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Prospective clinical results of an additive ligament bracing for stabilizing simple and complex elbow instabilities

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Ligament bracing augments ligament repair using a non-absorbable suture tape. Although biomechanically an increase in primary stability has been proven, there is a lack of clinical evidence. Purpose of this study was to evaluate clinical results of patients treated with ligament bracing due to primary elbow instability, including an analysis of complications. Furthermore, clinical results for patients treated with and without early functional mobilization were compared.

Materials and methods

This prospective case-series evaluated clinical and functional results from patients treated with ligament bracing due to primary elbow instability. Clinical outcome measures were range of motion (ROM) as well as objective and subjective elbow scores [Mayo Elbow Performance Score (MEPS); Disabilities of Arm, Shoulder and Hand Score (DASH score)]. Stability was evaluated sonographically by humero-radial gapping under varus stress.

Results

This study involved 34 patients treated with ligament bracing. After a mean follow-up of 12.9 months ROM was 112° ± 29, MEPS 88 ± 13 points, DASH 91 ± 11 points, and 84% were satisfied with their result. Lateral joint gapping was 2.4 mm. No significant difference was observed regarding a postoperative mobilization with and without limitations. Most common complication after ligament bracing was elbow stiffness including heterotopic ossifications in four patients (12%).

Conclusion

Operatively treated elbow instability with additional ligament bracing results in good clinical outcomes with high patient satisfaction and recovery of elbow stability. The high primary stability of the ligament bracing allows early functional mobilization without bracing, which facilitates postoperative rehabilitation. Elbow stiffness with heterotopic ossification seems to be a potential complication. Furthermore, the optimal tensioning of the ligament bracing remains challenging, including the risk of an over tensioning.

Level of evidence

III.

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Funding

No funding was received for conduction this study.

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Authors and Affiliations

  1. Department for Orthopaedic Surgery and Traumatology, DIAKOVERE Friederikenstift, Humboldtstr. 5, 30169, Hannover, Germany

    Alexander Ellwein, Larissa Janning, Rony-Orijit DeyHazra, Helmut Lill & Gunnar Jensen

  2. Department for Orthopaedic Surgery, Medical School Hannover, DIAKOVERE Annastift, Anna-von-Borries-Straße 1-7, 30625, Hannover, Germany

    Alexander Ellwein & Tomas Smith

Authors
  1. Alexander Ellwein
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  2. Larissa Janning
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  3. Rony-Orijit DeyHazra
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  4. Tomas Smith
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  5. Helmut Lill
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  6. Gunnar Jensen
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Contributions

All authors have substantial contribution to this study. All authors have reviewed and confirmed the accuracy of the whole manuscript before submission.

Corresponding author

Correspondence to Alexander Ellwein.

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Conflict of interest

Helmut Lill is consultant for Arthrex. Alexander Ellwein received speakers’ honorarium from Arthrex. All other authors declare that they have no conflict of interest.

Ethics approval

All work complied with the principles laid down in the 1964 Declaration of Helsinki and its later amendments. The study was approved by the local ethics committee (No. 7583). The study was registered at the German register for clinical studies (DRKS00012813).

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Informed consent was obtained from all individual participants included in the study.

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Ellwein, A., Janning, L., DeyHazra, RO. et al. Prospective clinical results of an additive ligament bracing for stabilizing simple and complex elbow instabilities. Arch Orthop Trauma Surg 142, 3837–3844 (2022). https://doi.org/10.1007/s00402-021-04276-2

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  • DOI: https://doi.org/10.1007/s00402-021-04276-2

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