Ligamentous repair of acute lateral collateral ligament rupture of the elbow

Abstract

Background: We evaluated the clinical outcome and findings of ligamentous repair for acute posterolateral rotatory instability (PLRI) of the elbow.

Materials and methods: Nineteen patients underwent lateral collateral ligament repair for acute PLRI. Ten male and nine female patients were observed for a mean of 9 months; their mean age was 46 years (14-70 years). The mean time from injury to operation was 8.1 days (1-18 days). The lateral pivot shift and varus stress test results were positive for all cases. We repaired the lateral ulnar collateral ligament with Ethibond in 6 cases and Bio-FASTak in 15 cases. We evaluated the range of motion, pain, and stability by the satisfaction of the patient, the Mayo Elbow Performance Score, and the Nestor grading.

Results: The lateral pivot shift test result was negative in all patients at the final follow-up. The mean elbow extension was 13°; flexion, 120°; supination, 74°; and pronation, 78°. Mild valgus laxity was noted in two patients who had mild pain on activity. The mean Mayo Elbow Performance Score was 86.9 points (65-100 points), with 13 excellent cases, 5 good cases, and 1 fair case. According to the Nestor grading, the results were rated excellent in 14 patients and good in 5. All patients were satisfied with their outcome in the subjective assessment. The complications were 1 case of knot irritation and 5 cases of ectopic ossification.

Conclusion: We obtained satisfactory outcomes with lateral collateral ligament repair for acute PLRI of the elbow.

Keywords: Case Series; Level IV; Posterolateral rotatory instability of the elbow; Treatment Study; lateral collateral ligament.