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Posterolateral rotatory instability of the elbow
S W O'Driscoll1, D F Bell, B F Morrey
1St. Michael's Hospital, Toronto, Ontario, Canada.
The Journal of Bone and Joint Surgery. American Volume
|March 1, 1991
Summary
Recurrent posterolateral rotatory instability of the elbow, a challenging diagnosis, was effectively treated by repairing lax ulnar lateral collateral ligament. Surgical intervention resolved this specific elbow instability in all five patients studied.
Area of Science:
- Orthopedic Surgery
- Elbow Biomechanics
- Sports Medicine
Background:
- Recurrent posterolateral rotatory instability of the elbow is an underdiagnosed condition.
- Instability is often only detectable via specific provocative maneuvers.
Purpose of the Study:
- To describe a novel clinical condition: recurrent posterolateral rotatory instability of the elbow.
- To present a diagnostic test and surgical treatment for this condition.
Main Methods:
- Developed and utilized the "posterolateral rotatory-instability test" for diagnosis.
- Treated five patients (ages 5-40) with operative repair of the ulnar part of the lateral collateral ligament.
Main Results:
- The posterolateral rotatory-instability test accurately identified the condition, showing sudden radiohumeral joint reduction during flexion.
- Surgical repair of the lax ulnar lateral collateral ligament successfully eliminated the instability in all patients.
- The annular ligament remained intact, preventing radio-ulnar joint dislocation.
Conclusions:
- Laxity of the ulnar part of the lateral collateral ligament is the likely cause of this elbow instability.
- Surgical repair of the affected ligament is an effective treatment for recurrent posterolateral rotatory instability of the elbow.