Associated capitellar and elbow ligamentous injuries in isolated type 1 radial head fractures based on MRI

James R. Meadows, Anil K. Dutta, Glenn Garcia

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: In our experience, there is a clinical subset of patients with type 1 radial head fracture who continue to have chronic elbow ache and pain with lifting. As advanced imaging has become more common in orthopaedic practices, there is a heightened awareness of associated injuries and the need to define such relationships. Using MRI, we sought to further describe the incidence of and characterize associated elbow injuries with a focus on insult to the capitellum and elbow collateral ligaments. Methods: Seventeen patients with 17 Mason type 1 radial head fractures underwent MRI of the affected elbow after being diagnosed by physical examination and orthogonal plain radiographs. Results: The incidence of associated elbow injuries was 100%. Capitellar injuries occurred in 82% of patients. Chondral injury occurred in 36%, and subchondral fracture in 6%. Medial collateral ligament (MCL) injury occurred in 88% of patients and in 86% of patients with capitellar injuries. All (100%) elbows had lateral ulnar collateral ligament (LUCL) injury with four complete tears. Conclusions: The incidence of capitellar and MCL injury is higher than previously reported in patients with isolated Mason type 1 radial head fractures. Patients diagnosed with such injuries should be followed closely and evaluated with advanced imaging if there is a failure of motion progression or persistent pain. Long-term clinical outcome of such patients with osteochondral damage of the capitellum should be investigated. Level of Evidence: IV, Case Series, Diagnostic Study.

Original languageEnglish (US)
Pages (from-to)467-471
Number of pages5
JournalCurrent Orthopaedic Practice
Volume25
Issue number5
StatePublished - 2014
Externally publishedYes

Fingerprint

Elbow
Wounds and Injuries
Collateral Ligaments
Pain
Incidence
Ankle Lateral Ligament
Tears
Physical Examination
Cartilage
Orthopedics

Keywords

  • Capitellum
  • Lateral ulnar collateral ligament
  • Medial collateral ligament
  • Radial head fracture

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Associated capitellar and elbow ligamentous injuries in isolated type 1 radial head fractures based on MRI. / Meadows, James R.; Dutta, Anil K.; Garcia, Glenn.

In: Current Orthopaedic Practice, Vol. 25, No. 5, 2014, p. 467-471.

Research output: Contribution to journalArticle

@article{302c8b705df84aadacc6aa11447c8e1c,
title = "Associated capitellar and elbow ligamentous injuries in isolated type 1 radial head fractures based on MRI",
abstract = "Background: In our experience, there is a clinical subset of patients with type 1 radial head fracture who continue to have chronic elbow ache and pain with lifting. As advanced imaging has become more common in orthopaedic practices, there is a heightened awareness of associated injuries and the need to define such relationships. Using MRI, we sought to further describe the incidence of and characterize associated elbow injuries with a focus on insult to the capitellum and elbow collateral ligaments. Methods: Seventeen patients with 17 Mason type 1 radial head fractures underwent MRI of the affected elbow after being diagnosed by physical examination and orthogonal plain radiographs. Results: The incidence of associated elbow injuries was 100{\%}. Capitellar injuries occurred in 82{\%} of patients. Chondral injury occurred in 36{\%}, and subchondral fracture in 6{\%}. Medial collateral ligament (MCL) injury occurred in 88{\%} of patients and in 86{\%} of patients with capitellar injuries. All (100{\%}) elbows had lateral ulnar collateral ligament (LUCL) injury with four complete tears. Conclusions: The incidence of capitellar and MCL injury is higher than previously reported in patients with isolated Mason type 1 radial head fractures. Patients diagnosed with such injuries should be followed closely and evaluated with advanced imaging if there is a failure of motion progression or persistent pain. Long-term clinical outcome of such patients with osteochondral damage of the capitellum should be investigated. Level of Evidence: IV, Case Series, Diagnostic Study.",
keywords = "Capitellum, Lateral ulnar collateral ligament, Medial collateral ligament, Radial head fracture",
author = "Meadows, {James R.} and Dutta, {Anil K.} and Glenn Garcia",
year = "2014",
language = "English (US)",
volume = "25",
pages = "467--471",
journal = "Current Orthopaedic Practice",
issn = "1940-7041",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Associated capitellar and elbow ligamentous injuries in isolated type 1 radial head fractures based on MRI

AU - Meadows, James R.

AU - Dutta, Anil K.

AU - Garcia, Glenn

PY - 2014

Y1 - 2014

N2 - Background: In our experience, there is a clinical subset of patients with type 1 radial head fracture who continue to have chronic elbow ache and pain with lifting. As advanced imaging has become more common in orthopaedic practices, there is a heightened awareness of associated injuries and the need to define such relationships. Using MRI, we sought to further describe the incidence of and characterize associated elbow injuries with a focus on insult to the capitellum and elbow collateral ligaments. Methods: Seventeen patients with 17 Mason type 1 radial head fractures underwent MRI of the affected elbow after being diagnosed by physical examination and orthogonal plain radiographs. Results: The incidence of associated elbow injuries was 100%. Capitellar injuries occurred in 82% of patients. Chondral injury occurred in 36%, and subchondral fracture in 6%. Medial collateral ligament (MCL) injury occurred in 88% of patients and in 86% of patients with capitellar injuries. All (100%) elbows had lateral ulnar collateral ligament (LUCL) injury with four complete tears. Conclusions: The incidence of capitellar and MCL injury is higher than previously reported in patients with isolated Mason type 1 radial head fractures. Patients diagnosed with such injuries should be followed closely and evaluated with advanced imaging if there is a failure of motion progression or persistent pain. Long-term clinical outcome of such patients with osteochondral damage of the capitellum should be investigated. Level of Evidence: IV, Case Series, Diagnostic Study.

AB - Background: In our experience, there is a clinical subset of patients with type 1 radial head fracture who continue to have chronic elbow ache and pain with lifting. As advanced imaging has become more common in orthopaedic practices, there is a heightened awareness of associated injuries and the need to define such relationships. Using MRI, we sought to further describe the incidence of and characterize associated elbow injuries with a focus on insult to the capitellum and elbow collateral ligaments. Methods: Seventeen patients with 17 Mason type 1 radial head fractures underwent MRI of the affected elbow after being diagnosed by physical examination and orthogonal plain radiographs. Results: The incidence of associated elbow injuries was 100%. Capitellar injuries occurred in 82% of patients. Chondral injury occurred in 36%, and subchondral fracture in 6%. Medial collateral ligament (MCL) injury occurred in 88% of patients and in 86% of patients with capitellar injuries. All (100%) elbows had lateral ulnar collateral ligament (LUCL) injury with four complete tears. Conclusions: The incidence of capitellar and MCL injury is higher than previously reported in patients with isolated Mason type 1 radial head fractures. Patients diagnosed with such injuries should be followed closely and evaluated with advanced imaging if there is a failure of motion progression or persistent pain. Long-term clinical outcome of such patients with osteochondral damage of the capitellum should be investigated. Level of Evidence: IV, Case Series, Diagnostic Study.

KW - Capitellum

KW - Lateral ulnar collateral ligament

KW - Medial collateral ligament

KW - Radial head fracture

UR - http://www.scopus.com/inward/record.url?scp=84927760060&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84927760060&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:84927760060

VL - 25

SP - 467

EP - 471

JO - Current Orthopaedic Practice

JF - Current Orthopaedic Practice

SN - 1940-7041

IS - 5

ER -