Effect of ulnar tunnel location on elbow stability in double-strand lateral collateral ligament reconstruction

Background Double-strand lateral ulnar collateral ligament (LUCL) reconstruction is an effective treatment for posterolateral rotatory instability (PLRI) of the elbow, but anatomic landmarks for ulnar tunnel placement are often difficult to identify intraoperatively, which potentially can result in...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2017-03, Vol.26 (3), p.409-415
Main Authors: Kim, H. Mike, MD, Andrews, Colin R., BS, Roush, Evan P., BS, Pace, Gregory I., MD, Lewis, Gregory S., PhD
Format: Article
Language:English
Subjects:
Adult
Anatomic Landmarks
Cadaver
Collateral Ligament, Ulnar - injuries
Collateral Ligament, Ulnar - surgery
docking technique
double-strand
Elbow Joint - injuries
Elbow Joint - physiology
Elbow Joint - surgery
elbow stability
Female
Humans
Joint Instability - etiology
Joint Instability - physiopathology
Joint Instability - surgery
Lateral ulnar collateral ligament reconstruction
Male
Middle Aged
Orthopedics
posterolateral rotatory instability
ulnar tunnels
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Summary:Background Double-strand lateral ulnar collateral ligament (LUCL) reconstruction is an effective treatment for posterolateral rotatory instability (PLRI) of the elbow, but anatomic landmarks for ulnar tunnel placement are often difficult to identify intraoperatively, which potentially can result in a nonanatomic LUCL reconstruction. This study investigated the effect of ulnar tunnel location on joint stability in double-strand LUCL reconstruction. Methods PLRI was artificially created in 7 cadaveric elbows, and double-strand LUCL reconstruction was performed. Five different ulnar tunnels were made along the length of the ulna. In each specimen, each possible pair of 2 tunnels (10 total) were used for graft passage. Varus and posterolateral joint gapping was measured after joint loading using a 3-dimensional digitizer system and X-ray image intensifier. Results No significant gapping was observed at the posterolateral ulnohumeral joint regardless of the location of the ulnar tunnels ( P  > .05). In contrast, the lateral radiocapitellar joint showed statistically significant varus gapping when both ulnar tunnels were placed proximal to the radial head-neck junction ( P  
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2016.08.008