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The Circumferential Graft Technique for Treatment of Chronic Multidirectional Ligamentous Elbow Instability
Michael Hackl1, Lars Peter Müller1, Kilian Wegmann1
1Center for Orthopedic and Trauma Surgery, University Medical Center of Cologne, Cologne, Germany.
Introduction:
The circumferential graft technique1,2 represents a potential option for the treatment of multidirectional ligamentous elbow instability using a single tendon graft (Video 1).
Step 1 Perform A Medial And Lateral Approach:
Approach the elbow joint through either a single posterior skin incision or separate lateral and medial incisions.
Step 2 Drill The Bone Tunnels:
Create humeral and ulnar bone tunnels for circumferential graft placement.
Step 3 Place The Graft:
Use a plantaris allograft, which we recommend; however, a semitendinosus autograft may also be used.
Step 4 Close The Wound:
Ensure that meticulous wound closure is achieved as it is key to preventing postoperative complications such as superficial or deep infection and persistent seroma.
Results:
As multidirectional instability represents a rather rare complication following ligamentous elbow dislocation, clinical data regarding the circumferential graft technique are scarce1,2.
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