The Oxford Elbow Score (OES) is an English-language questionnaire specifically designed to evaluate surgical elbow outcomes. This scoring system has been translated into other languages. Given the lack of an Italian version of the OES, the present study was designed to establish, culturally adapt, and validate the Italian version. The OES questionnaire was culturally adapted to Italian patients in accordance with the literature guidelines with a pilot phase including seven patients with elbow problems and seven healthy subjects. The study includes 110 participants from three hospitals, who underwent elbow surgery for acute (70%) or chronic diseases. At least one month after elbow surgery, at the “index visit”, the physician completed the Mayo Elbow Performance Index and patients completed the following questionnaires: the Italian OES, the shortened version of the Disability of Arm, Shoulder and Hand Questionnaire (QuickDASH) and the Short-Form 36 Health Survey. Internal consistency was evaluated using Cronbach's alpha. Reproducibility was assessed using the intraclass correlation coefficient in ten patients who completed the OES again two-three days after the index visit. Construct validity was assessed using Spearman correlation coefficients. Responsiveness was evaluated in 68 patients who answered the questionnaires four months after the index visit, using the Wilcoxon signed-rank test, the effect size and the standardized response mean calculation. Cronbach's alpha was excellent: 0.86 (0.82-0.90) for OES pain, 0.92 (0.90-0.94) for OES function, and 0.90 (0.87-0.93) for OES social/psychological. The intraclass correlation coefficient was 0.94 (0.78-0.98) for OES pain, 0.91 (0.71-0.97) for OES function, 0.95 (0.83-0.98) for OES social-psychological and 0.93 (0.76-0.98) for OES total. The Spearman ρ was >0.7 for OES pain and QuickDASH, for OES function and both QuickDASH and Mayo Elbow Performance Index, and for OES social-psychological and QuickDASH. Regarding responsiveness, the mean of the changes between the two visits ranged from 33.9 for OES pain, to 44 points for OES function and OES social/psychological. The effect size and the standardized response mean were >0.8 for all OES domains. This study demonstrates that the Italian version of the OES, translated in accordance with the international standardized guidelines, is reliable, valid, and responsive in patients who have undergone elbow surgery.

Background/Objectives: Radial head arthroplasty is a commonly preferred treatment for complex, unreconstructable radial head fractures. Recent studies have raised the question of whether factors such as bone resorption may be related to failure. This observational, retrospective, multicenter, spontaneous, and non-profit study aims to assess radiological outcomes, focusing on bone resorption around the stem, for radial head replacement using a modular, cementless radial head prosthesis with interconnected porosity. Methods: A series of 42 cases was available for review. Patients underwent radial head arthroplasty using a three-dimensional-printed radial head prosthesis. Patients were eligible for inclusion if they had undergone at least one follow-up between 6 and 15 months post-operatively. A scoring system to detect bone resorption was developed and administered by two independent evaluators. Results: Forty-two patients (14 males, 28 females), with an average age of 59 ± 11 years (range: 39–80 years), were analyzed with a minimum of six months’ and a maximum of 32 months’ follow-up. At follow-up, 50 radiological evaluations were collected, with 29 showing ≤3 mm and 12 showing 3–6 mm resorption around the stem. The average resorption was 3.5 mm ± 2.3. No correlation was found between the extent of resorption and the time of follow-up. The developed scoring system allowed for a high level of correlation between the evaluators’ measurements of bone resorption. Conclusions: Radial head prosthesis with interconnected porosity provided a low stem resorption rate for patients after a radial head fracture at short-to-mid-term follow-up after the definition of a reliable and easy-to-use radiological-based classification approach. (Level of Evidence: Level IV).

Recalcitrant lateral elbow pain is often associated with minor lateral elbow instability, involving laxity of the radial band of the lateral collateral ligament and the annular ligament. To date, the role of coronoid morphology in this pathology has never been studied. This study aims to investigate the potential relationship between lateral elbow pain and specific morphometric measurements of the coronoid process using flexion computed tomography arthrography. All elbow flexion computed tomography arthrography from the hospital server was retrospectively analyzed. A total of 133 patients were enrolled and divided into 2 groups: 108 with lateral elbow pain and 25 controls. Coronoid flange and width were measured and compared to the radioulnar articular width in both groups. No significant morphometric differences in the coronoid process were found between patients with chronic lateral elbow pain and controls. Other factors, such as capsuloligamentous structures, may have a greater impact on recalcitrant lateral elbow pain compared to the bony morphology of the medial structure of the elbow.

Introduction: Elbow primary stability is guaranteed by the anatomical congruency between the humeral trochlea and the greater sigmoid notch (GSN). Elbow dislocation typically occurs in a semi-extended position, but computed tomography (CT) scans are typically acquired at 90° of elbow flexion, which may misleadingly suggest that the apex of the coronoid aligns with the trochlear center of rotation. This study aims to evaluate the anatomical features of the coronoid and GSN in a dislocated versus non-dislocated group, demonstrating that a more prominent coronoid process is more commonly observed in elbows without dislocation compared to those with dislocation. Materials and Methods: A total of 50 CT scans, equally divided between dislocated elbows and non-dislocated elbows, were analyzed, and the critical coronoid angle (CCA) was measured on a specific slice of the CT scan (level of evidence III). The CCA was calculated from two lines that arise in the center of the GSN, with the first one crossing the coronoid tip and the second parallel to the posterior olecranon cortex. Results: A significant difference in the CCA (p < 0.001) between the two groups was highlighted. In particular, it was found that 14/25 patients from the dislocated elbow group had a CCA below or equal to 27°, and all the non-dislocated subjects had a CCA ≥ 27°. These preliminary results suggest that a CCA ≤ 27° could be a threshold for requiring further imaging of soft tissues or closer follow-up. This may result from either a hypoplastic coronoid process or a decreased concavity of the GSN. Based on the CCA values, a logistic regression model (DAM model) was proposed to associate a coefficient of protection to the CCA, the angle of flexion during dislocation (FdD), and a parameter X, which is a factor that encompasses the contribution of soft tissues. Conclusions: A low CCA is statistically more frequent in dislocated elbows versus non-dislocated ones, creating a specific anatomical condition. The CCA should be carefully evaluated by elbow surgeons to guide patient-specific treatment. The DAM model can permit the stratification of patients eligible for further diagnostic analysis.