Universität zu Köln

Hackl, M., Leschinger, T., Mueller, L. P. and Wegmann, K. (2016). Chronic ligamentous instability of the elbow. Orthopade, 45 (10). S. 809 - 822. NEW YORK: SPRINGER. ISSN 1433-0431

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Abstract

Chronic ligamentous instability of the elbow is an important pathology as it is accompanied with pronounced dysfunction. Moreover, it represents an established risk factor for the development of osteoarthritis. Posterolateral rotatory instability (PLRI) caused by insufficiency of the lateral collateral ligament (LCL) is the most common type of chronic elbow instability and is usually a sequel of traumatic elbow dislocation. Chronic overload can lead to insufficiency of the ulnar collateral ligament (UCL) with subsequent valgus instability, especially in overhead athletes. Subjective instability and recurrent elbow dislocations are not always the main symptoms but elbow instability is instead often characterized by pain and secondary joint stiffness. Many clinical tests are available yet eliciting them can be difficult and inconclusive. A drop sign on lateral radiographs as well as the detection of collateral ligament injuries and joint incongruity on MRI scans can support the suspected diagnosis. In some cases, instability can only be verified by diagnostic arthroscopy. Reconstruction of the lateral ulnar collateral ligament (LUCL) for treatment of PLRI generally leads to good clinical results, yet recurrent instability remains an issue and has been reported in 8 % of cases. UCL reconstruction for chronic valgus instability leads to a return-to-sports rate of about 86 % in the overhead athlete. Ulnar neuropathy, which is seen in approximately 6 % of patients, represents the most common complication. On the rare occasion of multidirectional instability, the box-loop technique can be used for simultaneous reconstruction of the LUCL and UCL with a circumferential graft. 15 cases with promising results have been reported in literature thus far.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hackl, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leschinger, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, L. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-261790
DOI:	10.1007/s00132-016-3324-z
Journal or Publication Title:	Orthopade
Volume:	45
Number:	10
Page Range:	S. 809 - 822
Date:	2016
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1433-0431
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ULNAR COLLATERAL LIGAMENT; POSTEROLATERAL ROTATORY INSTABILITY; 2-YEAR FOLLOW-UP; RADIAL ULNOHUMERAL LIGAMENT; BASEBALL PLAYERS; LATERAL LIGAMENT; SURGICAL RECONSTRUCTION; FUNCTIONAL-ANATOMY; MEDIAL INSTABILITY; SIMPLE DISLOCATION Multiple languages Orthopedics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26179