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Elbow instability.

S W O'Driscoll¹

¹Department of Orthopedics, Mayo Clinic, Rochester, MN, USA.

Acta Orthopaedica Belgica

|February 17, 2000

Summary

Elbow instability, particularly posterolateral rotatory instability, stems from lateral collateral ligament complex disruption. Surgical repair of this complex is the primary treatment for recurrent elbow instability.

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Area of Science:

Orthopedic Surgery
Biomechanics
Anatomy

Background:

Elbow instability is often linked to the lateral collateral ligament complex (LCLC).
The ulnar part of the LCLC is crucial for preventing posterolateral rotatory instability.
Understanding the mechanism of elbow subluxation and dislocation is key.

Purpose of the Study:

To elucidate the anatomy and biomechanics of elbow instability.
To detail the diagnostic methods for posterolateral rotatory instability.
To outline the surgical treatment for LCLC injuries.

Main Methods:

Review of anatomical structures and biomechanical principles.
Description of clinical diagnostic tests: lateral pivot-shift, posterolateral rotatory apprehension, and drawer tests.
Discussion of radiographic stress examinations.

Main Results:

The LCLC, especially its ulnar part, is vital for elbow stability.
Posterolateral rotatory instability involves a complex 3D motion during flexion.
The posterolateral rotatory apprehension test is the most sensitive diagnostic tool.

Conclusions:

Accurate diagnosis of elbow instability relies on understanding LCLC anatomy and injury mechanisms.
The posterolateral rotatory apprehension test is highly sensitive for diagnosing posterolateral rotatory instability.
Surgical repair or reconstruction of the LCLC is the standard treatment for elbow instability.

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