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Chronic elbow instability

M L Lee1, M P Rosenwasser

  • 1New York Orthopaedic Hospital, Columbia University College of Physicians and Surgeons, New York, New York, USA.

The Orthopedic Clinics of North America
|January 12, 1999
PubMed
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Chronic elbow instability in adults presents as valgus, posterolateral rotatory, or radial head instability. Treatment focuses on surgical reconstruction of damaged ligaments, particularly the medial collateral ligament for valgus instability.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Elbow Biomechanics

Background:

  • Chronic elbow instability without fractures in adults is categorized into three primary types: valgus instability, posterolateral rotatory instability, and isolated radial head instability.
  • Valgus instability is the most prevalent form, frequently affecting throwing athletes due to repetitive microtrauma to the medial collateral ligament's anterior band.

Purpose of the Study:

  • To outline the classification, common causes, diagnostic methods, and surgical treatment strategies for distinct types of chronic elbow instability in adults.
  • To emphasize the surgical goals for each instability type, focusing on ligamentous reconstruction.

Main Methods:

  • Review and synthesis of existing literature on adult elbow instability.
  • Description of diagnostic criteria, including the lateral pivot-shift test for posterolateral rotatory instability.

Related Experiment Videos

  • Outline of surgical approaches, including medial collateral ligament reconstruction, lateral ulnar collateral ligament reconstruction, and radial head resection or annular ligament reconstruction.

    • Main Results:

    • Valgus instability, often linked to medial collateral ligament damage, is surgically managed via anterior band reconstruction.
    • Posterolateral rotatory instability, associated with lateral ulnar collateral ligament injury, requires specific reconstruction techniques.
    • Isolated radial head instability, a rare condition stemming from annular ligament disruption, is treated with radial head resection or annular ligament reconstruction.

    Conclusions:

    • Effective management of chronic elbow instability hinges on accurate diagnosis and targeted surgical reconstruction of the specific ligamentous structures involved.
    • Surgical interventions aim to restore elbow stability by addressing the underlying ligamentous pathology in valgus, posterolateral rotatory, and radial head instability.