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Sublime tubercle avulsion

Case contributed by Liz Silverstone
Diagnosis almost certain

Presentation

Elbow injury

Patient Data

Age: 40 years
Gender: Male
x-ray

Minimally displaced small avulsion fracture of the sublime tubercle at the medial margin of the coronoid process.

Minor distension of the elbow joint capsule: displaced anterior and posterior fat pads.

Case Discussion

An uncommon but under-recognized injury, typically occurring in throwing athletes as an acute injury or due to repetitive stress.

The anterior bundle of the ulnar collateral ligament is the primary stabilizer for valgus elbow stress. It originates from the anteroinferior medial epicondyle of the humerus and inserts into the sublime tubercle.

MRI is diagnostic.

Conservative treatment frequently results in chronic valgus instability and pain.

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