Abstract
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.
Highlights
The elbow joint is the second most common site of dislocation in humans, and more than 90% of simple elbow dislocations occur in the posterolateral and posterior direction [1,2,3,4]
Elbow dislocation occurred on the right side (n = 17; 56.7%)
The present study revealed moderate to substantial interobserver reliability and substantial to perfect intraobserver reliability for medial and lateral soft tissues in Simple posterolateral elbow dislocations (SPLED)
Summary
The elbow joint is the second most common site of dislocation in humans, and more than 90% of simple elbow dislocations (i.e., no relevant osseous lesions) occur in the posterolateral and posterior direction [1,2,3,4]. MRI, a commonly used non-invasive test for assessing lesions of the soft tissues of the elbow, is highly accurate and remains the gold standard imaging approach to characterize the extent of soft tissue injuries. MRI, a commonly used non-invasive test for assessing lesion2soof 9f the soft tissues of the elbow, is highly accurate and remains the gold standard imaging approach to characterize the extent of soft tissue injuries. TThhiiss ssttuuddyy wwaass ccoonndduucctteedd ttoo ccoonnffiirrmm tthhee hhyyppootthheessiiss tthhaatt tthhee ssttaattuuss ooff tthhee ccoommmmoonn eexxtteennssoorr ccoommpplleexx iiss aa pprreeddiiccttoorr ttoo ddeetteerrmmiinnee ssttaabbiilliittyy iinn SSPPLLEEDD. TThhiiss rreettrroossppeeccttiivvee ccoohhoorrtt ssttuuddyy iinncclluuddeedd 3300 ppaattiieennttss wwiitthh SSPPLLEEDD wwhhoo wweerree mmaannaaggeedd aatt oouurr tteerrttiiaarryy ccaarree hhoossppiittaall bbeettwweeeenn JJaannuuaarryy 22000099 aanndd SSeepptteemmbbeerr 22001188 ((FFiigguurree 11)). WWhheenneevveerrppoossssiibbllee,,aann aatttteemmpptt wwaass mmaaddee ttoo evaluaattee elbow stability during the full range of motion after closed reduction. TThhee ppaaiirreedd SSttuuddeenntt tt--tteesstt wwaass uusseedd ttoo iiddeennttiiffyy ppootteennttiiaall ssttaattiissttiiccaall ddiiffffeerreenncceess bbeettwweeeenn tthhee mmeeaann κκvvaalluueess.. pp vvaalluueess ooff
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