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Elbow Instability.

Dimitri N Graf1,2, Benjamin Fritz1,2, Samy Bouaicha1,2

  • 1Department of Radiology, Balgrist University Hospital, Zurich, Switzerland.

Seminars in Musculoskeletal Radiology
|October 27, 2021
PubMed
Summary
This summary is machine-generated.

Elbow instability, often caused by ligament tears like the lateral ulnar collateral ligament (LUCL) or ulnar collateral ligament (UCL), requires imaging like MRI for diagnosis. Prompt identification of these injuries is crucial for effective treatment.

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Area of Science:

  • Orthopedic surgery
  • Sports medicine
  • Radiology

Background:

  • Elbow stability relies on static and dynamic stabilizers.
  • Varus stress is stabilized by bony structures and the lateral ulnar collateral ligament (LUCL); valgus stress by the ulnar collateral ligament (UCL).
  • Elbow instability ranges from acute traumatic to chronic, with posterolateral rotatory instability being most common.

Purpose of the Study:

  • To outline the diagnostic imaging approach for elbow instability.
  • To identify common soft tissue and osseous injuries associated with elbow instability.
  • To describe the characteristics of valgus instability, particularly in overhead athletes.

Main Methods:

  • Initial imaging typically involves radiographs.
  • Further evaluation may include magnetic resonance imaging (MRI) or computed tomography (CT) for soft tissue and osseous injuries.
  • MRI is particularly useful for visualizing UCL damage in valgus instability.

Main Results:

  • Posterolateral rotatory instability is the most frequent type, detectable acutely and chronically.
  • Common injuries include LUCL tears, radial collateral ligament tears, LUCL avulsion fractures, coronoid process fractures, and radial head fractures.
  • Valgus instability, often chronic, is linked to valgus extension overload, frequently involving UCL insufficiency in overhead athletes.

Conclusions:

  • Accurate diagnosis of elbow instability relies on a combination of clinical assessment and advanced imaging.
  • Understanding common injury patterns aids in timely and appropriate management.
  • Overhead athletes are particularly susceptible to valgus instability due to repetitive stress on the UCL.