{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T21:07:46Z","timestamp":1773608866669,"version":"3.50.1"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Musculoskelet Radiol"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The stability of the elbow is based on a combination of primary (static) and secondary stabilizers (dynamic). In varus stress, the bony structures and the lateral ulnar collateral ligament (LUCL) are the primary stabilizers, and in valgus stress, the ulnar collateral ligament (UCL) is the primary stabilizer. The flexor and extensor tendons crossing the elbow joint act as secondary stabilizers. Elbow instability is commonly divided into acute traumatic and chronic instability. Instability of the elbow is a continuum, with complete dislocation as its most severe form.<\/jats:p><jats:p>Posterolateral rotatory instability is the most common elbow instability and can be detected at imaging both in the acute as well as the chronic phase. Imaging of suspected elbow instability starts with radiographs. Depending on the type of injury suspected, it is followed by magnetic resonance imaging (MRI) or computed tomography evaluation for depiction of a range of soft tissue and osseous injures. The most common soft tissue injuries are tears of the LUCL and the radial collateral ligament; the most common osseous injuries are an osseous LUCL avulsion, a fracture of the coronoid process, and a radial head fracture.<\/jats:p><jats:p>Valgus instability is the second most common instability and mostly detected in the chronic phase, with valgus extension overload the dominant pattern of injury. The anterior part of the UCL is insufficient in valgus extension overload due to repetitive medial tension seen in many overhead throwing sports, with UCL damage readily seen at MRI.<\/jats:p>","DOI":"10.1055\/s-0041-1735467","type":"journal-article","created":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T22:30:30Z","timestamp":1635373830000},"page":"574-579","source":"Crossref","is-referenced-by-count":7,"title":["Elbow Instability"],"prefix":"10.1055","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2858-0030","authenticated-orcid":false,"given":"Dimitri N.","family":"Graf","sequence":"additional","affiliation":[{"name":"Department of Radiology, Balgrist University Hospital, Zurich, Switzerland"},{"name":"Faculty of Medicine, University of Zurich, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Fritz","sequence":"additional","affiliation":[{"name":"Department of Radiology, Balgrist University Hospital, Zurich, Switzerland"},{"name":"Faculty of Medicine, University of Zurich, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samy","family":"Bouaicha","sequence":"additional","affiliation":[{"name":"Department of Radiology, Balgrist University Hospital, Zurich, Switzerland"},{"name":"Faculty of Medicine, University of Zurich, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reto","family":"Sutter","sequence":"additional","affiliation":[{"name":"Department of Radiology, Balgrist University Hospital, Zurich, Switzerland"},{"name":"Faculty of Medicine, University of Zurich, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,10,27]]},"reference":[{"key":"ref1","first-page":"144","volume-title":"MRI of the Elbow. ESSR Sports Imaging Subcommittee","author":"R Sutter","year":"2018"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"872","DOI":"10.2106\/00004623-198163060-00002","article-title":"A biomechanical study of normal functional elbow motion","volume":"63","author":"B F Morrey","year":"1981","journal-title":"J Bone Joint Surg Am"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/S1058-2746(09)80053-0","article-title":"Stabilizers of the elbow","volume":"2","author":"G J King","year":"1993","journal-title":"J Shoulder Elbow Surg"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jhsa.2016.11.025","article-title":"Elbow instability: anatomy, biomechanics, diagnostic maneuvers, and testing","volume":"42","author":"L E Karbach","year":"2017","journal-title":"J Hand Surg Am"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S0030-5898(05)70061-4","article-title":"Acute elbow dislocations: simple and complex","volume":"30","author":"K A Hildebrand","year":"1999","journal-title":"Orthop Clin North Am"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"240","DOI":"10.2106\/JBJS.J.01663","article-title":"Incidence of elbow dislocations in the United States population","volume":"94","author":"J W Stoneback","year":"2012","journal-title":"J Bone Joint Surg Am"},{"issue":"S 01","key":"ref7","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s12306-016-0424-1","article-title":"Elbow instability: are we able to classify it? Review of the literature and proposal of an all-inclusive classification system","volume":"100","author":"A Marinelli","year":"2016","journal-title":"Musculoskelet Surg"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1148\/radiol.2521081614","article-title":"Elbow nerves: MR findings in 60 asymptomatic subjects\u2014normal anatomy, variants, and pitfalls","volume":"252","author":"D B Husarik","year":"2009","journal-title":"Radiology"},{"issue":"10","key":"ref9","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1007\/s00402-007-0424-6","article-title":"Dislocation of the elbow with fractures of the coronoid process and radial head","volume":"127","author":"T K\u00e4licke","year":"2007","journal-title":"Arch Orthop Trauma Surg"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"15","DOI":"10.5435\/00124635-199801000-00002","article-title":"Acute elbow dislocation: evaluation and management","volume":"6","author":"M S Cohen","year":"1998","journal-title":"J Am Acad Orthop Surg"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.ocl.2007.12.004","article-title":"Acute elbow dislocations","volume":"39","author":"M A Kuhn","year":"2008","journal-title":"Orthop Clin North Am"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"440","DOI":"10.2106\/00004623-199173030-00015","article-title":"Posterolateral rotatory instability of the elbow","volume":"73","author":"S W O'Driscoll","year":"1991","journal-title":"J Bone Joint Surg Am"},{"issue":"370","key":"ref13","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/00003086-200001000-00005","article-title":"Classification and evaluation of recurrent instability of the elbow","author":"S W O'Driscoll","year":"2000","journal-title":"Clin Orthop Relat Res"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"225","DOI":"10.2106\/00004623-199702000-00010","article-title":"Rotatory instability of the elbow. The anatomy and role of the lateral stabilizers","volume":"79","author":"M S Cohen","year":"1997","journal-title":"J Bone Joint Surg Am"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.jse.2004.08.003","article-title":"The effect of arthroscopic sectioning of the lateral ligament complex of the elbow on posterolateral rotatory stability","volume":"14","author":"T R McAdams","year":"2005","journal-title":"J Shoulder Elbow Surg"},{"issue":"12","key":"ref16","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.2106\/00004623-200112000-00009","article-title":"Ligamentous stabilizers against posterolateral rotatory instability of the elbow","volume":"83","author":"C E Dunning","year":"2001","journal-title":"J Bone Joint Surg Am"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/S0278-5919(05)70245-3","article-title":"Valgus instability of the elbow in athletes","volume":"20","author":"J Hyman","year":"2001","journal-title":"Clin Sports Med"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/S0278-5919(20)30807-3","article-title":"The diagnosis and nonoperative treatment of shoulder injuries in athletes","volume":"8","author":"F W Jobe","year":"1989","journal-title":"Clin Sports Med"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"67","DOI":"10.2106\/00004623-199274010-00009","article-title":"Medial instability of the elbow in throwing athletes. Treatment by repair or reconstruction of the ulnar collateral ligament","volume":"74","author":"J E Conway","year":"1992","journal-title":"J Bone Joint Surg Am"},{"key":"ref20","volume-title":"Nursemaid Elbow. Treasure Island","author":"N M Nardi","year":"2020"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"727","DOI":"10.2214\/AJR.07.3739","article-title":"Osborne-Cotterill lesion: an osseous defect of the capitellum associated with instability of the elbow","volume":"191","author":"I H Jeon","year":"2008","journal-title":"AJR Am J Roentgenol"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1302\/0301-620X.48B2.340","article-title":"Recurrent dislocation of the elbow","volume":"48","author":"G Osborne","year":"1966","journal-title":"J Bone Joint Surg Br"},{"issue":"11","key":"ref23","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1016\/j.jhsa.2015.04.039","article-title":"Terrible triad injuries of the elbow","volume":"40","author":"N C Chen","year":"2015","journal-title":"J Hand Surg Am"},{"issue":"04","key":"ref24","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.csm.2010.07.001","article-title":"Valgus extension overload: diagnosis and treatment","volume":"29","author":"J R Dugas","year":"2010","journal-title":"Clin Sports Med"},{"issue":"12","key":"ref25","doi-asserted-by":"crossref","first-page":"3019","DOI":"10.1177\/0363546518801914","article-title":"Comparative efficacy and safety of nonsurgical treatment options for enthesopathy of the extensor carpi radialis brevis: a systematic review and meta-analysis of randomized placebo-controlled trials","volume":"47","author":"J Lian","year":"2019","journal-title":"Am J Sports Med"},{"issue":"06","key":"ref26","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1177\/1941738115607208","article-title":"Ulnar collateral ligament reconstruction: anatomy, indications, techniques, and outcomes","volume":"7","author":"B J Erickson","year":"2015","journal-title":"Sports Health"},{"issue":"06","key":"ref27","doi-asserted-by":"crossref","first-page":"W515","DOI":"10.2214\/AJR.09.3741","article-title":"Elbow stiffness: effectiveness of conventional radiography and CT to explain osseous causes","volume":"194","author":"V Zubler","year":"2010","journal-title":"AJR Am J Roentgenol"}],"container-title":["Seminars in Musculoskeletal Radiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1735467.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T00:02:26Z","timestamp":1637280146000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1735467"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":27,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2021,10,27]]},"published-print":{"date-parts":[[2021,8]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1735467","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1089-7860","1098-898X"],"issn-type":[{"value":"1089-7860","type":"print"},{"value":"1098-898X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8]]}}}