Romain Bilger1, Pierre Laumonerie2,3, Hugo Barret2, Franck Lapègue4, Pierre Mansat2, Nicolas Sans4, Marie Faruch-Bilfeld4. 1. Service d'Imagerie Ostéoarticulaire, Centre Hospitalier Universitaire de Toulouse, Allée Jean Dausset, 31300, Toulouse, France. bilger.romain@hotmail.fr. 2. Service de Chirurgie Orthopédique, Centre Hospitalier Universitaire de Toulouse, Allée Jean Dausset, 31300, Toulouse, France. 3. Service de Chirurgie Orthopédique, Hôpital Pellegrin, 33000, Bordeaux, France. 4. Service d'Imagerie Ostéoarticulaire, Centre Hospitalier Universitaire de Toulouse, Allée Jean Dausset, 31300, Toulouse, France.
Abstract
PURPOSE: To evaluate whether ultrasonography can be used to explore the medial and lateral ligament structures during the acute phase of a closed elbow injury. METHODS: A single-center, prospective study performed between December 2019 and June 2020, including patients who suffered a radial head fracture or elbow dislocation. Two radiologists did a blinded analysis using ultrasonography of visibility, injury grade, and presence of bone avulsion for the radial collateral ligament (RCL), lateral ulnar collateral ligament (LUCL), annular ligament (AL), and anterior (MCLant) and posterior bundles (MCLpost) of the medial collateral ligament. The inter-rater agreement was calculated. The ultrasonography findings were compared with the intraoperative findings in the patients who subsequently underwent surgery. RESULTS: Forty patients were included (28 radial head fractures and 12 elbow dislocations). The inter-rater agreement was strong for all the study parameters (kappa between 0.65 and 1), except for the visibility of the LUCL (kappa 0.52) and the visibility and appearance of the MCLpost (kappa 0.54 and 0.47, respectively). The injured ligaments were thicker than their contralateral counterparts (p < 0.05). In the 10 patients who underwent surgery, the radiological-surgical correlation was 100% for the RCL and medial ligaments and 70% for the LUCL. CONCLUSION: Ultrasonography is a reproducible examination that can be used to assess the damage to elbow ligaments during the acute phase following an injury. This examination could be incorporated into the exploration protocol for elbow injuries during the preoperative assessment and to adapt the treatment.
PURPOSE: To evaluate whether ultrasonography can be used to explore the medial and lateral ligament structures during the acute phase of a closed elbow injury. METHODS: A single-center, prospective study performed between December 2019 and June 2020, including patients who suffered a radial head fracture or elbow dislocation. Two radiologists did a blinded analysis using ultrasonography of visibility, injury grade, and presence of bone avulsion for the radial collateral ligament (RCL), lateral ulnar collateral ligament (LUCL), annular ligament (AL), and anterior (MCLant) and posterior bundles (MCLpost) of the medial collateral ligament. The inter-rater agreement was calculated. The ultrasonography findings were compared with the intraoperative findings in the patients who subsequently underwent surgery. RESULTS: Forty patients were included (28 radial head fractures and 12 elbow dislocations). The inter-rater agreement was strong for all the study parameters (kappa between 0.65 and 1), except for the visibility of the LUCL (kappa 0.52) and the visibility and appearance of the MCLpost (kappa 0.54 and 0.47, respectively). The injured ligaments were thicker than their contralateral counterparts (p < 0.05). In the 10 patients who underwent surgery, the radiological-surgical correlation was 100% for the RCL and medial ligaments and 70% for the LUCL. CONCLUSION: Ultrasonography is a reproducible examination that can be used to assess the damage to elbow ligaments during the acute phase following an injury. This examination could be incorporated into the exploration protocol for elbow injuries during the preoperative assessment and to adapt the treatment.
Authors: Laurens Kaas; Jeroen L Turkenburg; Roger P van Riet; Jos P A M Vroemen; Denise Eygendaal Journal: Acta Orthop Date: 2010-06 Impact factor: 3.717
Authors: Aureliano Torquato Brandão; Edson Amaro Junior; Miguel José Francisco Neto; Rubens Mitsuo Tanaka; Durval do Carmo Barros Santos; Frederico Celestino Miranda; Antonio Rahal Junior; Laercio Alberto Rosemberg Journal: Einstein (Sao Paulo) Date: 2019-06-03