Purpose
To identify with magnetic resonance imaging the location and severity of ligamentous
injury after acute elbow dislocations. Based on observations that many elbow dislocations
arise from an initial acute valgus load, we hypothesized that all patients would have
a high-grade medial injury but not all would demonstrate injury of the lateral ligaments.
Methods
The medial collateral ligament was subdivided into anterior bands of the anterior
bundle of the medial collateral ligament (MCL) and posterior bands of the anterior
bundle of the MCL, whereas the lateral collateral ligament was divided into the lateral
ulnar collateral ligament and the radial collateral ligament. Distinction on magnetic
resonance imaging was made between normal morphology and low-grade partial tear (<
50% of the ligament fibers), high-grade partial tear (≥ 50%), and full-thickness disruption.
The site of disruption was also characterized.
Results
Acute magnetic resonance imaging studies for 16 patients were included. No low-grade
tears or intact evaluations of either the anterior or posterior bands of the anterior
bundle of the MCL were observed; most demonstrated complete tears. The lateral ulnar
collateral ligament most frequently showed complete disruption but was occasionally
intact. The radial collateral ligament infrequently showed full disruption. Complete
tears involving either the anterior or posterior portions of the anterior band of
the MCL were significantly more common than complete tears involving the ligaments
on the lateral side.
Conclusions
After elbow dislocation, complete ligamentous tears were more common on the medial
versus the lateral side. Whereas the lateral ligaments were occasionally preserved,
this was never observed on the medial side. These data suggest a sequence of failure
starting on the medial side with subsequent variable energy dissipation laterally.
Type of study/level of evidence
Diagnostic IV.
Key words
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Article info
Publication history
Accepted:
November 18,
2013
Received:
September 12,
2013
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
