New mechanism of the posterior elbow dislocation

Abstract

PL dislocation is thought to start from the medial side in contrary to PM dislocation beginning at the lateral side. If the disengagement of the coronoid process is not completed due to the insufficient valgus/varus distraction, a coronoid fracture will develop at the same time as the elbow dislocation during PFER.

Drop sign of the elbow joint after surgical stabilization of an unstable simple posterolateral dislocation: natural course and contributing factors

“…15 In PL dislocation of the elbow joint, we always found more severe damage of soft tissue at the medial side of the elbow joint compared with the lateral side, described as greater displacement and signal changes of the torn UCL and overlying muscles. Therefore, we thought the most common PL dislocation begins from the distractive rupture of the UCL, frequently with the overlying flexor-pronator teres muscles, to progress to the complete disengagement of the coronoid process.…”

“…However, we have previously documented the usefulness of manual stress tests using valgus or varus force around an elbow injury to evaluate the severity of damage to collateral ligaments and overlying flexorextensor muscles. 15 Fourth, it was not easy to measure the sulcus distance using the Coonrad method in cases with complex elbow anatomy or slightly different lateral views. Fifth, functional outcome was not available for all patients; DASH score was not evaluated in 7 patients, and MEPS was not available in 4 patients.…”

“…If there was no firm end point or redislocation, surgical repair was considered, in which the affected side was repaired with suture anchors or a transosseous technique. In our previous study, we reported a novel mechanism of PL elbow dislocation, 15 in which PL dislocation of the elbow starts from the medial side (Fig. 2).…”

Operative Therapie der Terrible-Triad-Verletzung des Ellenbogens

“…Durch das Valgusmoment wird eine initale Läsion des vorderen medialen kollateralen Bandapparats (MCL) postuliert, welche die Voraussetzung für die posterolaterale Luxation mit ihren osteoligamentären Verletzungen sein soll. Auch eine neuere Magnetresonanz-(MRT-)Studie unterstützt diese Hypothese [3]. Diese In-vivo-Beobachtungen stellen die klassische Theorie der lateral beginnenden Läsionssequenz [4] infrage und lassen eine häufigere Verletzung von Anteilen des MCL vermuten.…”

Cost analysis and outcomes of simple elbow dislocations

“…The terrible triad describes a complex posterior dislocation with an intraarticular fracture of the radial head and of the coronoid process [6] . Elbow dislocations are also defined by the direction and topography of the dislocated parts [7] . To date, there is no general consensus regarding the protocol of management of simple elbow dislocations with different protocols being suggested.…”