University of Pittsburgh, PA, USA.
University of Pittsburgh Medical Center, PA, USA.
Hand (N Y). 2022 Jul;17(4):730-733. doi: 10.1177/1558944720949961. Epub 2020 Aug 27.
The elbow is one of the most commonly dislocated joints, and dislocation is usually accompanied with an assortment of soft tissue injuries. The purpose of this study was to retrospectively analyze and describe the patterns of ligamentous, tendinous, and muscular injuries in patients with an acute elbow dislocation and subsequent magnetic resonance image (MRI) evaluation.
From 2008 to 2020, 235 patients clinically diagnosed with an elbow dislocation were seen in the department, of which only 19 underwent an MRI of the affected elbow. Twelve patients met inclusion criteria, and MRIs were evaluated by both a radiologist and an upper extremity orthopedic surgeon. Magnetic resonance images were assessed for injury to the ulnar collateral ligament (UCL); radial collateral ligament (RCL); lateral ulnar collateral ligament (LUCL); common flexor and extensor tendons; biceps, brachialis, and triceps tendons; fracture; and joint effusion.
Magnetic resonance imaging findings included the following: UCL was injured in 11 of 12 patients; RCL was injured in 9 of 12 patients; LUCL was injured in 9 of 12 patients; common flexor tendon was injured in 11 of 12 patients; and common extensor tendon was injured in 9 of 12 elbows. The biceps, brachialis, and triceps tendons showed injury in 1 of 12, 2 of 12, and 2 of 12 elbows, respectively. Four elbows had at least 1 fracture present, whereas 8 demonstrated an effusion.
In this series, injuries to the UCL and common flexor tendon were most common. Although ligamentous injuries are exceedingly common in elbow dislocations, large studies of MRI findings prove difficult due to MRI costs.
肘部是最常发生脱位的关节之一,脱位通常伴有多种软组织损伤。本研究的目的是回顾性分析和描述急性肘部脱位患者的韧带、肌腱和肌肉损伤模式,并对其随后的磁共振成像(MRI)评估结果进行描述。
2008 年至 2020 年期间,该科室共诊治了 235 例肘部脱位患者,其中仅 19 例行受累肘部 MRI 检查。12 例患者符合纳入标准,由放射科医生和上肢矫形外科医生对 MRI 进行评估。评估 MRI 对尺侧副韧带(UCL)、桡侧副韧带(RCL)、外侧尺侧副韧带(LUCL)、屈肌和伸肌肌腱、肱二头肌、肱肌和肱三头肌肌腱、骨折和关节积液的损伤情况。
MRI 检查结果如下:12 例患者中 UCL 损伤 11 例,RCL 损伤 9 例,LUCL 损伤 9 例,屈肌腱损伤 11 例,伸肌腱损伤 9 例。肱二头肌、肱肌和肱三头肌肌腱损伤分别为 12 例中的 1 例、2 例和 2 例。4 个肘部至少有 1 处骨折,8 个肘部有积液。
在本系列中,UCL 和屈肌腱损伤最常见。尽管韧带损伤在肘部脱位中非常常见,但由于 MRI 成本较高,因此很难进行大规模的 MRI 检查结果研究。