Repair of the acutely unstable elbow: use of tensionable anchors

Acute ruptures of the medial or lateral collateral ligaments of the elbow associated with elbow dislocations have traditionally been repaired back to their respective epicondyles using suture anchors or transosseous sutures. Tensioning of those ligaments using conventional techniques had been difficult because of the need to maintain tension while tying and securing sequential knots. Tensionable anchors are a new generation of anchors that have been used for rotator cuff repair, but can be employed for the repair of collateral ligaments and capsular tears. It allows fine control and sequential tensioning of the ligament repair, and on-table assessment of stability before locking the anchor. We present a modified surgical technique for the repair of collateral ligaments repair using tensionable anchors in acute elbow dislocations or fracture dislocations.