Patrick W Joyner1, Jeremy Bruce2, Ryan Hess3, Arron Mates4, Frederic Baker Mills5, James R Andrews6. 1. Bone & Joint/Sports Medicine Institute, Naval Medical Center Portsmouth, Portsmouth, VA, USA. Electronic address: patrick.w.joyner4.mil@mail.mil. 2. Erlanger Health System, University of Tennessee College of Medicine, Chattanooga, TN, USA. 3. University Specialty Clinics, University of South Carolina School of Medicine, Columbia, SC, USA. 4. College of Medicine, The University of South Alabama, Mobile, AL, USA. 5. The University of South Carolina School of Medicine, Columbia, SC, USA. 6. The Andrews Institute for Orthopaedics & Sports Medicine, Gulf Breeze, FL, USA.
Abstract
BACKGROUND: Magnetic resonance imaging (MRI) arthrography has been considered the gold standard for imaging ulnar collateral ligament (UCL) injuries. No classification system has been described for UCL tears to help discuss and guide treatment options. We propose that an MRI-based UCL classification system would correlate with valgus laxity and help predict surgical management. METHODS: The MRIs from 240 patients who underwent UCL reconstruction were reviewed and classified according to a system based on severity and location of the UCL injury. Bilateral elbow valgus stress radiographs were used to compare the amount of valgus laxity associated with each grade of UCL injury. Additional data from the imaging review included intraligamentous calcifications, T-sign presence, and a newly described "vacuum sign." RESULTS: The amount of valgus stress opening increased with the classification severity as follows: type I, 0.13 mm; type II, 0.20 mm; type III, 0.63 mm; and type IV, 0.76 mm. CONCLUSIONS: We propose a new classification for UCL injuries based on MRI findings that helps predict valgus laxity, improve communication, and guide treatment for UCL pathology in throwing athletes. Published by Elsevier Inc.
BACKGROUND: Magnetic resonance imaging (MRI) arthrography has been considered the gold standard for imaging ulnar collateral ligament (UCL) injuries. No classification system has been described for UCL tears to help discuss and guide treatment options. We propose that an MRI-based UCL classification system would correlate with valgus laxity and help predict surgical management. METHODS: The MRIs from 240 patients who underwent UCL reconstruction were reviewed and classified according to a system based on severity and location of the UCL injury. Bilateral elbow valgus stress radiographs were used to compare the amount of valgus laxity associated with each grade of UCL injury. Additional data from the imaging review included intraligamentous calcifications, T-sign presence, and a newly described "vacuum sign." RESULTS: The amount of valgus stress opening increased with the classification severity as follows: type I, 0.13 mm; type II, 0.20 mm; type III, 0.63 mm; and type IV, 0.76 mm. CONCLUSIONS: We propose a new classification for UCL injuries based on MRI findings that helps predict valgus laxity, improve communication, and guide treatment for UCL pathology in throwing athletes. Published by Elsevier Inc.
Authors: Frederic Baker Mills; Anuruddh K Misra; Nicholas Goyeneche; Joshua G Hackel; James R Andrews; Patrick W Joyner Journal: Orthop J Sports Med Date: 2021-03-17
Authors: Elisabetta Antonia Nocerino; Davide Cucchi; Paolo Arrigoni; Marco Brioschi; Cristiano Fusi; Eugenio A Genovese; Carmelo Messina; Pietro Randelli; Carlo Masciocchi; Alberto Aliprandi Journal: Acta Biomed Date: 2018-01-19
Authors: Prem N Ramkumar; Heather S Haeberle; Sergio M Navarro; Salvatore J Frangiamore; Lutul D Farrow; Mark S Schickendantz Journal: Orthop J Sports Med Date: 2019-04-26