Abstract
Recent studies have found that the radial collateral ligament (RCL) plays a key role in the lateral stability of the elbow joint, and there is no truly isometric location for LUCL tendon graft reconstruction tunnels using the original technique. However, no report has been issued on the treatment including RCL reconstruction and the modification of LUCL reconstruction in patients with posterolateral rotatory instability (PLRI). Three patients with PLRI were treated using two different ways and produced good results. First, dual reconstruction of the LUCL and RCL was performed, and second, the insertion of the reconstructed LUCL was shifted to the AL instead of to the original ulna to produce a more flexible isometric point setting. We want to report on the management of PLRI by dual reconstruction of the RCL and LUCL and a modification of the original technique of LUCL reconstruction.
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References
Charalambous CP, Stanley JK (2008) Posterolateral rotatory instability of the elbow. J Bone Joint Surg (Br) 90:272–279
Cheung EV (2008) Chronic lateral elbow instability. Orthop Clin North Am 39:221–228
Cohen MS, Bruno RJ (2001) The collateral ligaments of the elbow: anatomy and clinical correlation. Clin Orthop Relat Res 383:123–130
Cohen MS, Hasting H II (1997) Rotatory instability of the elbow: the anatomy and role of the lateral stabilizers. J Bone Joint Surg (Am) 79:225–233
Cohen MS (2008) Lateral collateral ligament instability of the elbow. Hand Clin 24:69–77
Dunning CD, Zarzour ZDS, Pattersson SD, Johnson JA, King GJW (2001) Ligamentous stabilizers against posterolateral rotatory instability of the elbow. J Bone Joint Surg (Am) 83:1823–1828
Galik K, Baratz ME, Butler AL, Doughrerty J, Cohen MS, Miller MC (2007) The effect of the annular ligament on kinematics of the radial head. J Hand Surg (Am) 32:1218–1224
Goren D, Budoff JE, Hipp JA (2010) Isometric placement of lateral ulnar collateral ligament reconstructions: a biomechanical study. Am J Sports Med 38:153–159
Hall JA, McKee MD (2005) Posterolateral rotatory instability of the elbow following radial head resection. J Bone Joint Surg (Am) 87:1571–1579
Jeon IH, Micic ID, Yamamoto N, Morrey BF (2008) Osborne-cotterill lesion: an osseous defect of the capitellum associated with instability of the elbow. AJR Am J Roentgenol 191:727–729
Lee BPH, Teo LHY (2003) Surgical reconstruction for posterolateral rotatory instability of the elbow. J Should Elbow Surg 12:476–479
McAdams TR, Masters GW, Srivastava S (2005) The effect of arthroscopic sectioning of the lateral ligament complex of the elbow on posterolateral rotatory stability. J Should Elbow Surg 14:298–301
Moritomo H, Murase T, Arimitsu S, Oka K, Yoshikawa H, Sugamoto K (2007) The in vivo isometric point of the lateral ligament of the elbow. J Bone Joint Surg (Am) 89:2011–2017
Nestor BJ, O’Driscoll SW, Morrey BF (1992) Ligamentous reconstruction for posterolateral rotatory instability of the elbow. J Bone Joint Surg (Am) 74:1235–1241
O’Driscol SW, Bell DF, Morrey BF (1991) Posterolateral rotatory instability of the elbow. J Bone Joint Surg (Am) 73:440–446
O’Driscoll SW (2007) Reconstruction of the lateral collateral ligament. In: Yamaguchi K, King GJW, Mckee MD, O’Driscoll SW (eds) Advanced reconstruction: elbow. AAOS, pp 159–165
Olsen BS, SØjbjerg JO, Dalstra M, Sneppen O (1996) Kinematics of the lateral ligamentous constraints of the elbow joint. J Should Elbow Surg 5:333–341
Olsen BS, SØjbjerg JO, Dalstra M, Sneppen O (1996) Lateral collateral ligament of the elbow joint: anatomy and kinematics. J Should Elbow Surg 5:103–112
Safran MR, Baillargeon D (2005) Soft-tissue stabilizers of the elbow. J Should Elbow Surg 14:179S–185S
Sanchez-Sotelo J, Morrey BF, O’Driscoll SW (2005) Ligamentous repair and reconstruction for posterolateral rotatory instability of the elbow. J Bone Joint Surg (Br) 87:54–61
Savoie FH III, Field LD, Gurley DJ (2009) Arthroscopic and open radial ulnohumeral ligament reconstruction for posterolateral rotatory instability of the elbow. Hand Clin 25:323–329
Schneeberger AG, Sadowski MM, Jacob HA (2004) Coronoid process and radial head as posterolateral rotatory stabilizers of the elbow. J Bone Joint Surg (Am) 86:975–978
Seki A, Olse BS, Jensen SL, Eygendaal D, SØjbjerg JO (2002) Functional anatomy of the lateral collateral ligament complex of the elbow: configuration of Y and its role. J Should Elbow Surg 11:53–59
Takahashi K, Minami A, Kato H, Kasajima T, Hirachi K (1997) Anatomical study of lateral ligament complex of the elbow. J Jpn Elbow Soc 4:15–16
Takigawa N, Ryu J, Kinoshita KM, Abe M (2005) Functional anatomy of the lateral collateral ligament complex of the elbow: morphology and strain. J Hand Surg (Br) 30:143–147
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Rhyou, I.H., Park, M.J. Dual reconstruction of the radial collateral ligament and lateral ulnar collateral ligament in posterolateral rotator instability of the elbow. Knee Surg Sports Traumatol Arthrosc 19, 1009–1012 (2011). https://doi.org/10.1007/s00167-010-1310-2
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DOI: https://doi.org/10.1007/s00167-010-1310-2