Reefing Procedure for Lateral Collateral Ligament Attenuation during Ligamentous Repair for Elbow Trauma

Abstract

Background Injury to the lateral soft tissue structures is common after complex elbow trauma and instability. Typically, this consists of lateral collateral ligamentous complex avulsion from the lateral distal humeral condyle. However, in some cases, attenuation of the ligament midsubstance may also occur, potentially resulting in residual ligamentous laxity after repair.Methods From 2007 to 2011, 37 patients were identified through a current procedural terminology code search as having undergone lateral ulnar collateral ligament (LUCL) repair during surgery for trauma to their elbow and were retrospectively reviewed. ResultsAttenuation of the ligament midsubstance was found in 19% (seven of 37) patients who underwent surgical repair of the LUCL for injuries to the elbow. In these patients, direct repair of the ligament with additional reefing of the ligament midsubstance was performed. Retrospective review of this population revealed no postsurgical instability or need for subsequent stabilizing procedures. ConclusionsThese findings demonstrate that, in select patients, repair with reefing of an attenuated LUCL ligament promotes stability to the elbow.

Technical trick: buttress plate fixation of comminuted capitellum fractures with combined suture repair of the lateral ulnar collateral ligament

“…However, these surgical alternatives are associated with complications such as elbow stiffness, donor site pain, and infection. 14 Our technical trick with the repair of the LUCL to the buttress plate in a running-locking fashion shows promise for favorable functional outcomes. The buttress plate serves as an anchor point in the setting of poor lateral column bone stock for the LUCL.…”