Monday, April 6, 2020

Elbow PosteroLateral Rotatory Instability Stages

Postero-lateral Rotatory Instability (PLRI) of the elbow

The most common pattern of recurrent elbow instability.
Three stages:

Stage 1:
- Tear / Insufficiency of LUCL
- Postero-lateral subluxation of the radius/ulna on humerus

Stage 2:
- "Perched" dislocation of radius/ulna on humerus
- Coronoid process perched under the tochlea
- Disruption of anterior and posterior joint capsule
- Disruption of the LUCL

Stage 3:
- Complete dislocation of elbow radius/ulna on humerus
- Coronoid process dislocated, positioned behind humerus.
- LUCL, RCL, joint capsule disruption
- MCL disruption
     - Stage 3A: Posterior bundle disrupted ; Anterior bundle intact
     - Stage 3B: Posterior and Anterior bundles disrupted
     - Stage 3C: Disrupted ligaments and tendons on both medial and lateral aspects


Reference:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447645/#!po=73.8636
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5443138/

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