Elbow Instability | ScienceGate

Greater sigmoid notch dysplasia causing elbow instability: Lateral ligament reconstruction and Stamp osteotomy

Shoulder & Elbow ◽

10.1177/1758573220987850 ◽

2021 ◽

pp. 175857322098785

Author(s):

Aparna Viswanath ◽

Jill L Thomas ◽

Adam C Watts

Keyword(s):

Ligament Reconstruction ◽

Iliac Crest ◽

Lateral Ligament ◽

Iliac Crest Bone Graft ◽

Elbow Instability ◽

Radiographic Outcome ◽

Level Of Evidence ◽

Opening Wedge ◽

Sigmoid Notch ◽

Buttress Plate

The coronoid is one of the elbow’s primary static stabilisers, and the importance of reconstruction following fracture with instability has been established. In the developing elbow, instability can lead to greater sigmoid notch dysplasia that can make reconstruction challenging. A novel technique to improve osseous stability with an opening wedge ‘stamp osteotomy’ reconstruction of the coronoid is described combined with a lateral ligament reconstruction, in two patients with recurrent posteromedial rotatory instability. The technique improves congruity and coverage of the greater sigmoid notch with the trochlea whilst maintaining articular cartilage. Extra-articular iliac crest bone graft is used to maintain the position with buttress plate support. The surgical technique is described and the clinical and radiographic outcome reported in two patients. Level of evidence: IV.

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The Role of Total Elbow Arthroplasty in the Setting of Elbow Instability

The Unstable Elbow ◽

10.1007/978-3-319-46019-2_16 ◽

2016 ◽

pp. 217-227

Author(s):

Ana Mata-Fink ◽

David Kovacevic ◽

Theodore A. Blaine

Keyword(s):

Total Elbow Arthroplasty ◽

Elbow Instability ◽

Elbow Arthroplasty

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Recurrent elbow instability in a child: A case report

Journal of Shoulder and Elbow Surgery ◽

10.1067/mse.2000.106320 ◽

2000 ◽

Vol 9 (5) ◽

pp. 441-442 ◽

Cited By ~ 4

Author(s):

Timothy M. Clough ◽

A. Javed ◽

R. Stephen

Keyword(s):

Case Report ◽

Elbow Instability

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Elbow Instability: Anatomy, Biomechanics, Diagnostic Maneuvers, and Testing

The Journal Of Hand Surgery ◽

10.1016/j.jhsa.2016.11.025 ◽

2017 ◽

Vol 42 (2) ◽

pp. 118-126 ◽

Cited By ~ 18

Author(s):

Lauren E. Karbach ◽

John Elfar

Keyword(s):

Elbow Instability

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Rehabilitation for Elbow Instability

Rehabilitation of the Hand and Upper Extremity, 2-Volume Set ◽

10.1016/b978-0-323-05602-1.00087-8 ◽

2011 ◽

pp. 1143-1153.e1

Author(s):

Kevin E. Wilk ◽

Leonard C. Macrina

Keyword(s):

Elbow Instability

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Arthroscopic Management of Lateral Elbow Instability

10.1007/978-981-16-4142-8_20 ◽

2021 ◽

pp. 623-632

Author(s):

Eugene T. Ek ◽

Julia C. Kirby

Keyword(s):

Elbow Instability ◽

Arthroscopic Management ◽

Lateral Elbow

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Biomechanical Role and Motion Contribution of Ligaments and Bony Constraints in the Elbow Stability: A Preliminary Study

Bioengineering ◽

10.3390/bioengineering6030068 ◽

2019 ◽

Vol 6 (3) ◽

pp. 68 ◽

Cited By ~ 1

Author(s):

Elisa Panero ◽

Laura Gastaldi ◽

Mara Terzini ◽

Cristina Bignardi ◽

Arman Sard ◽

...

Keyword(s):

Motion Capture ◽

Elbow Joint ◽

Large Deflection ◽

Elbow Flexion ◽

Elbow Instability ◽

Joint Stability ◽

Coronoid Fracture ◽

Flexion Extension ◽

Preliminary Study ◽

Functional Investigation

In flexion–extension motion, the interaction of several ligaments and bones characterizes the elbow joint stability. The aim of this preliminary study was to quantify the relative motion of the ulna with respect to the humerus in two human upper limbs specimens and to investigate the constraints role for maintaining the elbow joint stability in different section conditions. Two clusters of four markers were fixed respectively to the ulna and humerus, and their trajectory was recorded by a motion capture system during functional orthopedic maneuver. Considering the posterior bundle of medial collateral complex (pMUCL) and the coronoid, two section sequences were executed. The orthopedic maneuver of compression, pronation and varus force was repeated at 30°, 60° and 90° flexion for the functional investigation of constraints. Ulna deflection was compared to a baseline elbow flexion condition. With respect to the intact elbow, the coronoid osteotomy influences the elbow stability at 90° (deflection = 11.49 ± 17.39 mm), while small differences occur at 30° and 60°, due to ligaments constraint. The contemporary pMUCL section and coronoid osteotomy causes elbow instability, with large deflection at 30° (deflection = 34.40 ± 9.10 mm), 60° (deflection = 45.41 ± 18.47 mm) and 90° (deflection = 52.16 ± 21.92 mm). Surgeons may consider the pMUCL reconstruction in case of unfixable coronoid fracture.

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