Research status of diagnosis and treatment of varus-posteromedial rotatory instability of the elbow joint.

J Hand Microsurg · Mar 2026 · Review

Wang GY, Hu JN, Zhai RK, Mai Tu di MMTY, Tian X, Dong JM

Tianjin Hospital, Trauma Upper limb Department, No.2, China

Hand & Upper Extremity Shoulder & Elbow

SUMMARY — THE REDUCTIONThis review covers diagnosis and conservative and surgical management of varus-posteromedial rotatory instability of the elbow, stressing early recognition to avoid arthritis, stiffness, and other long-term complications.
Abstract, as published

BACKGROUND: Varus-posteromedial rotatory instability (VPMRI) of the elbow is a relatively uncommon yet significant injury that can often present with subtle clinical symptoms, such as mild joint misalignment. These initial symptoms may be easily overlooked or misdiagnosed, especially in the absence of overt signs of instability. As a result, the injury is frequently missed in early stages, leading to improper or delayed treatment. If left untreated, VPMRI can result in severe long-term complications, including rapid joint degeneration, traumatic arthritis, heterotopic ossification, elbow stiffness, and ulnar nerve entrapment. The progressive nature of these issues can lead to permanent functional impairment and reduced quality of life.

METHODS: A comprehensive literature review was performed to investigate the study objective.

RESULTS: By examining both conservative and surgical interventions, the review provides a comprehensive understanding of this injury, emphasizing the importance of early diagnosis and appropriate management. Understanding the specific forces involved, such as axial loading, varus stress, and forearm pronation, is crucial for developing effective treatment strategies.

CONCLUSION: Early intervention can prevent long-term complications and improve functional outcomes, making timely and accurate diagnosis essential for optimal care.

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