Ligamentous repair of acute lateral collateral ligament rupture of the elbow

Medial Patellofemoral ligament(MPFL) is the main passive stabilizer of the patellofemoral joint. MPFL is injured in the 2/3 rds of the patients after patella luxation. In this study we present a novel aproach to the anatomical MPFL reconstruction and preliminary results of the technique. We operated 7 patients(4 female and female and 3 male) who applied to our clinic after a patella luxation episode. The mean age was 27,1 years(16-42). The mean follow up time was 23,5 months(24-35). We evaluated the patients clinically and radiologically for concommitant pathologies. 1 patient had patellar cartilage demage and patella alta, 1 patient had medial collateral ligament rupture, 1 patient had lateral collateral ligament and anterior cruciate ligament rupture and these pathologies were treated as well. The operation was done in the supine position on a radiolucent table and under the image intensifier control. The semitendinosus autograft was prepared. The femoral tunnel was drilled and double strand graft was introduced in the femoral tunnel and secured with ToggleLoc femoral fixation device(Biomet). The graft was advanced over the facia to the patellar side and passed through the 2 patellar tunnels and tied to each other. After exercising the knee the graft tension was rechecked at 30 degrees of knee flexion. Early postoperatively range of motion and quadriceps strenghtening exercises were carried out and patients were allowed to bear weight. All of the patients had full range of motion and free of pain. Postoperative x-ray and MRI examinations revealed the correction of patellar tilt and lateral shift of the patella in all patients. The only complication was a fissure of patella in 1 patient in the 6th week of rehabilitation due to anteriorly located patellar tunnel and heavy exercise. We immobilsed the patient in a brace and the patient returned to rehabilitation after 6 weeks when the fissure healed. All the patients returned to the previous functional level. Our anatomical MPFL technique uses ToggleLoc for the femoral side but implant free at the patellar side. The technique provided excellent preliminiary result in all of the patients. The technique allows graft retensioning again and again from both the femoral and the patellar side. The double bundle reconstruction seems to immitate the natural behaviour of the MPFL. However patellar tunnels carry a substantial risk of patella fracture and must be placed with great attention.

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Biomechanical Properties of the Stifle Joint Lateral Collateral Ligament in Dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633103 ◽

1992 ◽

Vol 05 (04) ◽

pp. 158-162 ◽

Cited By ~ 1

Author(s):

D. Blackketter ◽

J Harari ◽

J. Dupuis

Keyword(s):

Mechanical Properties ◽

Cruciate Ligament ◽

Lateral Collateral Ligament ◽

Biomechanical Properties ◽

Fibular Head ◽

Joint Stability ◽

Collateral Ligament ◽

Cranial Cruciate Ligament ◽

Stifle Joint

Bone/lateral collateral ligament/bone preparations were tested and structural mechanical properties compared to properties of cranial cruciate ligament in 15 dogs. The lateral collateral ligament has sufficient stiffness to provide stifle joint stability and strength to resist acute overload following fibular head transposition.

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Repair of a Divergent Elbow Dislocation with Distal Ulnar Fracture in a Dog Using TightRope and External Skeletal Fixation

VCOT Open ◽

10.1055/s-0041-1731439 ◽

2021 ◽

Vol 04 (01) ◽

pp. e58-e64

Author(s):

Marcos Garcia ◽

Camille Bismuth ◽

Claire Deroy-Bordenave

Keyword(s):

Elbow Dislocation ◽

Lateral Collateral Ligament ◽

Normal Activity ◽

Long Term Results ◽

Collateral Ligament ◽

Elbow Luxation ◽

Ulnar Fracture ◽

Fixation System

AbstractThe aim of this study was to report the outcome in a 6-year-old male English Setter dog that suffered a combination of divergent elbow dislocation and open distal ulnar fracture. This study is a case report. After surgical reduction in the elbow luxation, the dog was treated with the TightRope fixation system used as replacement of the lateral collateral ligament, a radioulnar positional screw, and external skeletal fixation. Removal of all implants was performed 3 months postoperatively. The 6-month follow-up visit found the dog without lameness, displaying normal activity, and with normal elbow range of motion and normal Campbell's test. Successful surgical management was achieved with good long-term results using TightRope, a positional screw, and an external skeletal fixator.

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Surgical Treatment for Malunion of the Lateral Humeral Epicondyle with Posterior Subluxation of the Radial Head: A Case Report and Literature Review

Case Reports in Orthopedics ◽

10.1155/2018/1901235 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Koichi Yano ◽

Yasunori Kaneshiro ◽

Hideki Sakanaka

Keyword(s):

Lateral Collateral Ligament ◽

High Energy ◽

Limited Range ◽

Forearm Rotation ◽

Collateral Ligament ◽

Lateral Epicondyle ◽

Limited Range Of Motion ◽

Contracture Release ◽

Normal Congruence ◽

The Right

A 24-year-old right-handed man suffered right olecranon and lateral epicondylar fracture from high energy trauma. Fixation of olecranon was performed by a previous doctor. Three months after operation, he presented with limited range of motion (ROM) of the right elbow caused by malunion of the lateral epicondylar fracture and subluxation of the radiohumeral joint. Preoperative ROM of the right elbow was flexion 110° and extension −75°. Forearm rotation was pronation 85° and supination 65°. Fragment excision of the lateral epicondyle, which was 27 mm in length, and lateral collateral ligament repair using anchors were performed. Fourteen months postoperatively, contracture release of the elbow was performed. Twenty-four months postoperatively, radiograph of the elbow showed normal congruence without osteoarthritic changes and the ROM of the right elbow was flexion 120° and extension −35°. Forearm rotation was pronation 90° and supination 70°. In the surgical setting, in case of the size of the lateral epicondylar fragment is relatively large, the fragment should be fixed or lateral collateral ligament should be repaired when the instability of the elbow is found.

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