[Diagnosis and treatment for posterolateral rotatory instability of the elbow].

OBJECTIVE: To study the effects of surgical reconstruction of the lateral ligament complex for posterolateral rotatory instability (PLRI) of the elbow joint.

METHODS: From January 2013 to January 2015, 20 patients with posterolateral rotatory instability of elbow joint were treated in our department. There were 12 males and 8 females whose age ranged from 30 to 60 years old, with an average age of 45.5 years old. Sixteen patients had injuries on the right side and 4 patients had injuries on the left side. Nine patients were caused by elbow dislocation and 6 cases were caused by elbow fracture. Five patients had no history of trauma. All the patients had closed injuries. According to the patient's history, physical examination and preoperative X-ray and MRI examination, a definite diagnosis was made. All the patients were treated conservatively for more than 2 months without efficacy, and they were treated with reconstruction of the lateral collateral ligament complex using palmaris longus tendon as a reconstruction graft under general anesthesia. Individual rehabilitation exercises were carried out according to the patient's condition.

RESULTS: All the patients were followed up, and the duration ranged from 12 to 23 months(mean, 16 months). There were no complications such as infection and obvious limitation of elbow joint. The HSS score of all the patients was improved from preoperative 75.2±8.3 to postoperative 94.1±5.4; and the VAS score was improved from preoperative 6.7±3.2 to postoperative 2.3±1.5.

CONCLUSIONS: The lateral cubital ligament complex is the most important limiting structure for the posterolateral rotatory instability of the elbow joint. Reconstruction of the lateral ligament complex is an effective method for the treatment of posterolateral rotatory instability of the elbow joint.