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Posterolateral rotatory instability of the elbow
Oke A Anakwenze1, Vamsi K Kancherla, Jaicharan Iyengar
1William N. Levine, Department of Orthopaedic Surgery, Center for Shoulder, Elbow, and Sports Medicine, Columbia University, New York, New York. wnl1@columbia.edu.
The American Journal of Sports Medicine
|July 13, 2013
Summary
Posterolateral rotatory instability (PLRI) of the elbow, caused by lateral collateral ligament injury, presents subtly and requires careful diagnosis. Effective treatment involves surgical repair or reconstruction for symptomatic cases.
Area of Science:
- Orthopedic Surgery
- Elbow Biomechanics
- Sports Medicine
Background:
- Symptomatic posterolateral rotatory instability (PLRI) stems from lateral collateral ligament complex injury.
- Subtle symptoms like pain, clicking, and subluxation can lead to misdiagnosis.
- A history of elbow trauma (dislocation, surgery, injections) is common in PLRI patients.
Purpose of the Study:
- To highlight the diagnostic challenges of symptomatic PLRI.
- To emphasize the importance of thorough history and physical examination.
- To outline diagnostic and confirmatory methods for PLRI.
Main Methods:
- Detailed patient history including trauma and prior interventions.
- Provocative physical examination maneuvers for instability assessment.
- Radiographs, advanced imaging, and examination under anesthesia with arthroscopic visualization or stress radiography.
Main Results:
- PLRI diagnosis requires careful evaluation due to subtle clinical presentations.
- Diagnostic imaging and specialized examinations aid in confirming the instability.
- Symptomatic PLRI cases are effectively managed through surgical intervention.
Conclusions:
- Accurate diagnosis of PLRI relies on meticulous clinical assessment and specific provocative tests.
- Advanced imaging and intraoperative assessments are crucial for confirmatory diagnosis.
- Surgical repair or isometric ligament reconstruction offers effective treatment for symptomatic PLRI.
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