Skip to main content

Advertisement

Log in

MRI in acute simple elbow dislocations: correlation of preoperative imaging and intraoperative findings of collateral ligaments and associated soft tissue injuries

  • Original Article
  • Published:
MUSCULOSKELETAL SURGERY Aims and scope Submit manuscript

Abstract

Purpose

The aim of our study was the evaluation of correspondence among collateral ligaments and other soft tissue injuries detected by MRI and by intraoperative findings in a consecutive series of patients treated for simple elbow dislocation.

Methods

After clinical and MRI examination, 16 out of 59 consecutive patients with moderate or severe instability after simple elbow dislocation were addressed to surgical treatment. There were 14 men and 2 women. The mean age was 39.6 years (range 16–69 years).

Results

MRI showed full-thickness lesion of MCL in 9/16 patients (53.3%) and partial lesion in 6/16 patients (40%), and in 1 case, the MCL was considered intact. On the lateral side, MRI showed complete injury of LCL in 7/16 patients (46.6%) and partial injury in 7/16 patients (40%). No lesions of LCL were observed in 2 patients (13.4%). MCL was surgically explored in all the patients. We observed 10/16 full-thickness lesions (62.5%) and 6/16 partial lesions (37.5%). LCL was surgically explored in 11/16 patients. We observed 6/11 full-thickness lesions (54.6%) and 5/11 partial lesions (45.4%). In 3 cases, associated soft tissue injuries were detected. The rate of concordance between MRI and surgical findings was 87.5% (14/16 cases) on the medial side and 90.9% (10/11 cases) on the lateral side.

Conclusion

Our study demonstrated that MRI is a reliable and useful tool to investigate collateral ligaments and soft tissue injuries around the elbow and to plan the most adequate surgical treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Stoneback JW, Owens BD, Sykes J, Athwal GS, Pointer L, Wolf JM (2012) Incidence of elbow dislocations in the United States population. J Bone Joint Surg Am 94(3):240–245. https://doi.org/10.2106/JBJS.J.01663

    Article  PubMed  Google Scholar 

  2. Josefsson PO, Johnell O, Wendenberg B (1987) Ligamentous injuries in dislocations of the elbow joint. Clin Orthop Relat Res 221:221–225

    Article  Google Scholar 

  3. Mehlhoff TL, Noble PC, Bennett JB, Tullos HS (1988) Simple dislocation of the elbow in the adult. Results after closed treatment. J Bone Joint Surg Am 70(2):244–249

    Article  CAS  Google Scholar 

  4. Hildebrand KA, Patterson SD, King GJ (1999) Acute elbow dislocations: simple and complex. Orthop Clin North Am 30(1):63–79

    Article  CAS  Google Scholar 

  5. Marinelli A, Guerra E, Rotini R (2016) Elbow instability: are we able to classify it? Review of the literature and proposal of an all-inclusive classification system. Musculoskelet Surg 100(1):S61–S71. https://doi.org/10.1007/s12306-016-0424-1

    Article  Google Scholar 

  6. Micic I, Kim SY, Park IH, Kim PT, Jeon IH (2009) Surgical management of unstable elbow dislocation without intra-articular fracture. Int Orthop 33:1141–1147. https://doi.org/10.1007/s00264-008-0624-x

    Article  PubMed  Google Scholar 

  7. Daneshwar P, Pollock JW, Athwal GS (2014) Fractures and dislocations of proximal ulna and radial head. In: Antuna S, Barco R (eds) Essentials in elbow surgery. Springer, London

    Google Scholar 

  8. Schnetzke M, Aytac S, Studier-Fischer S, Grützner PA, Guehrin T (2015) Initial joint stability affects the outcome after conservative treatment of simple elbow dislocations: a retrospective study. J Orthop Surg Res 10:128. https://doi.org/10.1186/s13018-015-0273-x

    Article  PubMed  PubMed Central  Google Scholar 

  9. Schnetzke M, Aytac S, Keil H, Deuss M, Studier-Fischer S, Grützner PA, Guehrin T (2017) Unstable simple elbow dislocations: medium-term results after non-surgical and surgical treatment. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-016-4100-7

    Article  PubMed  Google Scholar 

  10. Robinson PM, Griffiths E, Watts AC (2017) Simple elbow dislocation. Shoulder Elb 9(3):195–204. https://doi.org/10.1177/1758573217694163

    Article  Google Scholar 

  11. Schreiber JJ, Potter HG, Warren RF, Hotckiss RN, Daluiski A (2014) Magnetic resonance imaging findings in acute elbow dislocations. Insight into mechanism. J Hand Surg Am 39:199–205. https://doi.org/10.1016/j.jhsa.2013.11.031

    Article  PubMed  Google Scholar 

  12. Schnetzke M, Schüler S, Hoffend J, Simon R, Keil H, Porschke F, Studier-Fischer S, Grützner PA, Guehring T (2017) Interobserver and intraobserver agreement of ligamentous injuries on conventional MRI after simple elbow dislocation. BMC Musculoskelet Disord 18(1):85. https://doi.org/10.1186/s12891-017-1451-2

    Article  PubMed  PubMed Central  Google Scholar 

  13. Luokkala T, Temperley D, Basu S, Karjalainen TV, Watts AC (2019) Analysis of magnetic resonance imaging–confirmed soft tissue injury pattern in simple elbow dislocations. J Shoulder Elb Surg 28:341–348. https://doi.org/10.1016/j.jse.2018.08.010

    Article  Google Scholar 

  14. Batlle JA, Cerezal L, López Parra MD, Alba B, Resano S, Blázquez Sánchez J (2019) The elbow: review of anatomy and common collateral ligament complex pathology using MRI. Insights Imaging 10:43. https://doi.org/10.1186/s13244-019-0725-7

    Article  Google Scholar 

  15. Morrey BF, Sanchez Sotelo J (2009) The elbow and its disorders, 4th edn. Sanders Elsevier, Amsterdam

    Google Scholar 

  16. Chin TY, Chou H, Peh WGC (2019) The acutely injured elbow. Radiol Clin N Am 57:911–930. https://doi.org/10.1016/j.rcl.2019.03.006

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S. Artiaco.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (include name of committee + reference number) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dutto, E., Artiaco, S., Gallo, A. et al. MRI in acute simple elbow dislocations: correlation of preoperative imaging and intraoperative findings of collateral ligaments and associated soft tissue injuries. Musculoskelet Surg 106, 127–132 (2022). https://doi.org/10.1007/s12306-020-00678-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12306-020-00678-4

Keywords

Navigation