CORRInsights®: What Injury Mechanism and Patterns of Ligament Status Are Associated With Isolated Coronoid, Isolated Radial Head, and Combined Fractures?

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In the current study, Rhyou and colleagues retrospectively studied 54 patients with surgically-treated elbow fractures. Patients were grouped by those with isolated coronoid fractures, isolated radial head fractures, and injuries in which both the coronoid and the radial head were fractured. In all patients, the coronoid process and/or radial head fractures were visualized using three-dimensional-CT. The authors then used MRI to identify both the cartilaginous and the ligament injuries. The injured ligaments were confirmed at the time of subsequent open surgery.
The value of MRI in identifying the ligament injuries and the correlation of the ligament injuries with bony injuries fits with the findings of earlier studies [1-3]. In a paper published in 2014, Rhyou and colleagues [5] reported their outcomes in 18 patients treated surgically for this group of injuries. The study found that the varus stress test under fluoroscopy with forearm pronation was useful in determining the necessity of repairing the lateral ulnar collateral ligament.
In the current study, Rhyou and colleagues describe these mechanisms with even greater clarity using detailed MRIs and CTs, and their study is a valuable addition to our understanding of ligament injuries.
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