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Split Anconeus Fascia Transfer for Posterolateral Rotatory Instability of the Elbow
Brett D Haislup1, Linda L Zhang, Caroline Chebli
1From the Department of Should and Elbow Surgery, MedStar Union Memorial Hospital, Baltimore, MD (Haislup and Murthi), the Portland Veterans Affairs Center, Portland, OR (Zhang), and the Department of Orthopaedic Surgery, University of South Florida, Tampa, FL (Chebli).
The Journal of the American Academy of Orthopaedic Surgeons
|September 2, 2025
Summary
Posterolateral rotatory instability (PLRI) of the elbow, often from lateral ulnar collateral ligament (LUCL) injury, can cause chronic instability. Split anconeus fascia transfer offers a novel surgical solution without ulnar drilling.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Elbow Biomechanics
Background:
- Chronic lateral ulnar collateral ligament (LUCL) injury causes posterolateral rotatory instability (PLRI) of the elbow.
- This instability leads to ulnohumeral joint and radial head subluxation, impacting activities with axial loading.
- Previous treatments using free grafts have limitations, including fixation requirements and suboptimal kinematic replication.
Purpose of the Study:
- To describe the evaluation, management, and treatment of PLRI.
- To present the split anconeus fascia transfer as a surgical technique for PLRI.
- To provide a video and detailed description of the surgical procedure.
Main Methods:
- Surgical technique paper detailing the split anconeus fascia transfer.
- Focus on avoiding ulnar drilling and minimizing graft site morbidity.
- Includes evaluation and management strategies for PLRI.
Main Results:
- The split anconeus fascia transfer is presented as an alternative surgical option.
- This technique avoids the need for ulnar drilling.
- It also minimizes graft site morbidity compared to traditional free grafts.
Conclusions:
- Split anconeus fascia transfer is a viable surgical option for chronic PLRI.
- The technique offers advantages over free graft procedures.
- It addresses LUCL deficiency without extensive ulnar bone preparation.
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