Simultaneous Reconstruction of Both Medial and Lateral Collateral Ligament Complexes for Recurrent Instability of Elbow Dislocation: A Case Report

2012 ◽  
Vol 21 (04) ◽  
pp. 266-269 ◽  
Author(s):  
Jesse B. Jupiter ◽  
Carolina M. Baptista
Keyword(s):  
Case Report ◽  
Elbow Dislocation ◽  
Lateral Collateral Ligament ◽  
Collateral Ligament ◽  
Recurrent Instability ◽  
Simultaneous Reconstruction

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

VCOT Open ◽  
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.

Autologous Osteoligamentous Reconstruction of Scaphoid Proximal Pole With Metatarsal Head and Collateral Ligament: Cadaver Anatomic Description of Novel Surgical Technique

Hand ◽  
2020 ◽  
pp. 155894471989561
Author(s):  
Christopher G. Larkins ◽  
Shruti C. Tannan ◽  
Alison E. Burkett ◽  
Suhail K. Mithani ◽  
Ramesh C. Srinivasan ◽  
...  
Keyword(s):  
Lateral Collateral Ligament ◽  
Metatarsal Head ◽  
Cadaver Study ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Collateral Ligament ◽  
Cadaveric Specimen ◽  
Simultaneous Reconstruction ◽  
Second Metatarsal ◽  
Fresh Frozen

Background: Historically, scaphoid nonunion has been surgically treated with vascularized bone graft taken from multiple different anatomic sites. However, none of these grafts fully recapitulate the unique osteoligamentous anatomy of the proximal pole of the scaphoid and the attachment of the scapholunate ligament (SLIL). We studied the anatomy of the vascularized second metatarsal head with its lateral collateral ligament as a potential novel treatment of proximal pole scaphoid nonunion with collapse. Methods: Scaphoids and second metatarsal heads were harvested from bilateral upper and lower extremities of 18 fresh frozen cadavers (10 male, 8 female) for a total of 36 scaphoids and 36 second metatarsal heads. The ipsilateral second metatarsal head was harvested with its lateral collateral ligament and its blood supply from the second dorsal metatarsal artery (SDMA). Measurements of the scaphoid, the SLIL, the second metatarsal head, and lateral collateral ligaments were compared to matched limbs from the same cadaver. Results: The anatomic dimensions of the second metatarsal head with its lateral collateral ligament are similar to the scaphoid proximal pole and the SLIL in matched cadaveric specimen. Conclusions: This anatomic cadaver study reveals that the second metatarsal head with its associated lateral collateral ligament is a well-matched donor to reconstruct the proximal pole of the scaphoid and SLIL. This anatomic similarity may be well suited to treat nonunion of the scaphoid proximal pole with or without avascular necrosis with simultaneous reconstruction of the SLIL. The authors describe a technique of vascularized reconstruction of the osteoligamentous proximal pole of the scaphoid with its attached SLIL utilizing autologous second metatarsal head with its attached lateral collateral ligament. Based on this cadaver study, this technique merits consideration.

scholarly journals Does the Coronoid Always Need to Be Fixed in Terrible Triad Injuries of the Elbow? Mid-Term Postoperative Outcomes Following a Standardized Protocol

2020 ◽  
Vol 9 (11) ◽  
pp. 3500
Author(s):  
Beom-Soo Kim ◽  
Du-Han Kim ◽  
Seok-Ho Byun ◽  
Chul-Hyun Cho
Keyword(s):  
Operative Treatment ◽  
Radial Head ◽  
Lateral Collateral Ligament ◽  
Type I ◽  
Dash Score ◽  
Terrible Triad ◽  
Collateral Ligament ◽  
Recurrent Instability ◽  
Standardized Protocol ◽  
Coronoid Fractures

The purpose of this study was to investigate mid-term outcomes and complications after operative treatment according to a standardized protocol for terrible triad injuries. Twenty-four patients that were treated by a single surgeon with a standardized surgical protocol were retrospectively reviewed. After the complete reconstruction of radial head and/or lateral collateral ligament (LCL) complex through a lateral approach, coronoid process, and/or medial collateral ligament (MCL) complex through a medial approach were fixed if the elbow is unstable. For coronoid fractures, only type III were fixed in four cases (16.7%). Twenty-two LCL (91.7%) and five MCL (20.8%) complexes were repaired. At the final follow-up, the mean MEPS and Quick-DASH score were 91.5 and 17.3, respectively. There was no recurrent instability after operation in all cases. This study revealed that operative treatment that was based on our standardized protocol for terrible triad injuries yielded satisfactory mid-term clinical and radiographic outcomes without any recurrent instability. These results suggest that Type I and II coronoid fractures in terrible triad injuries do not need to be fixed if the radial head and ligamentous complex are completely reconstructed.

scholarly journals Common Extensor Complex Is a Predictor to Determine the Stability in Simple Posterolateral Elbow Dislocation: Analysis of MR Images of Stable vs. Unstable Dislocation

2020 ◽  
Vol 9 (10) ◽  
pp. 3094
Author(s):  
Chul-Hyun Cho ◽  
Beom-Soo Kim ◽  
Jaehyuck Yi ◽  
Hoseok Lee ◽  
Du-Han Kim
Keyword(s):  
Soft Tissue ◽  
Interobserver Reliability ◽  
Elbow Dislocation ◽  
Lateral Collateral Ligament ◽  
Soft Tissue Injuries ◽  
Collateral Ligament ◽  
Mri Findings ◽  
Partial Tears ◽  
Choice Of Treatment ◽  
Tissue Injuries

Simple posterolateral elbow dislocations (SPLED) may be treated nonoperatively using closed reduction, followed by controlled mobilization. However, the extent of soft tissue injuries might affect the choice of treatment, rehabilitation approach, and prognosis. The purpose of this study is to compare the characteristics of soft tissue injuries between patients with unstable and stable SPLED using MRI findings. Thirty MRIs of elbows with SPLED (unstable group (n = 15); stable group (n = 15)) were randomly reviewed by two experienced musculoskeletal radiologists. Soft tissue injuries were characterized as an intact, partial tear or complete tear for the: medial collateral ligament (MCL) complex, common flexor complex, lateral collateral ligament (LCL) complex, common extensor complex, anterior capsule, and posterior capsule. Moderate to substantial interobserver reliability and substantial to perfect intraobserver reliability were observed for medial and lateral complexes in SPLED. The proportion of soft-tissue injuries of the common extensor complex were significantly different between the unstable (four partial tears and 11 complete tears) and stable groups (11 partial tears and four complete tears). In conclusion, based on MRI findings, the degree of common extensor complex injuries may be a predictor of stability and help inform treatment decisions for SPLED.

Development of 3D Finite Element Model of Human Elbow to Study Elbow Dislocation and Instability

2009 ◽  
Author(s):  
Samer Khodor Al Kork ◽  
Farid Amirouche ◽  
Edward Abraham ◽  
Mark Gonzalez
Keyword(s):  
Finite Element ◽  
Medial Collateral Ligament ◽  
Inverse Dynamics ◽  
Elbow Dislocation ◽  
Lateral Collateral Ligament ◽  
Element Model ◽  
Fe Model ◽  
Collateral Ligament ◽  
Coronoid Fracture ◽  
Flexion Extension

The mechanics of elbow dislocation and its stages of dislocation are complex and not well understood. Reconstructing a fall where someone lands on their hand is one of the most challenging problem in biomechanics. Current models which attempt to reconstruct falls usually focus on experimental kinematical conditions that cause the fall coupled with inverse dynamics to determine the joint and muscles forces [1,2] to provide on insight into the joint instability. Our hypothesis based on our experimental investigation is that the mechanism of posterior elbow dislocation is initiated at radial head where the ulna and coronoid fracture followed by anterior tearing of the joint capsule, lateral collateral ligament will then rupture followed by posterior medial collateral ligament rupture and then the medial collateral ligament peeling off the ulna. In this study we developed a quasi-static three-dimensional finite element of human elbow joint, and conducted several cadaveric studies to study elbow dislocation. The FE model is used to investigate how the ligaments, cartilages behave under different flexion, extension of the elbow. Dislocation is investigated as function of different loads and moments applied to the radius-ulna with arm being flexed and configured into a supination or pronation.

scholarly journals Humeral Avulsion of the Lateral Collateral Ligament of the Elbow Concomitant with the Medial Epicondyle Fracture of a Child with General Joint Laxity

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Toru Morimoto ◽  
Masashi Izumi ◽  
Hiroaki Ueba ◽  
Masahiko Ikeuchi
Keyword(s):  
Chronic Conditions ◽  
Elbow Dislocation ◽  
Lateral Collateral Ligament ◽  
Medial Epicondyle ◽  
Joint Laxity ◽  
Collateral Ligament ◽  
Elbow Injury ◽  
Satisfactory Outcome ◽  
To Receive ◽  
Medial Epicondyle Fracture

Medial epicondyle fracture is a common elbow injury for children, and it was reported that 30-50% of this fracture was associated with elbow dislocation. However, dysfunction of the lateral collateral ligament (LCL) complex accompanied with the medial epicondyle fracture has rarely been reported. In this report, a 13-year-old girl who had a humeral avulsion of the LCL concomitant with a displaced medial epicondyle fracture was presented. Since her general joint laxity had been recognized from past medical history and the humeral avulsion of the LCL was clearly confirmed by ultrasonography, simultaneous surgical repair for the LCL avulsion and medial epicondyle fracture was conducted and satisfactory outcome was achieved. Although general joint laxity does not tend to receive attention in trauma as much as chronic conditions, it should be borne in mind to prevent overlooking important soft tissue damage coexisting with apparent fractures.

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