The varus posteromedial rotatory instability (VPMRI) of the elbow involves combined anteromedial coronoid fracture and lateral collateral ligament injury, producing a characteristic instability pattern distinct from PLRI.
The anteromedial coronoid facet and the lateral collateral ligament together provide the primary constraint against varus-posteromedial rotation — their combined failure produces the VPMRI pattern.
VPMRI injury (O'Driscoll type II coronoid fracture with LCL disruption) requires combined anteromedial coronoid fixation and LCL repair/reconstruction for stability. Isolated coronoid fixation without LCL repair fails to address the complete instability.
Combined anteromedial coronoid ORIF and lateral collateral ligament repair for varus posteromedial rotatory instability, addressing both structural components of this complex elbow injury pattern.
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