Arthroscopic Reinsertion of Lateral Collateral Ligament, Anterior Capsular Plication, and Coronoid Tunneling Technique for Chronic Elbow Posterolateral Rotatory Instability

Arrigoni, Paolo; D’Ambrosi, Riccardo; Nicoletti, Simone; Randelli, Pietro

doi:10.1016/j.eats.2016.01.031

Cited by 14 publications

(7 citation statements)

References 22 publications

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“…1,2 The main lesion of PLRI is due to injury to the lateral ulnar collateral ligament (LUCL), which is the essential component of the lateral collateral ligament of the elbow, and it resists varus tension and external rotating forces at the ulnohumeral joint. 3 Most frequently LUCL occurs due to trauma. 4 Moreover, its dysfunction may occur as a result of iatrogenic injuries, e.g., surgery of the lateral side of elbow; repeated steroid injections for lateral epicondylitis; or in chronic varus deformity as a complication of a supracondylar fracture of children.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction Surgeries for Management of Posterolateral Rotatory Instability of The Elbow: A Systematic Review

Alrabai¹,

Raizah²

2021

PJMHS

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We aimed to investigate the indications, techniques, and results of lateral ulnar collateral ligament reconstruction (LUCLR) for posterolateral rotatory instability of the elbow (PLRI) by collecting currently available data. Several databases (PUBMED & EMBASE) were explored for articles published between 2010 and 2020. A search strategy was applied. Altogether, 2,583 studies were recovered for possible inclusion. After adjusting for duplicates, revision of methodology, exclusion of non-full text studies, and those in languages other than English, only four studies remained, which included 51 patients, with more males than females (56.9% and 43.1%, respectively). The patients’ mean age was 35.1 years. Eight patients (15.7%) were managed by the Docking technique in one retrospective study, while 43 patients (84.3%) were managed by the trans-osseous technique. Both trans-osseous and Docking techniques are safe and efficient in the management of PLRI cases. The trans-osseous technique has better functional and postoperative results and lesser complications. Mesh Words: posterolateral rotatory instability of the elbow; lateral ulnar collateral ligament reconstruction surgery; systematic review; meta-analysis

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Section: Introductionmentioning

confidence: 99%

Reconstruction Surgeries for Management of Posterolateral Rotatory Instability of The Elbow: A Systematic Review

Alrabai¹,

Raizah²

2021

PJMHS

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“…Arthroscopic fixation of coronoid process fractures through coronoid tunnelling and capsular plication was also recommended. 10 , 11 …”

Section: Introductionmentioning

confidence: 99%

“…1 Most terrible triad injuries are managed surgically, and good results are achievable using a standard treatment protocol that includes fixation of the coronoid fracture, fixation or replacement of the radial head, and repair of the lateral collateral ligament (LCL). [2][3][4][5][6][7][8][9][10] Some patients who demonstrate residual instability after this repair may require additional repair of the medial collateral ligament (MCL) 3 . Despite this knowledge, the optimal approach and treatment strategy for coronoid fractures in terrible triad injuries remains controversial.…”

Section: Introductionmentioning

confidence: 99%

“…Arthroscopic fixation of coronoid process fractures through coronoid tunnelling and capsular plication was also recommended. 10,11 Coronoid fractures are often reported as tip fractures, and anteromedial coronoid fractures in terrible triad injuries have received minimal attention. 6,[12][13][14] However, we have treated a series of terrible triad injuries with anteromedial coronoid fractures through a combinatorial approach.…”

Section: Introductionmentioning

confidence: 99%

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Surgical treatment for terrible triad injury of the elbow with anteromedial coronoid fracture through a combined surgical approach

Liu

et al. 2018

J Int Med Res

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SummaryObjectiveTo report the results of the surgical treatment of terrible triad injury with anteromedial coronoid fracture through a combined surgical approach.MethodsThis retrospective study evaluated data from patients who underwent surgery to repair terrible triad injuries and anteromedial coronoid fractures. Surgical treatment involved radial head repair or replacement, medial and lateral collateral ligament repair, and coronoid fracture fixation through combined approaches. Evaluations were performed using the Mayo Elbow Performance Score (MEPS) and anteroposterior and lateral radiographs of the elbow.ResultsTwenty-two patients (15 males, seven females; mean ± SD age, 47.5 ± 11.4 years) were enrolled in this study. Fracture union and concentric reduction of both the ulnotrochlear and radiocapitellar articulations were achieved in all patients. The mean ± SD follow-up was 31.6 ± 11.9 months. The mean ± SD arc of flexion–extension was 110.3° ± 26.3° and arc of forearm rotation was 139.5° ± 17.1°. The mean ± SD MEPS was 88.1 ± 12.2 points, with results classified as excellent in eight elbows, good in ten, and fair in four. Six patients had radiographic signs of post-traumatic arthritis. Three patients required secondary surgeries.ConclusionCombined surgical approaches can be considered for the treatment of terrible triad injuries in association with anteromedial coronoid fractures.

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“…The ubiquitous lesion of PLRI is injury to the lateral ulnar collateral ligament (LUCL) complex, which resists varus stress and external rotation forces to the ulnohumeral joint. 2 Most commonly, LUCL injury is the result of trauma, such as falling on an outstretched hand. 22 The mechanism typically involves a combination of axial load, valgus force, and supination on the forearm, resulting in the disruption of the LUCL from its humeral origin in most cases.…”

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confidence: 99%

Indications, Outcomes, and Complications of Lateral Ulnar Collateral Ligament Reconstruction of the Elbow for Chronic Posterolateral Rotatory Instability: A Systematic Review

Badhrinarayanan

Desai²,

Watson³

et al. 2020

Am J Sports Med

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Background: Posterolateral rotatory instability (PLRI) of the elbow can lead to pain, recurrent dislocations, and, in the worst-case scenario, disability. Purpose: To report the indications, outcomes, and complication rates of lateral ulnar collateral ligament (LUCL) reconstruction for chronic PLRI of the elbow. Study Design: Systematic review. Methods: This systematic review was registered with PROSPERO and performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The review entailed 17 studies that included 168 patients with isolated LUCL reconstruction for chronic PLRI. Patients with concurrent medial collateral ligament reconstruction were excluded. The primary outcome measures were patient characteristics, indication for surgery, surgical technique, functional outcomes, and complications. Results: Chronic PLRI commonly occurred after a previous traumatic injury (n = 168). Of these, there were 119 simple instabilities (no fracture) and 33 complex instabilities (associated fracture). In 11 patients, PLRI was iatrogenic. The cause was unknown in 5 patients. Grafts used were autograft (n = 102; 61%), allograft (n = 18; 11%), synthetic graft (n = 15; 9%), and unknown (n = 33; 20%). The most common surgical technique was a docking procedure or a modification of this (n = 145; 86%). Other techniques included suture anchors (n = 18; 11%), nonanatomic (n = 1; 0.6%), and unknown (n = 4; 2%). There were 45 complications reported in 37 patients (22%). The most frequent complication was recurrent instability (21/138; 15%). No other major complications were reported. The rate of recurrent instability was significantly higher in revision reconstructions (6/15 elbows; 40%) compared with primary reconstructions (15/123 elbows; 12.2%) ( P = .005). The mean Mayo Elbow Performance Score and abbreviated Disabilities of the Arm, Shoulder and Hand score were 87.5 (range, 40-100) and 18.8 (range, 0-77), respectively. Of the patients in whom range of motion was measured, 134 of 144 patients (93%) regained a functional range (30L–130L). Conclusion: LUCL reconstruction for chronic PLRI proved a reliable method of reconstruction, save for the moderate rate of recurrent instability, which was highest in revision reconstructions.

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Arthroscopic Reinsertion of Lateral Collateral Ligament, Anterior Capsular Plication, and Coronoid Tunneling Technique for Chronic Elbow Posterolateral Rotatory Instability

Cited by 14 publications

References 22 publications

Reconstruction Surgeries for Management of Posterolateral Rotatory Instability of The Elbow: A Systematic Review

Reconstruction Surgeries for Management of Posterolateral Rotatory Instability of The Elbow: A Systematic Review

Surgical treatment for terrible triad injury of the elbow with anteromedial coronoid fracture through a combined surgical approach

Indications, Outcomes, and Complications of Lateral Ulnar Collateral Ligament Reconstruction of the Elbow for Chronic Posterolateral Rotatory Instability: A Systematic Review

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