Presentation
High-energy impact of the elbow during a ski race fall with outstretched hand. Intense pain on the lateral side immediately after a fall with clicking sound when patient extend the arm.
Patient Data
X ray left elbow
Presence of a small bone fragment near the upper margin of the radial head. There is no anterior and posterior “sail sign” as for joint effusion. No sign of dislocation.
MRI left elbow
Proximal complete avulsion of lateral collateral ligament complex (LCL) with an avulsed thin fragment of the lateral epicondyle but the conjoined extensor tendon is not involved. Normal the medial collateral ligament complex and the annular ligament. There's joint effusion with bone marrow edema of lateral epicondyle and a small distraction lesion of the lateral head of the triceps brachii muscle.
Surgical report
Italian English translation
Suture of the external collateral ligament (ulnar component only) with 1 press FT 2.6 mm twin tail in arthrotomy
Case Discussion
Acute care treatment of lateral collateral ligament complex (LCL) injuries is dictated by the treatment of the elbow dislocation which is often its cause. However primary repair is indicated in acute injuries. The LCL tear can give elbow instability.
Case courtesy of Dr.ssa Laura Braccaioli
Radiographer: TSRM Fabio Imola
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