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Journal articles on the topic 'Elbow instability'

Author: Grafiati

Published: 7 June 2025

Last updated: 17 July 2025

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1

O'Driscoll, Shawn W. "ELBOW INSTABILITY." Hand Clinics 10, no. 3 (1994): 405–15. http://dx.doi.org/10.1016/s0749-0712(21)01179-3.

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2

Graf, Dimitri N., Benjamin Fritz, Samy Bouaicha, and Reto Sutter. "Elbow Instability." Seminars in Musculoskeletal Radiology 25, no. 04 (2021): 574–79. http://dx.doi.org/10.1055/s-0041-1735467.

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AbstractThe stability of the elbow is based on a combination of primary (static) and secondary stabilizers (dynamic). In varus stress, the bony structures and the lateral ulnar collateral ligament (LUCL) are the primary stabilizers, and in valgus stress, the ulnar collateral ligament (UCL) is the primary stabilizer. The flexor and extensor tendons crossing the elbow joint act as secondary stabilizers. Elbow instability is commonly divided into acute traumatic and chronic instability. Instability of the elbow is a continuum, with complete dislocation as its most severe form.Posterolateral rotatory instability is the most common elbow instability and can be detected at imaging both in the acute as well as the chronic phase. Imaging of suspected elbow instability starts with radiographs. Depending on the type of injury suspected, it is followed by magnetic resonance imaging (MRI) or computed tomography evaluation for depiction of a range of soft tissue and osseous injures. The most common soft tissue injuries are tears of the LUCL and the radial collateral ligament; the most common osseous injuries are an osseous LUCL avulsion, a fracture of the coronoid process, and a radial head fracture.Valgus instability is the second most common instability and mostly detected in the chronic phase, with valgus extension overload the dominant pattern of injury. The anterior part of the UCL is insufficient in valgus extension overload due to repetitive medial tension seen in many overhead throwing sports, with UCL damage readily seen at MRI.

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3

Adams, Julie E. "Elbow Instability." Hand Clinics 36, no. 4 (2020): 485–94. http://dx.doi.org/10.1016/j.hcl.2020.07.013.

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4

Vollans, Sam R., and Roger P. van Riet. "Elbow instability." Orthopaedics and Trauma 30, no. 4 (2016): 310–16. http://dx.doi.org/10.1016/j.mporth.2016.05.011.

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5

Lee, Guy A., Stephen D. Katz, and Mark D. Lazarus. "Elbow Valgus Stress Radiography in an Uninjured Population." American Journal of Sports Medicine 26, no. 3 (1998): 425–27. http://dx.doi.org/10.1177/03635465980260031401.

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Valgus instability of the elbow joint is a clinical diagnosis. However, many authors describe valgus stress radiographs as an aid in making this diagnosis. We studied valgus stress radiographs of 20 men (40 elbows) and 20 women (40 elbows), none with a history of elbow trauma or instability. The medial ulnohumeral distance was measured with no stress, valgus stress by gravity, and an applied valgus stress of 25 N (approximately 5 pounds). Measurements were made with the elbow positioned in extension and in 30° of flexion. The increase in medial ulnohumeral gapping with either gravity or 5 pounds of stress was statistically significant at both extension and 30° of flexion compared with the unstressed condition. The difference in ulnohumeral gapping between gravity stress and 5 pounds of valgus stress in extension and in 30° of flexion was also significant. We found no differences with regard to hand dominance or sex. We conclude that uninjured elbows have significant medial ulnohumeral gapping on valgus stress radiography. Although this is an important tool in diagnosing valgus instability of the elbow, it may yield a false-positive assessment of valgus instability. Valgus stress radiographs comparing contralateral elbows may reduce the false-positive rate since there appears to be no significant difference in medial ulnohumeral gapping between the two elbows.

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6

Shalaby, M. A., and M. Y. A. Younan. "Limit Loads for Pipe Elbows Subjected to In-Plane Opening Moments and Internal Pressure." Journal of Pressure Vessel Technology 121, no. 1 (1999): 17–23. http://dx.doi.org/10.1115/1.2883661.

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The purpose of this study is to determine limit loads for pipe elbows subjected to inplane bending moments that tend to open the elbow (i.e., increase its radius of curvature), and the influence of internal pressure on the value of the limit load. Load-deflection curves were obtained, and from these curves plastic collapse and instability loads at various values of internal pressure were determined. This was done for different pipe bend factors (h = Rt/r2) using the nonlinear finite element analysis code (ABAQUS) with its special elbow element. A set of limit curves was generated from the results. These curves show the variation of collapse and instability loads with internal pressure for different elbows. Collapse loads were found to increase and then decrease with increasing pressure for all the elbow geometries studied. Instability loads were difficult to reach because of the large stiffening effect of the elbow cross-sectional deformation, and they were generally found to decrease with increasing pressure.

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7

TEZUKA, KAZUSHI, YUKINORI TOMODA, TOKUHIDE DOI, et al. "BASEBALL ELBOW AND ELBOW JOINT INSTABILITY." Japanese Journal of Physical Fitness and Sports Medicine 37, no. 1 (1988): 37–45. http://dx.doi.org/10.7600/jspfsm1949.37.37.

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8

Tashjian, Robert Z., and Julia A. Katarincic. "Complex Elbow Instability." Journal of the American Academy of Orthopaedic Surgeons 14, no. 5 (2006): 278–86. http://dx.doi.org/10.5435/00124635-200605000-00003.

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9

Graf, Dimitri N., Benjamin Fritz, Samy Bouaicha, and Reto Sutter. "Erratum: Elbow Instability." Seminars in Musculoskeletal Radiology 25, no. 04 (2021): e1-e1. http://dx.doi.org/10.1055/s-0041-1740231.

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10

Hutchinson, M. R. "ELBOW INSTABILITY - GYMNASTICS." Medicine & Science in Sports & Exercise 34, no. 5 (2002): S96. http://dx.doi.org/10.1097/00005768-200205001-00536.

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11

Steinmann, S. P., and S. W. O'Driscoll. "(iii) Elbow instability." Current Orthopaedics 16, no. 5 (2002): 341–48. http://dx.doi.org/10.1054/cuor.2002.0287.

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12

Lee, Michael L., and Melvin P. Rosenwasser. "CHRONIC ELBOW INSTABILITY." Orthopedic Clinics of North America 30, no. 1 (1999): 81–89. http://dx.doi.org/10.1016/s0030-5898(05)70062-6.

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13

Modi, Chetan S., Emma Lawrence, and Tom M. Lawrence. "(iv) Elbow instability." Orthopaedics and Trauma 26, no. 5 (2012): 316–27. http://dx.doi.org/10.1016/j.mporth.2012.08.004.

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14

Ebrahimzadeh, Mohamed H., Husain Amadzadeh-Chabock, and David Ring. "Traumatic Elbow Instability." Journal of Hand Surgery 35, no. 7 (2010): 1220–25. http://dx.doi.org/10.1016/j.jhsa.2010.05.002.

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15

DiPaola, Matthew, William B. Geissler, and A. Lee Osterman. "Complex Elbow Instability." Hand Clinics 24, no. 1 (2008): 39–52. http://dx.doi.org/10.1016/j.hcl.2007.11.010.

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16

Kovacevic, David, Laura A. Vogel, and William N. Levine. "Complex Elbow Instability." Hand Clinics 31, no. 4 (2015): 547–56. http://dx.doi.org/10.1016/j.hcl.2015.06.004.

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17

Clitherow, Harry Dominic Stracey, Duncan Thomas McGuire, and Gregory Ian Bain. "Lateral elbow instability." Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology 1, no. 1 (2014): 11–18. http://dx.doi.org/10.1016/j.asmart.2013.12.003.

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18

Sonar, Satish B., Hemant Parekh, and Rajendra Baitule. "POSTEROLATERAL ROTATORY, INSTABILITY, ELBOW." Journal of Evidence Based Medicine and Healthcare 2, no. 33 (2015): 4981–88. http://dx.doi.org/10.18410/jebmh/2015/695.

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19

Flanigan, David Clint, and Lee D. Kaplan. "Elbow dislocations and instability." Current Opinion in Orthopaedics 15, no. 4 (2004): 280–85. http://dx.doi.org/10.1097/00001433-200408000-00016.

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20

Wills, R., J. Nacht, and G. Popich. "CHRONIC ELBOW INSTABILITY -WRESTLING." Medicine & Science in Sports & Exercise 24, Supplement (1992): S81. http://dx.doi.org/10.1249/00005768-199205001-00487.

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21

Lattanza, Lisa L., and Greg Keese. "Elbow Instability in Children." Hand Clinics 24, no. 1 (2008): 139–52. http://dx.doi.org/10.1016/j.hcl.2007.11.007.

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22

Chen, Neal C. "Elbow Fractures with Instability." Hand Clinics 34, no. 1 (2018): 75–83. http://dx.doi.org/10.1016/j.hcl.2017.09.008.

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23

Pipicelli, Joey G., and Graham J. W. King. "Rehabilitation of Elbow Instability." Hand Clinics 36, no. 4 (2020): 511–22. http://dx.doi.org/10.1016/j.hcl.2020.07.003.

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24

Grace, Sean P., and Larry D. Field. "Chronic Medial Elbow Instability." Orthopedic Clinics of North America 39, no. 2 (2008): 213–19. http://dx.doi.org/10.1016/j.ocl.2007.12.003.

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25

Cheung, Emilie V. "Chronic Lateral Elbow Instability." Orthopedic Clinics of North America 39, no. 2 (2008): 221–28. http://dx.doi.org/10.1016/j.ocl.2007.12.007.

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26

Shetty, Ganesh R., M. Sabari, Yogadeepan Dhakshinamurthi, Muthusarvanakumar Meignanaguru, and Deepak Srinivasan. "Management of Adult Lateral Condyle Fracture: Unveiling a Complex Elbow Injury: A Case Report." Journal of Orthopaedic Case Reports 15, no. 3 (2025): 53–57. https://doi.org/10.13107/jocr.2025.v15.i03.5332.

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Introduction: Lateral condyle fracture with elbow instability is a rare injury. To our knowledge, this is the second case report describing the mechanism of injury and its management. Case Report: We report the case of 42-year-old gentleman sustained injury to elbow following slip and fall. He presented to us after 2 weeks of injury diagnosed to have lateral condyle fracture of humerus managed conservatively with elbow instability which was missed initially. On further evaluation, he was found to have type 1 coronoid avulsion injury. Intraoperatively, we found that the capsular avulsion injury from coronoid was the primary reason for instability. We have tried to describe the possible mechanism of injury and management in this case report. Conclusion: Lateral condyle fracture in adults is a rare injury which can disguise the more complex trauma associated with fracture dislocation of elbow. Proper preoperative evaluation with intraoperative assessment of elbow instability is crucial for obtaining good outcome. Keywords: Lateral condyle fracture, complex elbow dislocation, elbow instability, terrible triad.

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27

Abellán-Miralles, César, Daniel Berlanga-de-Mingo, Raquel Samaniego-Alonso, Jorge Hugo Villafañe, and Karla Bascones-Rodríguez. "Annular Ligament Instability." Topics in Geriatric Rehabilitation 40, no. 2 (2024): 170–74. http://dx.doi.org/10.1097/tgr.0000000000000438.

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Purpose: Lateral elbow pain is frequently attributed to epicondylalgia; yet, less common pathologies with limited literature representation exist. This study aims to delineate the diagnostic significance of alterations in the biomechanics and morphology of the annular ligament as a distinctive factor in lateral elbow pain. Methods: A retrospective observational analysis was conducted on patients surgically treated for lateral elbow pain with arthroscopic assistance from January 2015 to December 2018. Initial preoperative diagnoses primarily indicated epicondylalgia. Results: The study encompassed 82 patients (48 men, 34 women; mean age: 44.6 ± 5.3 years), with 91.46% involved in demanding manual work. Notably, 17 patients underwent surgery due to recurrent symptoms. Arthroscopic assessments revealed diverse morphological and biomechanical variations in annular ligaments, designating 36 patients with an identified incompetent annular ligament. Conclusions: Our arthroscopic study on lateral epicondylalgia cases involved a comprehensive analysis of annular ligament anatomy and radiocapitellar joint biomechanics. The formulated anatomic classification, incorporating crucial variables such as radial head coverage and ligament tension, unveiled implications for joint instability. Recognition of simultaneous pathologies, notably annular ligament lesions, signifies a potential, yet unexplored, avenue for differential diagnosis in cases of lateral elbow pain.

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28

Gomes, Pedro, and Amar Adam. "Postero-External Dislocations of the Bilateral Elbow Associated with Detachment of the Medial Epicondyls in Children: About a Case Report." Scholars Journal of Medical Case Reports 11, no. 07 (2023): 1384–87. http://dx.doi.org/10.36347/sjmcr.2023.v11i07.015.

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Posterolateral dislocations of the bilateral elbow associated with medial epicondyle detachment in children are rare lesions following high-energy trauma and are more often observed in children elbow dislocation associated with unilateral epicondyle detachment but bilateral remains exceptional. Constitute a pediatric emergency and ineffective treatment causes instability of the elbow and pseudarthrosis of the lateral epicondyle. We report the case of a case of bilateral posterolateral elbow dislocation associated with detachment of the medial epicondyles. This is an 11-year-old patient, admitted for blunt trauma to the bilateral elbows, the clinical examination noted edema and deformities of both elbows. Radiological assessment showed bilateral posterolateral dislocation of the elbows associated with stage IV medial epicondyle detachments according to the Watson-Jones classification. The patient underwent closed manual reduction and open-hearth pinning and then BABP cast; for right medial epicondyle and open screwing for left medial epicondyle and then BABP cast. Immediate and remote postoperative control deemed satisfactory, splints removed at 3 weeks, elbow rehabilitation was prescribed, osteosynthesis materials removed at 6 weeks with good clinical results.

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29

Mironov, S. P., and G. M. Burmakova. "Medial Elbow Instability in Athletes." N.N. Priorov Journal of Traumatology and Orthopedics 3, no. 4 (1996): 16–23. http://dx.doi.org/10.17816/vto103877.

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In Sports and Ballet Trauma Department of CITO 52 sportsmen of high qualification with medial elbow instability were treated from 1983 to 1995. Clinical signs and methods of examination are presented. The authors define three degrees of elbow instability resulted from medial collateral ligament insufficiency. This classification is taken as a principle for the choice of treatment tacktics. In 28 patients with instability of degree 1 the lateral stability of the joint was restored conservatively (remedial gymnastics to strengthen the surrounding muscles with special attention to the medial head of the triceps, electrostimulation, novocaine blockade along the ligament). Sixteen patients out of that group underwent the revision of elbow joint with chondroplasty and removal of loose bodies. Instability of degrees 2 and 3 was the indication to surgical treatment. Damaged capsular ligamentous system was sutured by dublicatums technique. In 3 patients autograft from triceps tendon was used to strengthen the medial wall of the elbow joint. Forty six patients were examined within 1-6 years after treatment; function elbow and sports activity were restored completely in all patients.

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30

Sanchez-Sotelo, Joaquín, and Mark Morrey. "Complex elbow instability: surgical management of elbow fracture dislocations." EFORT Open Reviews 1, no. 5 (2016): 183–90. http://dx.doi.org/10.1302/2058-5241.1.000036.

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31

Pacelli, Lorenzo L., Madonna Guzman, and Michael J. Botte. "Elbow Instability: The Orthopedic Approach." Seminars in Musculoskeletal Radiology 09, no. 01 (2005): 56–66. http://dx.doi.org/10.1055/s-2005-867103.

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32

Jung, Hyoung Seok, and Min Jong Park. "Medial Instability of the Elbow." Archives of Hand and Microsurgery 23, no. 2 (2018): 78. http://dx.doi.org/10.12790/ahm.2018.23.2.78.

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33

Ring, David, Mark Koris, and Jesse B. Jupiter. "Instability after total elbow arthroplasty." Orthopedic Clinics of North America 32, no. 4 (2001): 671–77. http://dx.doi.org/10.1016/s0030-5898(05)70236-4.

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34

Ring, David, and Jesse B. Jupiter. "Reconstruction of Posttraumatic Elbow Instability." Clinical Orthopaedics and Related Research 370 (January 2000): 44–56. http://dx.doi.org/10.1097/00003086-200001000-00006.

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35

Ring, David. "Instability After Total Elbow Arthroplasty." Hand Clinics 24, no. 1 (2008): 105–12. http://dx.doi.org/10.1016/j.hcl.2007.11.002.

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36

Szekeres, Mike, Shrikant J. Chinchalkar, and Graham J. W. King. "Optimizing Elbow Rehabilitation After Instability." Hand Clinics 24, no. 1 (2008): 27–38. http://dx.doi.org/10.1016/j.hcl.2007.11.005.

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37

Tarassoli, Payam, Philip McCann, and Rouin Amirfeyz. "Complex instability of the elbow." Injury 48, no. 3 (2017): 568–77. http://dx.doi.org/10.1016/j.injury.2013.09.032.

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38

Giannicola, Giuseppe, Federico Maria Sacchetti, Alessandro Greco, Gianluca Cinotti, and Franco Postacchini. "Management of complex elbow instability." MUSCULOSKELETAL SURGERY 94, S1 (2010): 25–36. http://dx.doi.org/10.1007/s12306-010-0065-8.

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39

Rotini, Roberto. "An overview about elbow instability." MUSCULOSKELETAL SURGERY 98, S1 (2014): 1–3. http://dx.doi.org/10.1007/s12306-014-0330-3.

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40

Joshi, Ruban Raj, and Gabriel David Sundararaj. "Clinical Results of Surgically Treated Medial Humeral Epicondylar Apophyseal Avulsion Injury in Children and Adolescent." Journal of Lumbini Medical College 2, no. 2 (2014): 31. http://dx.doi.org/10.22502/jlmc.v2i2.54.

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Introduction: Fractures of the medial humeral epicondyle represent approximately 10% of all paediatric elbow fractures. Objective of our study was to assess treatment outcomes of children and adolescent with medial epicondylar fracture of the elbow using standard operative protocols. Methods: 20 surgically treated fractures of the medial humeral epicondyle were analysed & reviewed for their epidemiological, clinical and surgical parameters. A valgus stress test was performed under general anesthesia or sedation. All patients underwent open reduction internal fixation using a similar technique. The medial epicondylar fragment was anatomically reduced and fixed in all cases with screws, Kirshner wires or tension band wiring. At final evaluation, union (radiologically) and elbow function [MAYO elbow performance score (MEPS)] was assessed. Results: An evaluation of all of our patients after a mean follow-up of 8.75 months (SD=4.76) after initial surgery was possible. The mean age of patients at the time of injury was 10.8years (SD=2.3). Fifteen (75%) dominant elbows were injured in our study and 12(60%) elbows had an associated elbow dislocation. On examination in operating room post anaesthesia, all of the elbow injuries revealed some degree of valgus instability. All of our patients(n=20) showed good to excellent results in the MAYO elbow performance score (MEPS). Radiographically, union was achieved in all cases. Three patients developed postoperative ulnar nerve neuropraxia, all recovered at time of final follow up. One patient developed mild lateral heterotrophic ossification but did not require any additional surgical intervention. Conclusion: Our results suggest that open reduction internal fixation of displaced medial epicondyle fractures leads to satisfactory motion and function. A valgus stress test in operating room can reveal the true nature of joint instability that can warrant operative stabilization of medial epicondylar injuries.

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41

Danilov, M. A., D. S. Ershov, M. V. Liadova, D. A. Badriev, and N. S. Ershov. "TREATMENT OF SIMPLE CHRONIC INSTABILITY OF THE ELBOW JOINT." Surgical practice, no. 1 (March 20, 2022): 14–21. http://dx.doi.org/10.38181/2223-2427-2022-1-14-21.

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Simple chronic instability of the elbow joint is one of the urgent problems in modern traumatology due to the fact that the standard tactics of managing patients with traumatic injuries of the elbow joint due to dislocation, which amounts to its elimination, immobilization of the upper limb and subsequent development of movements in the joint, most often does not take into account damage to specific soft tissue structures. With untimely treatment for qualified help, with late or unsuccessful attempts to eliminate dislocation of the bones of the forearm, less often with chronic traumatization of the ligamentous apparatus of the elbow joint during some types of occupation, one of the most unpleasant complications may form, namely, chronic instability. This article discusses the main types of chronic instability of the elbow joint, analyzes approaches to the management of patients with simple chronic instability. Despite the not very high occurrence of this pathology, the effectiveness of modern surgical treatment options aimed at reconstruction of the ligamentous apparatus of the elbow joint, the percentage of unsatisfactory results of treatment of simple chronic recurrent and persistent instability of the elbow joint remains high.

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42

Shih, K. S., T. W. Lu, Y. C. Fu, S. M. Hou, J. S. Sun, and C. Y. Cheng. "Biomechanical Analysis of Nonconstrained and Semiconstrained Total Elbow Replacements: A Preliminary Report." Journal of Mechanics 24, no. 1 (2008): 103–10. http://dx.doi.org/10.1017/s172771910000160x.

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ABSTRACTThe development of elbow arthroplasties has significantly improved the quality of life for many patients suffering from disabling elbow disorders. However, the high complication rate such as loosening and instability limits the long term use of total elbow replacement (TER). In the present study, biomechanical analyses on patients with unilateral nonconstrained (Souter-Strathclyde) and semiconstrained (Coonard-Morrey) TER subjects were performed to investigate differences of their motion patterns under unloaded and loaded conditions. In a biomechanical laboratory, each subject performed vertical and horizontal elbow flexion/extension first without and then with external loading (5 lb). The kinematic data were measured using 3D motion analysis system and the motion axis of the elbow was calculated by a well-defined mathematic model. During these tests, the upperarm was fixed with a special fixation device and their forearms fully supinated. The elbow motion patterns of the affected sides were compared with those of the normal sides and between different conditions. The results revealed that the elbows moved about a relatively fixed axis both in the semiconstrained and nonconstrained groups in the vertical flexion/extension with or without external loading, compatible with the normal elbows. However, the nonconstrained elbows were less stable during horizontal flexion/externsion motion with or without external loading and the elbow axis moved significantly, indicating of less stability. We conclude that this methodology of elbow motion analysis is acceptable and can be widely recommended for total elbow study. Moreover, the nonconstrained TER is less stable than the semiconstrained TER during the horizontal movement, which was compatible with previous clinical results. The patients with nonconstrained TER are suggested to avoid using their elbows in horizontal motion, especially in loaded conditions.

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Shalaby, M. A., and M. Y. A. Younan. "Limit Loads for Pipe Elbows With Internal Pressure Under In-Plane Closing Bending Moments." Journal of Pressure Vessel Technology 120, no. 1 (1998): 35–42. http://dx.doi.org/10.1115/1.2841882.

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The purpose of this study is to determine limit loads for pipe elbows subjected to in-plane bending moments that tend to close the elbow (i.e., decrease its radius of curvature), and the influence of internal pressure on the value of the limit load. Load-deflection curves were obtained, and from these curves plastic collapse or instability loads at various values of internal pressure were determined. This was done for different pipe bend factors (h = Rt/r2) using the nonlinear finite element analysis code (ABAQUS) with its special elbow element. The limit load was found to increase and then decrease with increasing pressure for all the elbow geometries studied.

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44

Ahmad, Christopher S., Thay Q. Lee, and Neal S. ElAttrache. "Biomechanical Evaluation of a New Ulnar Collateral Ligament Reconstruction Technique with Interference Screw Fixation." American Journal of Sports Medicine 31, no. 3 (2003): 332–37. http://dx.doi.org/10.1177/03635465030310030201.

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Background Techniques for ulnar collateral ligament reconstruction have evolved. Hypothesis Ulnar collateral ligament reconstruction with interference screw fixation restores elbow kinematics and failure strength to that of the native ligament. Study Design Controlled laboratory study. Methods Of 10 matched pairs of cadaveric elbows, one underwent kinematic testing under conditions of an intact, released, and reconstructed ligament. Single 5-mm diameter bone tunnels were created at the isometric anatomic insertion sites on the medial epicondyle and sublime tubercle. Graft fixation was achieved with 5 × 15 mm soft tissue interference screws. The reconstructed and contralateral intact elbows were then tested to failure. Results Average stiffness for intact elbows (42.81 ± 11.6 N/mm) was significantly greater than for reconstructed elbows (20.28 ± 12.5 N/mm). Ultimate moment for intact elbows (34.0 ± 6.9 N·m) was not significantly different from reconstructed elbows (30.6 ± 19.2 N·m). Release of the ulnar collateral ligament caused a significant increase in valgus instability. Reconstruction restored valgus stability to near that of the intact elbow. Conclusions With this reconstruction method, failure strength was comparable with that of the native ligament and physiologic elbow kinematics were reliably restored. Clinical Relevance This technique returns elbow kinematics to near normal, with less soft tissue dissection and risk of ulnar nerve injury and ease of graft insertion, tensioning, and fixation.

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45

Mahasupachai, Nattakorn, Nutthakorn Samathi, Arnakorn Premsiri, and Cholawish Chanlalit. "The sonographic posterolateral rotatory stress test: Normal ulnohumeral gap difference in healthy volunteers." Journal of Orthopaedic Surgery 30, no. 3 (2022): 102255362211288. http://dx.doi.org/10.1177/10225536221128861.

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Background: The sonographic posterolateral rotatory stress test may be a good preoperative diagnostic tool for posterolateral rotatory instability, especially in atraumatic or occult cases. However, there is lack of study on the living population or the normal elbow. Hypothesis/Purpose: This study evaluates the ulnohumeral opening gap difference between elbows in resting and stress positions while performing ultrasonography in normal healthy volunteers. The hypothesis is that the normal ulnohumeral opening gap difference is less than 2 mm. Methods: A total of 21 participants (9 males and 12 females) who presented at our institution between May and June 2021 were recruited. First, participants with elbow deformity, major elbow trauma, history of injection or surgery around the elbow, or evidence of elbow instability were excluded. Only healthy elbows without symptoms were included in this study. Participants’ both elbows were examined using ultrasonography. The ulnohumeral gap was measured in millimeters, and the difference was calculated from the means of ulnohumeral gap in resting and stress positions. Results: The mean age of participants was 36.14 years old. No samples with hyperlaxity were included. Overall, the means of ulnohumeral gap in resting and stress positions were 2.55 ± 0.69 mm and 3.16 ± 0.80 mm, respectively. The average mean of overall ulnohumeral opening gap difference was 0.61 ± 0.32 mm. There was no statistically significant difference between males and females ( p = .989). The intraobserver reliability was 0.89 and 0.9 for resting and stress positions, respectively. Conclusion: The sonographic posterolateral rotatory stress test shows that the ulnohumeral opening gap difference between resting and stress positions is less than 2 mm in healthy volunteers. Clinical Relevance: In patients with inconclusively-diagnosed PLRI, the sonographic posterolateral rotatory stress test may be a reliable preoperative diagnosis tool, providing its non-invasiveness and the ability to assess the contralateral side as a comparison.

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Seo, Joong-Bae, Hyung-Suk Yi, Kyu-Beom Kim, and Jae-Sung Yoo. "Clinical outcomes of arthroscopic lateral ulnar collateral ligament repair with or without intra-articular fracture." Journal of Orthopaedic Surgery 28, no. 1 (2020): 230949902090834. http://dx.doi.org/10.1177/2309499020908348.

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Background: The pathoanatomy and biomechanics of elbow instability have been previously reported; however, few researchers have dealt with the operative management and clinical consequence of recurrent elbow instability. Recent studies on arthroscopic lateral collateral ligament (LCL) complex repair have reported successful outcomes similar to those achieved by open repair. We aimed to determine the validity of arthroscopic repair of the LCL complex in elbows with unstable dislocation with or without intra-articular fracture. Methods: Eighteen consecutive patients who had undergone arthroscopic repair of the LCL complex for unstable dislocation of the elbow with or without intra-articular fracture and who were followed for at least 12 months were included in the study. Ligament injury combined with coronoid and/or radial head fractures were treated with arthroscopic technique. Pain, range of motion, clinical outcomes based on the Mayo Elbow Performance Score (MEPS), and surgical complications were evaluated. Results: At 12 months follow-up, all 18 patients demonstrated complete settlement of the instability and mean (and standard deviation) extension of 1.7 ± 3.8°, flexion of 138.3 ± 3.8°, supination of 88.6 ± 5.3°, and pronation of 88.2 ± 5.6°. The average MEPS was 97.7 ± 3.9 points and according to this validated outcome score. However, slight widening (2 mm) of the radiocapitellar joint space was accompanied in one patient, although the varus stress test and pivot shift test were not observed. One patient showed delayed union of the anteromedial facet fracture, and two patients showed pin site irritation, which was a complication of arthroscopic coronoid fracture fixation and was fully resolved after pin removal. Conclusion: In patients with unstable elbow dislocation, with or without an intra-articular fracture, arthroscopic repair of the LCL complex is an effective and alternative treatment option that can restore elbow stability and have satisfactory clinical and radiographic results.

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van Riet, Roger P. "Assessment and decision making in the unstable elbow: management of simple dislocations." Shoulder & Elbow 9, no. 2 (2017): 136–43. http://dx.doi.org/10.1177/1758573216686533.

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Simple elbow dislocations are usually treated conservatively. Radiographs are negative in simple dislocations. Results are generally good, although a small percentage of patients may develop chronic instability. Ligamentous repair can be indicated in high demand patients or if the elbow remains unstable following a closed reduction. Chronic instability is classified per their direction. Surgery is often indicated in the chronically unstable elbow.

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RAMSEY, MATTHEW L., ROBERT A. ADAMS, and BERNARD F. MORREY. "Instability of the Elbow Treated with Semiconstrained Total Elbow Arthroplasty*." Journal of Bone & Joint Surgery 81, no. 1 (1999): 38–47. http://dx.doi.org/10.2106/00004623-199901000-00006.

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Manocha, Ranita H. K., James A. Johnson, and Graham J. W. King. "The Effectiveness of a Hinged Elbow Orthosis in Medial Collateral Ligament Injuries: An In Vitro Biomechanical Study." American Journal of Sports Medicine 47, no. 12 (2019): 2827–35. http://dx.doi.org/10.1177/0363546519870517.

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Background: Medial collateral ligament (MCL) injuries are common after elbow trauma and in overhead throwing athletes. A hinged elbow orthosis (HEO) is often used to protect the elbow from valgus stress early after injury and during early return to play. However, there is minimal evidence regarding the efficacy of these orthoses in controlling instability and their influence on long-term clinical outcomes. Purpose: (1) To quantify the effect of an HEO on elbow stability after simulated MCL injury. (2) To determine whether arm position, forearm rotation, and muscle activation influence the effectiveness of an HEO. Study Design: Controlled laboratory study. Methods: Seven cadaveric upper extremity specimens were tested in a custom simulator that enabled elbow motion via computer-controlled actuators and motors attached to relevant tendons. Specimens were examined in 2 arm positions (dependent, valgus) and 2 forearm positions (pronation, supination) during passive and simulated active elbow flexion while unbraced and then while braced with an HEO. Testing was performed in intact elbows and repeated after simulated MCL injury. An electromagnetic tracking device measured valgus angulation as an indicator of elbow stability. Results: When the arm was dependent, the HEO increased valgus angle with the forearm in pronation (+1.0°± 0.2°, P = .003) and supination (+1.5°± 0.0°, P = .006) during active motion. It had no significant effect on elbow stability during passive motion. In the valgus position, the HEO had no effect on elbow stability during passive or active motion in pronation and supination. With the arm in the valgus position with the HEO, muscle activation reduced instability during pronation (–10.3°± 2.5°, P = .006) but not supination ( P = .61). Conclusion: In this in vitro study, this HEO did not enhance mechanical stability when the arm was in the valgus and dependent positions after MCL injury. Clinical Relevance: After MCL injury, an HEO likely does not provide mechanical elbow stability during rehabilitative exercises or when the elbow is subjected to valgus stress such as occurs during throwing.

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Trasolini, Nicholas A., Jerry Chidester, Alidad Ghiassi, and Milan Stevanovic. "Brachioradialis Flap With Vascularized Lateral Ulnar Collateral Ligament Reconstruction: A Case Report." HAND 15, no. 2 (2019): NP37—NP41. http://dx.doi.org/10.1177/1558944719843632.

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Background: Soft tissue defects about the elbow with concurrent ligamentous instability can be challenging to treat. Methods: We present a case report of a lateral elbow wound that resulted in lateral ulnar collateral ligament deficiency and posterolateral elbow instability. Results: We describe our technique of a modified brachioradialis rotational flap, in which the muscle is rotated to cover the soft tissue defect, while the vascularized brachioradialis tendon is used to simultaneously reconstruct the lateral ulnar collateral ligament. This procedure successfully restored posterolateral elbow stability at the time of wound coverage. Conclusion: Elbow soft tissue defects with associated ligamentous injuries can be treated using a modification of the brachioradialis rotational flap.

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