  
Author(s):  
Samer Khodor Al Kork ◽  
Farid Amirouche ◽  
Edward Abraham ◽  
Mark Gonzalez
Keyword(s):  
Finite Element ◽  
Medial Collateral Ligament ◽  
Inverse Dynamics ◽  
Elbow Dislocation ◽  
Lateral Collateral Ligament ◽  
Element Model ◽  
Fe Model ◽  
Collateral Ligament ◽  
Coronoid Fracture ◽  
Flexion Extension

The mechanics of elbow dislocation and its stages of dislocation are complex and not well understood. Reconstructing a fall where someone lands on their hand is one of the most challenging problem in biomechanics. Current models which attempt to reconstruct falls usually focus on experimental kinematical conditions that cause the fall coupled with inverse dynamics to determine the joint and muscles forces [1,2] to provide on insight into the joint instability. Our hypothesis based on our experimental investigation is that the mechanism of posterior elbow dislocation is initiated at radial head where the ulna and coronoid fracture followed by anterior tearing of the joint capsule, lateral collateral ligament will then rupture followed by posterior medial collateral ligament rupture and then the medial collateral ligament peeling off the ulna. In this study we developed a quasi-static three-dimensional finite element of human elbow joint, and conducted several cadaveric studies to study elbow dislocation. The FE model is used to investigate how the ligaments, cartilages behave under different flexion, extension of the elbow. Dislocation is investigated as function of different loads and moments applied to the radius-ulna with arm being flexed and configured into a supination or pronation.

scholarly journals Humeral Avulsion of the Lateral Collateral Ligament of the Elbow Concomitant with the Medial Epicondyle Fracture of a Child with General Joint Laxity

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Toru Morimoto ◽  
Masashi Izumi ◽  
Hiroaki Ueba ◽  
Masahiko Ikeuchi
Keyword(s):  
Chronic Conditions ◽  
Elbow Dislocation ◽  
Lateral Collateral Ligament ◽  
Medial Epicondyle ◽  
Joint Laxity ◽  
Collateral Ligament ◽  
Elbow Injury ◽  
Satisfactory Outcome ◽  
To Receive ◽  
Medial Epicondyle Fracture

Medial epicondyle fracture is a common elbow injury for children, and it was reported that 30-50% of this fracture was associated with elbow dislocation. However, dysfunction of the lateral collateral ligament (LCL) complex accompanied with the medial epicondyle fracture has rarely been reported. In this report, a 13-year-old girl who had a humeral avulsion of the LCL concomitant with a displaced medial epicondyle fracture was presented. Since her general joint laxity had been recognized from past medical history and the humeral avulsion of the LCL was clearly confirmed by ultrasonography, simultaneous surgical repair for the LCL avulsion and medial epicondyle fracture was conducted and satisfactory outcome was achieved. Although general joint laxity does not tend to receive attention in trauma as much as chronic conditions, it should be borne in mind to prevent overlooking important soft tissue damage coexisting with apparent fractures.

scholarly journals Topographic and Histologic Analysis of the Collateral Ligament Complex around the Elbow

2021 ◽  
Vol 26 (3) ◽  
pp. 152-160
Author(s):  
Jong-Pil Kim ◽  
Ji-Kang Park ◽  
Joon-Young Yoo ◽  
Won-Jeong Shin ◽  
Jeong-Sang Kim ◽  
...  
Keyword(s):  
Polarized Light ◽  
Lateral Collateral Ligament ◽  
Ulnar Collateral Ligament ◽  
Anatomic Reconstruction ◽  
Type I ◽  
Micro Ct ◽  
Micro Computed Tomography ◽  
Collateral Ligament ◽  
Proximal Ulna ◽  
Maximal Diameter

Purpose: The purpose of this study was to evaluate topographic anatomy of the footprints of key ligaments of the elbow and assess their relationships with bony parameters using micro-computed tomography (micro-CT). Additionally, the ratios of type I/III collagen at the medial collateral ligament (MCL) and lateral collateral ligament (LCL) of elbow were investigated.Methods: Eleven cadaveric elbows attached by both the MCL and LCL were scanned using micro-CT and reconstructed three-dimensionally. Additionally, the ligaments were examined under polarized light microscopy to determine the histological characteristics of collagen patterns. Results: Areas of footprints of the MCL and LCL attaching onto the humerus were 133.2±25.8 mm² and 128.3±23.2 mm², respectively. Footprint sizes of anterior and posterior bundles of the MCL in the proximal ulna and lateral ulnar collateral ligament (LUCL) attaching to the proximal ulna averaged to 109.9 mm², 89.2 mm², and 89.7 mm², respectively. There were a positive correlation between footprint size of the MCL and LUCL at the humeral side and a negative correlation between the footprint size of the MCL at humeral side and maximal diameter of the radial head. The collagen I/III ratio of the humeral attachment of the MCL was higher than distal attachment of the MCL. Conclusion: This study provides a better understanding of the pathologies of the MCL and LCL complex of the elbow and their relationships with osseous anatomy and may assist the clinician with an anatomic reconstruction of the ligaments.

Lateral Ulnar Collateral Ligament Reconstruction for Posterolateral Rotatory Instability of the Elbow: A Systematic Review

Hand ◽  
2020 ◽  
pp. 155894472091776
Author(s):  
Austin Fares ◽  
Nicholas Kusnezov ◽  
John C. Dunn
Keyword(s):  
Systematic Review ◽  
Elbow Dislocation ◽  
Ulnar Collateral Ligament ◽  
Tendon Graft ◽  
Common Mechanism ◽  
Collateral Ligament ◽  
Rotatory Instability ◽  
Posterolateral Rotatory Instability ◽  
Additional Surgery ◽  
Lateral Ulnar Collateral Ligament

Background: Posterolateral rotatory instability (PLRI) is a common form of recurrent elbow instability. The aim of this systematic review is to present the outcomes and complications of lateral ulnar collateral ligament (LUCL) reconstruction surgery for PLRI. Methods: A literature search of LUCL reconstructions was performed, identifying 99 potential papers; 11 of which met inclusion/exclusion criteria, accounting for 148 patients. Papers were included if they reviewed cases of PLRI from 1976 to 2016 with reported outcome measures. Data were pooled and analyzed focusing on patient demographics as well as subjective and objective patient outcomes and complications. Results: The average age of patients was 34 years with a mean follow-up time of 49.8 months. The most common mechanism of injury was a traumatic elbow dislocation (66%), followed by cubitus varus deformity (7%), and unknown mechanisms (7%). Overall, 90% of patients achieved elbow stability and 2.7% experienced a failed reconstruction that necessitated an additional surgery. Furthermore, 93% were satisfied with the outcome of the reconstruction, and 83% reported good to excellent outcomes with 11% reporting moderate to severe persistent pain. Nearly half (45%) of reconstructions were done using a palmaris longus tendon graft, 24% with a triceps tendon graft, and 7% with a synthetic graft. Conclusions: Outcomes following LUCL reconstruction for PLRI are excellent and revision rates are low. LUCL reconstruction is a safe and reliable procedure. Level of Evidence: IV Therapeutic

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