Traumatic Rotatory Instability of the Elbow

Posterolateral Rotatory Instability (PLRI) and Posteromedial Rotatory Instability (PMRI)
  • Andreas Lenich
  • Sebastian Siebenlist
  • Andreas B. Imhoff
Part of the Strategies in Fracture Treatments book series (SFT)


The epidemiology of elbow rotatory instability is until now not fully understood. The phenomen of various elbow instabilities as the posterolateral rotatory instability (PLRI) is multiple described but the pathomechanism for a posterior medial rotatory instability (PMRI) could not be simulated until now. Especially the combined injuries of the fracture of a coronoid and ligament ruptures could not be identified by the classification of Regan and Morrey [1]. The PMRI was first described by O’Driscoll et al. [2] in 2003 as anteromedial fractures of the coronoid (AMC) and lateral varus instability. After acute trauma these fractures are often missed because of their rarity. Moreover, associated to coronoid fractures they often look subtle like terrible triad injuries. This might lead to poor clinical outcomes. Further teaching in diagnostics, understanding of the rotatory pathomechanism and treatment has to be trained to reduce the rate of insuffizient outcome of the PMRI and PLRI, respectively.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Andreas Lenich
    • 1
  • Sebastian Siebenlist
    • 2
  • Andreas B. Imhoff
    • 2
  1. 1.Department of Trauma- and Sportorthopaedic SurgeryHelios Klinikum München WestMunichGermany
  2. 2.Department of Orthopaedic Sports MedicineTechnical University Munich Klinikum rechts der IsarMunichGermany

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