Lateral Epicondyle Ligament Tears: Causes, Symptoms, and Treatment

Regarding the avulsion fracture of the lateral collateral ligament of the left elbow?

Hello, Doctor.
I was involved in a motorcycle collision previously.
On the day of the incident, I took the other party to the emergency room, where X-rays were taken.
The emergency physician stated that there were no obvious issues, only minor contusions or abrasions.
However, the other party later visited an orthopedic specialist a week later and received a diagnosis certificate stating a specific condition, demanding compensation of 700,000.
I have requested the court to send a letter to the hospital questioning why the X-ray showed no issues on that day, yet later indicated a problem.
The response I received stated that there were no obvious issues in the emergency room, but hidden injuries could not be ruled out.
A week later, they discovered a tear of the lateral collateral ligament of the left elbow with an associated fracture.
Is this possible? I searched online but couldn't find the same diagnosis.
Is it similar to tennis elbow? Could it be chronic, or is it always caused by acute trauma? What are the related symptoms? What is the golden treatment period? How long is the healing time approximately? I am truly facing a difficult situation in my life, and I would greatly appreciate your clarification and any relevant medical knowledge you can provide.
Thank you very much!

Miss Jian, 30~39 year old female. Ask Date: 2016/08/19

Dr. Shi Guozheng reply Orthopedics

Lateral humeral epicondylar avulsion fractures can be treated by fixing larger bone fragments with bone screws, which can lead to good functional outcomes.
The ideal surgical intervention typically occurs around two weeks post-injury.
Unlike tennis elbow, which is usually caused by chronic overuse, these fractures are typically the result of acute trauma.
If the surgery is successful, recovery can be expected in about three months.

Reply Date: 2016/08/19

More Info

Lateral epicondyle ligament tears, often referred to in the context of lateral epicondylitis or "tennis elbow," are injuries that can occur due to acute trauma or chronic overuse. Understanding the causes, symptoms, and treatment options for this condition is crucial, especially in light of your recent motorcycle accident and the subsequent legal implications.

Causes
Lateral epicondyle ligament tears can arise from two primary mechanisms: acute injury and chronic overuse. In your case, the motorcycle accident could have resulted in an acute injury, where the force of the impact may have caused a tear in the ligaments or tendons around the elbow. The fact that the emergency physician did not find any immediate issues on the X-ray does not rule out the possibility of soft tissue injuries, which are not always visible on standard X-rays.
Chronic overuse injuries, on the other hand, typically develop over time due to repetitive motions, such as those seen in sports like tennis, hence the name "tennis elbow." This condition is characterized by inflammation and micro-tears in the tendons that attach to the lateral epicondyle of the humerus.

Symptoms
The symptoms of a lateral epicondyle ligament tear can include:
- Pain on the outer part of the elbow, which may radiate down the forearm.

- Weakness in the grip or difficulty in performing tasks that require wrist extension.

- Swelling or tenderness around the elbow joint.

- Stiffness, particularly in the morning or after periods of inactivity.

In your situation, if you are experiencing persistent pain or weakness in the elbow following the accident, it is possible that a ligament tear or other soft tissue injury has developed, even if it was not immediately apparent.

Diagnosis
Diagnosis typically involves a thorough clinical examination and may include imaging studies such as MRI, which can provide a clearer picture of soft tissue injuries. If the initial X-ray did not show any fractures, it is still possible for a ligament tear to have occurred, which might explain the delayed symptoms.

Treatment
The treatment for lateral epicondyle ligament tears generally includes:
1. Rest and Activity Modification: Avoiding activities that exacerbate the pain is crucial.

2. Physical Therapy: A physical therapist can provide exercises to strengthen the muscles around the elbow and improve flexibility.

3. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.

4. Bracing: A forearm brace can help alleviate strain on the elbow during activities.

5. Injections: Corticosteroid injections may be considered for persistent pain.

6. Surgery: In severe cases where conservative treatments fail, surgical intervention may be necessary to repair the torn ligaments.

Healing Time
The healing time for a lateral epicondyle ligament tear can vary significantly based on the severity of the injury and the treatment approach. Generally, acute injuries may take several weeks to a few months to heal, while chronic conditions may require a longer rehabilitation period.

Conclusion
In summary, it is indeed possible for a lateral epicondyle ligament tear to develop after an acute injury, even if initial evaluations did not reveal significant issues. The symptoms you are experiencing could be related to this injury, and it is advisable to seek further evaluation from an orthopedic specialist. They can provide a comprehensive assessment and recommend appropriate treatment options tailored to your specific condition.
If you are facing legal challenges regarding this injury, having a thorough medical evaluation and documentation of your condition will be essential in addressing any claims made against you. It is important to keep records of all medical visits, treatments, and any changes in your symptoms as this information may be crucial in your case.

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