F I Dehlinger1, C Ries, B Hollinger. 1. Abteilung für Schulter- und Ellenbogenchirurgie, ARCUS-Sportklinik, Rastatter Str. 17-19, 73157, Pforzheim, Deutschland.
Abstract
OBJECTIVE: Re-establishment of radial stability within the elbow joint in cases of arthroscopically or clinically confirmed posterolateral rotatory instability. INDICATIONS: Posttraumatic or chronic degenerative posterolateral rotatory instability at least grade I-II according to O'Driscoll. CONTRAINDICATIONS: Elbow stiffness or elbow arthritis and lateral epicondylitis, if a posterolateral rotatory instability has been excluded as the reason for the symptoms. SURGICAL TECHNIQUE: Reconstruction or augmentation of the insufficient lateral ulnar collateral ligament (LUCL) with an autologous triceps tendon graft. A stripe of the triceps tendon is fixed at the epicondylus humeri radialis and at the base of the annular ligament at the proximal radial ulna with tenodesis screws or buttons, then the extensor origins, which were detached before are fixated as well. POSTOPERATIVE MANAGEMENT: Postoperative treatment with an elbow orthesis for 6 weeks, in the first 4 weeks limitation of complete extension and flexion, full weight bearing after 3 months. RESULTS: Retrospective analysis of 47 LUCL reconstructions from 2008-2010 with good results concerning pain reduction and acceptance, improvement of the Mayo Elbow Performance Score from 49 to 82, low complication rate with one elbow stiffness, one temporary ulnar nerve lesion, and one recurrent instability.
OBJECTIVE: Re-establishment of radial stability within the elbow joint in cases of arthroscopically or clinically confirmed posterolateral rotatory instability. INDICATIONS: Posttraumatic or chronic degenerative posterolateral rotatory instability at least grade I-II according to O'Driscoll. CONTRAINDICATIONS: Elbow stiffness or elbow arthritis and lateral epicondylitis, if a posterolateral rotatory instability has been excluded as the reason for the symptoms. SURGICAL TECHNIQUE: Reconstruction or augmentation of the insufficient lateral ulnar collateral ligament (LUCL) with an autologous triceps tendon graft. A stripe of the triceps tendon is fixed at the epicondylus humeri radialis and at the base of the annular ligament at the proximal radial ulna with tenodesis screws or buttons, then the extensor origins, which were detached before are fixated as well. POSTOPERATIVE MANAGEMENT: Postoperative treatment with an elbow orthesis for 6 weeks, in the first 4 weeks limitation of complete extension and flexion, full weight bearing after 3 months. RESULTS: Retrospective analysis of 47 LUCL reconstructions from 2008-2010 with good results concerning pain reduction and acceptance, improvement of the Mayo Elbow Performance Score from 49 to 82, low complication rate with one elbow stiffness, one temporary ulnar nerve lesion, and one recurrent instability.
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