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Lateral collateral ligament elbow

Taku Hatta, Shingo Nobuta, Toshitake Aizawa, Koichi Sasajima, Soichi Nakajima, Masahito Honda, Gosuke Oki, Yoshiaki Yamanaka, Eiji Itoi
The aim of our study is to evaluate the clinical and radiologic outcomes in patients with terrible triad injury, who underwent surgical treatment with or without the medial collateral ligament (MCL) repair. Fourteen patients who underwent surgery with a minimum of 12-month follow-up (mean, 17 months) were reviewed. Based on the systematic treatment protocol, radial head fracture, lateral collateral ligament, and coracoid fracture were treated. Subsequently, torn MCL was repaired in 7 patients, whereas in the remaining 7 patients, the MCL was not treated...
September 19, 2016: Orthopedic Reviews
H Mike Kim, Colin R Andrews, Evan P Roush, Gregory I Pace, Gregory S Lewis
BACKGROUND: Double-strand lateral ulnar collateral ligament (LUCL) reconstruction is an effective treatment for posterolateral rotatory instability (PLRI) of the elbow, but anatomic landmarks for ulnar tunnel placement are often difficult to identify intraoperatively, which potentially can result in a nonanatomic LUCL reconstruction. This study investigated the effect of ulnar tunnel location on joint stability in double-strand LUCL reconstruction. METHODS: PLRI was artificially created in 7 cadaveric elbows, and double-strand LUCL reconstruction was performed...
October 10, 2016: Journal of Shoulder and Elbow Surgery
K Gharanizadeh, F N Mazhar, N Molavy, A Bagherifard, H Shariatzadeh
This study reports the clinical presentations, intra -operative findings, type of the treatments, outcome of the treatment and specially associated injuries in patients with the avulsion of the distal end of the triceps brachii (TB) tendon. We studied 6 patients with rupture or avulsion of the distal end of the TB tendon. The medical records, imaging files, clinical outcomes at the final follow up visit were reviewed. The clinical outcomes were assessed by Mayo Elbow Score at the final follow-up visit. All patients were male, 4 of them having injury in the left hand as the non-dominant hand...
August 2016: Acta Orthopaedica Belgica
M Hackl, T Leschinger, L P Müller, K Wegmann
BACKGROUND: Chronic ligamentous instability of the elbow is an important pathology as it is accompanied with pronounced dysfunction. Moreover, it represents an established risk factor for the development of osteoarthritis. Posterolateral rotatory instability (PLRI) caused by insufficiency of the lateral collateral ligament (LCL) is the most common type of chronic elbow instability and is usually a sequel of traumatic elbow dislocation. Chronic overload can lead to insufficiency of the ulnar collateral ligament (UCL) with subsequent valgus instability, especially in overhead athletes...
October 2016: Der Orthopäde
M Hackl, T Leschinger, C Ries, W F Neiss, L P Müller, K Wegmann
BACKGROUND: Chronic posterolateral rotatory instability (PLRI) of the elbow is the result of an insufficiency of the lateral collateral ligament (LCL). Lateral ulnar collateral ligament (LUCL) reconstruction represents a well-established treatment method for PLRI. However, recurrent instability remains a problem. OBJECTIVES: The goal of this in-vitro study was to evaluate the posterolateral rotatory stability of the intact elbow, after sectioning of the LCL and after LUCL reconstruction with a triceps tendon autograft and double BicepsButton(TM) fixation...
October 2016: Der Orthopäde
Jeong Woo Kim, Young Yi, Tae Kyun Kim, Hong Je Kang, Jong Yun Kim, Jong Myoung Lee, Kyu Hwan Bae, Min Su Joo
BACKGROUND: Lateral ulnar collateral ligament injury following unstable elbow dislocation can induce posterolateral rotatory instability that requires surgery. The aim of this study was to determine the effectiveness of arthroscopic repair of the lateral collateral ligament (LCL) complex in an unstable elbow joint. METHODS: The study group consisted of 13 patients who experienced posterolateral rotatory instability after an unstable elbow dislocation with an injury to the lateral ulnar collateral ligament...
August 3, 2016: Journal of Bone and Joint Surgery. American Volume
Femke M A P Claessen, Amir R Kachooei, Gregory P Kolovich, Geert A Buijze, Luke S Oh, Michel P J van den Bekerom, Job N Doornberg
PURPOSE: In this anatomical cadaver study, the distance between major nerves and ligaments at risk for injury and portal sites created by trainees was measured. Trainees, inexperienced in elbow arthroscopy, have received a didactic lecture and cadaver instruction prior to portal placement. The incidence of iatrogenic injury from novice portal placement was also determined. METHODS: Anterolateral, direct lateral, and anteromedial arthroscopic portals were created in ten cadavers by ten inexperienced trainees in elbow arthroscopy...
June 28, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Christopher L Camp, Shawn W O'Driscoll, Michael K Wempe, Jay Smith
BACKGROUND: Although clinical tests can detect posterolateral rotatory instability (PLRI) of the elbow, the ability of ultrasound to evaluate PLRI has not been assessed. OBJECTIVE: To determine whether increasing stages of posterolateral rotatory subluxation of the elbow could be assessed accurately with a sonographic posterolateral rotatory stress test. DESIGN: Cadaveric study. SETTING: Laboratory. PATIENTS: Ten, unpaired, cadaveric upper limbs...
June 16, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
C J Bodaan, C B Riley, E Engeli
The objectives of this study were to evaluate the likelihood of successful arthrocentesis of the equine elbow joint using the caudolateral approach and to determine if the deep branch of the radial nerve (DBRN) varies in its proximity to the site of centesis. Methylene blue (MB) was injected into 71 elbow joint specimens immediately caudal to the lateral collateral ligament using a 3.8-cm needle advanced to its hub. The elbow joints were dissected, staining of the synovial structures assessed and the proximity of DBRN to the site of centesis evaluated...
August 13, 2016: Veterinary Record
Aashay L Kekatpure, Iman Widya Aminata, In-Ho Jeon, In-Hyeok Rhyou, Hyun-Joo Lee, Jae-Myeung Chun
BACKGROUND: Ligamentous injury associated with isolated coronoid fracture had been sparingly reported. Concealed or unclear fractures and ligamentous or articular cartilage lesions are promptly acknowledged by magnetic resonance imaging (MRI) but cannot be entirely pictured in regular radiological assessments. In isolated coronoid fracture, the fragment size is very small and due to the complex anatomy surrounding the coronoid radiographic imaging may not be sufficient. The purpose of this study was to evaluate the incidence of combined osteochondral and ligamentous injuries by magnetic resonance imaging (MRI) in 24 patients with an isolated coronoid fracture...
May 2016: Indian Journal of Orthopaedics
Dave R Shukla, Elan Golan, Philip Nasser, Maya Culbertson, Michael Hausman
BACKGROUND: There has been a renewed interest in the pathomechanics of elbow dislocation, with recent literature having suggested that the medial ulnar collateral ligament is more often disrupted in dislocations than the lateral ligamentous complex. The purpose of this serial sectioning study was to determine the influence of the posterior bundle of the medial ulnar collateral ligament (pMUCL) as a stabilizer against elbow dislocation. METHODS: An elbow dislocation was simulated in 5 cadaveric elbows by mechanically applying an external rotation moment and valgus force...
June 7, 2016: Journal of Shoulder and Elbow Surgery
You Zhang, Shiqing Liu, Hongbin Zhou, Xiaorong Qin, Xiangwei Zhang
OBJECTIVE: To investigate the feasibility of modified classification of terrible triad of the elbow and the effectiveness of treatment strategy which was chosen by modified classification results. METHODS: Between March 2007 and November 2013, 12 cases of terrible triad of the elbow were treated by operation. There were 5 males and 7 females with an average age of 37.2 years (range, 26-74 years). The mechanism of injury was falling from height in 8 cases and traffic accident in 4 cases...
March 2016: Chinese Journal of Reparative and Reconstructive Surgery
M Hackl, M Bercher, K Wegmann, L P Müller, J Dargel
INTRODUCTION: The aim of this study was to analyze the functional anatomy of the lateral collateral ligament complex (LCLC) and the surrounding forearm extensors. MATERIALS AND METHODS: Using 81 human cadaveric upper extremities, the anatomy of the forearm extensors-especially the anconeus, supinator and extensor carpi ulnaris (ECU)-was analyzed. After removal of aforementioned extensors the functional anatomy of the LCLC was analyzed. The origin of the LCLC was evaluated for isometry...
July 2016: Archives of Orthopaedic and Trauma Surgery
Catherine J Fedorka, Luke S Oh
Posterolateral rotatory instability of the elbow is often caused by a complex injury to the lateral ulnar collateral ligament complex. This often leads to chronic mechanical symptoms of instability and pain. Surgical repair or reconstruction of the ligament is often required to stabilize the radiocapitellar joint. Multiple techniques have been described in the literature for repair or reconstruction of the lateral ligamentous complex with overall good clinical outcomes.
June 2016: Current Reviews in Musculoskeletal Medicine
Mehmet Hakan Özsoy, Metin Işık, Abdurrahman Sakaoğulları, Hacı Mustafa Özdemir, Mehmet Yücel, Veysel Ercan Dincel
OBJECTIVE: The purpose of this study was to evaluate the results of a new reconstruction with anconeus interposition arthroplasty in acute multiligamentous elbow injuries with irreparable radial head fractures. METHODS: Five patients (3 males, 2 females) with a mean age of 42.6 years who underwent reconstruction with anconeus arhtroplasty were evaluated. With lateral approach, lateral capsuloligamentous structures were repaired, the radial head was excised, and anconeus interposition arthroplasty was performed...
2016: Acta Orthopaedica et Traumatologica Turcica
X H Liu, X Y Jiang, M Q Gong, Y J Zha
OBJECTIVE: To discuss the effect of single low dose local radiotherapy and indomethacin together in the prevention of recurrence of ectopic ossification around the elbow after resection. METHODS: From Jun. 2009 to Dec. 2011, we performed excision of ectopic ossification around the elbow in 78 stiff elbows. For each case, we used both medial and lateral approaches, and we performed both anterior and posterior capsulectomies and removal of ectopic ossification. In the lateral approach, we started proximally, the lateral supracondylar ridge of the humerus was exposed from the interval between extensor carpi radialis longus (ECRL) and triceps, and then distally passed the interval between ECRL and extensor carpi radialis brevis (ECRB)...
April 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Y J Zha, X Y Jiang, M Q Gong
OBJECTIVE: To introduce the surgical techniques and treating results of the old "terrible triad" of the elbow. METHODS: A retrospective analysis of 11 cases of old "terrible triad" of the elbow treated by the author from March 2009 to February 2014 were performed, with 9 males and 2 females; mean age was (31.82±8.66) years (17-45 years). The average time after injury was (6.36±2.50) weeks (4-12 weeks), with 7 cases on the left and 4 right. The combined injury included 2 cases with distal radius fractures, 1 with ankle fractures, fractures of the distal radius and the head injury (minor epidural hematoma, no surgery), and 1 with Pilon fractures and L4 fractures (fixed at local hospital)...
April 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Shizhan Wei, Yujin Tang, Peng Weibo, Huadeng Ban
OBJECTIVE: To investigate the effectiveness of a modified surgical treatment of old Monteggia fracture. METHODS: Between March 2006 and December 2013, 40 cases of old Monteggia fracture were treated with modified operation. Modified operation procedure included expanding excision of pedicled forearm fascia flap for reconstruction of the annular ligament and repair of elbow radial lateral collateral ligament complex and extending osteotomy of the ulna, callus replantation, and internal fixation with steel plate...
January 2016: Chinese Journal of Reparative and Reconstructive Surgery
Robert Z Tashjian, Brian R Wolf, Roger P van Riet, Scott P Steinmann
Elbow instability is common and may occur after a variety of injuries, including falls or direct blows. Instability can be classified as either acute or chronic. Acute instability is classified as simple (without fracture) or complex (with associated fracture). Chronic instability is classified as a chronically dislocated or recurrently unstable elbow. Recurrent instability commonly presents as isolated medial or lateral collateral ligament insufficiency. A chronically dislocated elbow is often more complex, involving both osseous and ligamentous injuries...
2016: Instructional Course Lectures
Paolo Arrigoni, Riccardo D'Ambrosi, Pietro Randelli
An elongation or partial articular-sided tear of the radial lateral collateral ligament (R-LCL) is a rare injury causing disability and instability of the elbow. In our experience this condition is often associated with a pathologic sign of the annular ligament named the "annular drive through" caused by a redundancy of the ligament. The benefits of performing an arthroscopic procedure for surgical stabilization of the R-LCL include smaller incisions with less soft-tissue dissection, better visualization of the joint, better repair accessibility, and elimination of the annular drive-through sign...
December 2015: Arthroscopy Techniques
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