Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Elbow 38 articles


Transverse Coronoid Fracture: When Does It Have to Be Fixed?

Robert U. Hartzler MD, Manuel Llusa-Perez MD, Scott P. Steinmann MD, Bernard F. Morrey MD, Joaquin Sanchez-Sotelo MD, PhD

After elbow fracture-dislocation, surgeons confront numerous treatment options in pursuing a stable joint for early motion. The relative contributions of the radial head and coronoid, in combination, to elbow stability have not been defined fully.

A Large Humeral Avulsion of the Glenohumeral Ligaments Decreases Stability That Can Be Restored With Repair

Kyoung Jin Park MD, PhD, Mallika Tamboli, Lauren Y. Nguyen, Michelle H. McGarry MS, Thay Q. Lee PhD

Humeral avulsion of the glenohumeral ligaments (HAGL) has become a recognized cause of recurrent shoulder instability; however, it is unknown whether small and large HAGL lesions have similarly destabilizing effects and if large lesion repair results in restoration of stability.

Single-staged Treatment Using a Standardized Protocol Results in Functional Motion in the Majority of Patients With a Terrible Triad Elbow Injury

Akash Gupta MD, David Barei MD, Ansab Khwaja BA, Daphne Beingessner MD

Terrible triad injuries of the elbow, defined as elbow dislocation with associated fractures to the radial head and coronoid, are associated with stiffness, pain, and loss of motion. Studies to date have consisted of small sample sizes and used heterogeneous surgical techniques, which render comparisons difficult and unreliable.

Terrible Triad Injuries of the Elbow: Does the Coronoid Always Need to Be Fixed?

Loukia K. Papatheodorou MD, PhD, James H. Rubright MD, Kathryn A. Heim MD, Robert W. Weiser MPAs, PA-C, Dean G. Sotereanos MD

The “terrible triad” of the elbow is a complex injury that can lead to pain, stiffness, and posttraumatic arthritis if not appropriately treated. The primary goal of surgery for these injuries is to restore stability of the joint sufficient to permit early motion. Although most reports recommend repair and/or replacement of all coronoid and radial head fractures when possible, a recent cadaveric study demonstrated that type II coronoid fractures are stable unless the radial head is removed and not replaced.

Fixation Versus Replacement of Radial Head in Terrible Triad: Is There a Difference in Elbow Stability and Prognosis?

Tyler Steven Watters MD, Grant E. Garrigues MD, David Ring MD, PhD, David S. Ruch MD

Surgical treatment for terrible triad injuries of the elbow (defined as elbow dislocations with concomitant fractures of the radial head and coronoid) remains a challenging clinical problem. Specifically, the question of whether to repair or replace the radial head remains controversial.

Injury Complexity Factors Predict Heterotopic Ossification Restricting Motion After Elbow Trauma

Jimme K. Wiggers MD, Gijs T. T. Helmerhorst MD, Kim M. Brouwer MD, PhD, Maarten C. Niekel MD, Fiesky Nunez MD, David Ring MD, PhD

Heterotopic ossification (HO) is a common extrinsic cause of elbow stiffness after trauma. However, factors associated with the development of HO are incompletely understood.

Can Ulnar Variance Be Used to Detect Overstuffing After Radial Head Arthroplasty?

Jun-Gyu Moon MD, PhD, Jin-Ho Hong MD, Nitin Bither MD, Won-Yong Shon MD, PhD

Overstuffing of the radiocapitellar joint during metallic radial head arthroplasty has been reported to cause loss of elbow flexion, capitellar erosion, and early-onset osteoarthritis. Although this is known, there is no agreed-on measurement approach to determine whether overstuffing has occurred.

Does Radiographic Beam Angle Affect the Radiocapitellar Ratio Measurement of Subluxation in the Elbow?

Fannie McCann BSc, Fanny Canet MScA Ing, Emilie Sandman MD, Yvan Petit PhD Ing, Dominique M. Rouleau MD, MSc, FRCSC

Radial head alignment is the key to determine elbow reduction after treatment of subluxations or Monteggia fractures. The radiocapitellar ratio (RCR) quantifies the degree of subluxation, by evaluating radial head alignment with the capitellum of the humerus; this ratio is reproducible when measured on true lateral radiographs of nonsubluxated elbows. However, the impact of beam angulation on RCR measurement is unknown.

Ulnar Nerve Innervation of the Triceps Muscle: Real or Apparent? An Anatomic Study

Aran Pascual-Font PhD, Teresa Vazquez PhD, Fernando Marco PhD, Jose R. Sañudo PhD, Marc Rodriguez-Niedenführ PhD

Since the 18th century, the existence of ulnar nerve innervation of the medial head of the triceps brachii muscle has been controversial. The evidence for or against such innervation has been based on macroscopic dissection, an unsuitable method for studying intraneural topography or intramuscular branching. The study of smaller specimens (embryos or fetuses) by means of serial histologic sections may resolve the controversy.

Surgical Technique: Spike Translation: A New Modification in Step-cut Osteotomy for Cubitus Varus Deformity

Ali Moradi MD, Ehsan Vahedi MD, Mohammad H. Ebrahimzadeh MD

Various methods of osteotomy have been proposed for the treatment of cubitus varus. We designed a modification of the step-cut osteotomy to achieve more correction of the deformity. We describe this new technique called spike translation step-cut osteotomy and report the clinical and radiographic outcomes (deformity correction, ROM, function, osteotomy healing, complications) in a series of patients treated for cubitus varus using this technique.