Lateral Collateral Ligament Injury

Background: There is no consensus how to determine the varus laxity due to the LCL injury using the ultrasonography. There is a risk of lateral collateral ligament injury during or after arthroscopic extensor carpi radialis brevis release for tennis elbow. The equator of the radial head has been suggested as a landmark for the safe zone to not increase this risk; however, the safe zone from the intra-articular space has not been established. Hypothesis: Increased elbow varus laxity due to lateral collateral ligament–capsular complex (LCL-cc) injury could be assessed reliably via ultrasound. Study Design: Descriptive laboratory study. Methods: Eight cadaveric elbows were evaluated using a custom-made machine allowing passive elbow flexion under gravity varus stress. The radiocapitellar joint (RCJ) space was measured via ultrasound at 30° and 90° of flexion during 4 stages: intact elbow (stage 0), release of the anterior one-third of the LCL-cc (stage 1), release of the anterior two-thirds (stage 2), and release of the entire LCL-cc (stage 3). Two observers conducted the measurements separately, and the mean RCJ space in the 3 LCL-cc injury models (stages 1-3) at both flexion angles was compared with that of the intact elbow (stage 0). We also compared the measurements at 30° versus 90° of flexion. Results: At 30° of elbow flexion, the RCJ space increased 2 mm between stages 0 and 2 (95% confidence interval [CI], 1-3 mm; P < .01) and 4 mm between stages 0 and 3 (95% CI, 2-5 mm; P < .01). At 90° of elbow flexion, the RCJ space increased 1 mm between stages 0 and 2 (95% CI, 1-2 mm; P < .01) and 2 mm between stages 0 and 3 (95% CI, 2-3 mm; P < .01). Conclusion: Elbow varus laxity under gravity stress can be reliably assessed via ultrasound by measuring the RCJ space. Clinical Relevance: Because ultrasonographic measurement of the RCJ space can distinguish the increasing varus laxity seen with release of two-thirds or more of the LCL-cc, the anterior one-third of the LCL-cc, based on the diameter of the radial head, can be considered the safe zone in arthroscopic extensor carpi radialis brevis release for tennis elbow.

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Injury risk functions for the four primary knee ligaments

10.1101/2021.07.30.454445 ◽

2021 ◽

Author(s):

Jiota Nusia ◽

Jia Cheng Xu ◽

Reimert Sjöblom ◽

Johan Knälmann ◽

Astrid Linder ◽

...

Keyword(s):

Posterior Cruciate Ligament ◽

Injury Risk ◽

Failure Modes ◽

Cruciate Ligament ◽

Lateral Collateral Ligament ◽

Ligament Injury ◽

Collateral Ligament ◽

Knee Ligament ◽

Knee Ligaments ◽

Risk Functions

Aim: The purpose of this study was to develop Injury Risk Functions (IRFs) for the Anterior- and Posterior Cruciate Ligament (ACL and PCL, respectively) and the Medial- and Lateral Collateral Ligament (MCL and LCL, respectively) in the knee joint and address two injury mechanisms of the ligaments, mid-substance failure and ligament insertion detachment. Method: The IRFs were developed from Post-Mortem Human Subject (PMHS) tensile failure strains of Bone-Ligament-Bone (BLB) or dissected Ligament (LIG) preparations. To compensate for insufficient sample size of experimental datapoints, virtual failure strains were as well generated based on mean- and standard deviation from experiments that did not provide specimen-specific results. All virtual and specimen-specific values were then categorised into groups of static and dynamic rates and tested for the best fitting theoretical distribution to formulate the ligament IRF. Results: Nine IRFs were derived (3 for ACL, 2 for PCL, 1 for MCL and 3 for LCL). Conclusion: These IRFs are, to the best of the authors' knowledge, the first knee ligament injury predicting tool based on PMHS data. The IRFs of BLB address both failure modes of mid-ligament and attachment failure, while the IRFs of LIG address mid-ligament failures only. The proposed risk functions can be used to determine the effectiveness of injury prevention measures. Keywords: Injury risk functions, knee ligaments, anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, lateral collateral ligament.

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Treatment and outcomes of lateral collateral ligament injury associated with anterior and posterior cruciate ligament injury at 2-year follow-up

Journal of Orthopaedics ◽

10.1016/j.jor.2019.05.010 ◽

2019 ◽

Vol 16 (6) ◽

pp. 489-492 ◽

Cited By ~ 1

Author(s):

Leonardo Adeo Ramos ◽

Tiago Zogbi ◽

Edilson Ferreira de Andrade ◽

Gabriel Taniguti de Oliveira ◽

Alexandre Pedro Nicolini ◽

...

Keyword(s):

Posterior Cruciate Ligament ◽

Cruciate Ligament ◽

Lateral Collateral Ligament ◽

Ligament Injury ◽

Posterior Cruciate Ligament Injury ◽

Collateral Ligament

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Coronal Shear Fractures of the Distal Humerus: A Review of Diagnosis, Treatment, and Outcomes

Hand ◽

10.1177/1558944719878817 ◽

2019 ◽

pp. 155894471987881 ◽

Cited By ~ 1

Author(s):

Brianna R. Fram ◽

Daniel A. Seigerman ◽

Asif M. Ilyas

Keyword(s):

Literature Review ◽

Lateral Collateral Ligament ◽

Distal Humerus ◽

Open Reduction Internal Fixation ◽

Ligament Injury ◽

Associated Injuries ◽

Collateral Ligament ◽

Radial Head Fractures ◽

Comprehensive Literature Review ◽

Fragment Excision

Fractures of the capitellum and trochlea are uncommon fractures of the elbow and can be challenging to treat due to their size, location, and articular nature. Because of their intra-articular nature and predilection toward displacement, these fractures are typically treated operatively. Furthermore, capitellum fractures have high rates of associated injuries, including radial head fractures or lateral collateral ligament injury in ~30% to 60% of patients. In addition to open reduction internal fixation, operative options include fragment excision, arthroscopic assisted reduction and fixation, and elbow arthroplasty. In this article, we undertake a comprehensive literature review of capitellum fractures of the distal humerus, in an attempt to summarize the existing body of evidence and propose areas of future study.

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