Posterolateral Rotatory Instability of the Elbow

Nonoperative Management of Complete Lateral Elbow Ligamentous Disruption in an NFL Player: A Case Report

“…In this case, nonoperative treatment and protection in a hinged elbow brace allowed rapid healing. If surgical management had been chosen, authors recommend return to contact sports after 6 months [10]. In the absence of clinical or radiographic evidence of PLRI despite the extent of his injury to his lateral elbow, we propose that the conservative management of this injury may allow a quicker return to pre-injury level of competition without long-term sequelae.…”

“…When symptomatic, most authors recommend surgery to reconstruct the LUCL [1,9,10]. The most common causes of lateral ligament disruption are elbow dislocation and iatrogenic surgical release [10]. Although medial elbow ligamentous injuries are commonly associated with sports, particularly overuse injuries in throwing athletes, lateral ligament injuries have rarely been described in competitive athletes.…”

“…Once these ligaments are disrupted, PRLI can lead to a variety of symptoms including clicking, locking, weakness, and functional disability. When symptomatic, most authors recommend surgery to reconstruct the LUCL [1,9,10]. The most common causes of lateral ligament disruption are elbow dislocation and iatrogenic surgical release [10].…”

Reinvestigation of the Morphological Characteristics of the Lateral Ulnar Collateral Ligament in Humans

“…Because the LUCL was attached to the AL, it could be thought the LUCL protects the radial head like a hammock, and thus the radial head and the ulna to prevent its subluxation; it is considered to be the principal constraint of the elbow joint against PLRI 6,17,19,20) . In the literature on the insertion on the ulna, numerous studies have reported that the insertion of the LUCL was located at the supinator crest 5,17) ; however, a few studies pointed out that the relationship between the LUCL and the lesser sigmoid notch were also important 3,19) . In this study, the LUCL insertion at the ulna was found to be attached from the lesser sigmoid notch to the supinator crest, and the proximal end of the LUCL insertion was located approximately 7.0 mm distal to the radial head border, showing that both the supinator crest and the lesser sigmoid notch could be useful as osseous landmarks.…”

“…In biomechanical studies, the tunnel should be placed 16-20 mm distal to the radial head 1,2,10,14,19,[21][22][23][24] . On the other hand, Cohen et al suggested that the two bone tunnels should be placed at the proximal margin of the radial head and 15-20 mm distal to it 25) .…”