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

  • Case Report/CME Article
  • Published:
HSS Journal

Abstract

Disruptions of the lateral soft tissue restraints of the elbow, including the lateral ulnar collateral ligament, are a well-recognized clinical entity which may result in chronic elbow instability. When symptomatic, most authors recommend surgery to reconstruct the LUCL. We report on a case of a professional football player who sustained complete disruption of the lateral collateral ligamentous complex from the lateral humeral epicondyle with extension of his injury into his common extensor origin. He was treated conservatively and returned to play after 4 weeks. Treatment algorithm and a review of the literature are discussed.

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References

  1. O’Driscoll SW, Bell DF, Morrey BF (1991) Posterolateral rotatory instability of the elbow. J. Bone Joint Surg. Am. 73(3):440–446

    PubMed  Google Scholar 

  2. Dunning CE, Zarzour ZD, Patterson SD, Johnson JA, King GJ (2001) Ligamentous stabilizers against posterolateral rotatory instability of the elbow. J. Bone Joint Surg. Am. 83-A(12):1823–1828

    CAS  PubMed  Google Scholar 

  3. Hannouche D, Begue T (1999) Functional anatomy of the lateral collateral ligament complex of the elbow. Surg. Radiol. Anat. 21(3):187–191

    Article  CAS  PubMed  Google Scholar 

  4. Imatani J, Ogura T, Morito Y, Hashizume H, Inoue H (1999) Anatomic and histologic studies of lateral collateral ligament complex of the elbow joint. J. Shoulder Elbow Surg. 8(6):625–627

    Article  CAS  PubMed  Google Scholar 

  5. 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. Shoulder Elbow Surg. 14(3):298–301

    Article  PubMed  Google Scholar 

  6. Morrey BF, An KN (1985) Functional anatomy of the ligaments of the elbow. Clin. Orthop. Relat. Res. 201(201):84–90

    PubMed  Google Scholar 

  7. Morrey BF, An KN (1983) Articular and ligamentous contributions to the stability of the elbow joint. Am. J. Sports Med. 11(5):315–319

    Article  CAS  PubMed  Google Scholar 

  8. Seki A, Olsen BS, Jensen SL, Eygendaal D, Sojbjerg JO (2002) Functional anatomy of the lateral collateral ligament complex of the elbow: configuration of Y and its role. J. Shoulder Elbow Surg. 11(1):53–59

    Article  PubMed  Google Scholar 

  9. Cohen MS, Bruno RJ (2001) The collateral ligaments of the elbow: anatomy and clinical correlation. Clin. Orthop. Relat. Res. 383(383):123–130

    Article  PubMed  Google Scholar 

  10. Mehta JA, Bain GI (2004) Posterolateral rotatory instability of the elbow. J. Am. Acad. Orthop. Surg. 12(6):405–415

    PubMed  Google Scholar 

  11. Kenter K, Behr CT, Warren RF, O’Brien SJ, Barnes R (2000) Acute elbow injuries in the National Football League. J. Shoulder Elbow Surg. 9(1):1–5

    Article  CAS  PubMed  Google Scholar 

  12. Cohen MS, Hastings H 2nd (1997) Rotatory instability of the elbow. The anatomy and role of the lateral stabilizers. J Bone Joint Surg Am 79(2):225–233

    Article  CAS  PubMed  Google Scholar 

  13. Osborne G, Cotterill P (1966) Recurrent dislocation of the elbow. J. Bone Joint Surg. Br. 48(2):340–346

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Mark C. Drakos MD.

Additional information

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the reporting of this case, that all investigations were conducted in conformity with ethical principles of research.

Please read each question and circle the correct answer.

Please read each question and circle the correct answer.

1) Injury to what structure has been described as the “essential lesion” of posterolateral rotatory instability?

  1. a.

    Radial Collateral Ligament

  2. b.

    Annular Ligament

  3. c.

    Common Extensor Tendon Origin

  4. d.

    Accessory Annular Ligament

  5. e.

    Lateral Ulnar Collateral Ligament

2) Which of the following is not part of the lateral elbow capsular ligamentous complex?

  1. a.

    Radial Collateral Ligament

  2.  b.

    Annular Ligament

  3. c.

    Common Extensor Tendon Origin

  4. d.

    Accessory Annular Ligament

  5. e.

    Lateral Ulnar Collateral Ligament

3) All professional athletes with a complete avulsion of the lateral ligamentous restrains of the elbow should be managed surgically in order to return to competition.

  1. a.

    True

  2. b.

    False

4) Return to play after surgical reconstruction of the lateral ulnar collateral ligaments has been reported at

  1. a.

    4 weeks

  2. b.

    3 months

  3. c.

    6 months

  4. d.

    1 year

5) Athletes more commonly injure the lateral aspect of their elbow rather than the medial aspect

  1. a.

    True

  2. b.

    False

6) Approximately what % of total injuries to lateral elbow sprains represent in football players?

  1. a.

    30%

  2. b.

    20%

  3. c.

    10%

  4. d.

    <5%

7) The two most common causes of lateral elbow ligament disruption are:

  1. a.

    Elbow dislocation and iatrogenic release

  2. b.

    Degenrative tendinopathy and iatrogenic release

  3. c.

    Degenrative tendinopathy and Elbow dislocation

  4. d.

    Iatrogenic release and direct lacertation

8) Hyperextension and valgus injuries are the most common mechanisms for acute elbow injuries

  1. a.

    True

  2. b.

    False

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Muller, M.S., Drakos, M.C., Feeley, B. et al. Nonoperative Management of Complete Lateral Elbow Ligamentous Disruption in an NFL Player: A Case Report. HSS Jrnl 6, 19–25 (2010). https://doi.org/10.1007/s11420-009-9146-3

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  • DOI: https://doi.org/10.1007/s11420-009-9146-3

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