Posterolateral rotatory instability of the elbow

Area of Science:

• Orthopedic Surgery
• Elbow Biomechanics
• Sports Medicine

Background:

• Posterolateral rotatory instability is the most frequent cause of symptomatic chronic elbow instability.
• This condition involves external rotation of the forearm relative to the humerus, leading to radial head subluxation or dislocation.
• Disruption of the lateral ligament complex, radial head, and coronoid process are key factors in its pathogenesis.

Purpose of the Study:

• To review the diagnosis and management of posterolateral rotatory instability of the elbow.
• To highlight the importance of the lateral ligament complex in elbow stability.
• To discuss current and emerging surgical treatment options.

Main Methods:

• Clinical diagnosis based on suspicion, apprehension tests, and examination under anesthesia.
• Review of surgical outcomes for elbow instability.
• Comparison of open versus arthroscopic surgical techniques.

Main Results:

• Diagnosis requires a high clinical suspicion and specific provocative tests.
• Surgical treatment, particularly open lateral ligament reconstruction with tendon grafts, yields consistently successful results.
• Arthroscopic techniques are emerging as a viable alternative for surgical management.

Conclusions:

• Posterolateral rotatory instability is a significant cause of chronic elbow dysfunction.
• Accurate diagnosis is crucial for effective management.
• Surgical reconstruction remains the gold standard, with arthroscopic approaches gaining traction.