Anatomie fonctionnelle du complexe ligamentaire collatéral latéral du coude

Abstract

Postero-lateral instability of the elbow joint is a rare clinical condition, commonly related to a disruption of the lateral collateral ligament complex of the elbow. Twenty elbow joint specimens were studied in order to describe the morphologic characteristics of this complex, and to determine the role of its different components in the stability of the elbow. After a morphologic and morphometric investigation, serial divisions of the medial bundle of the lateral collateral ligament were performed, with or without section of the annular ligament and the anterior bundle of the lateral collateral ligament. The anterior and medial bundles of the lateral collateral ligament had close relationships with the annular ligament and a common proximal course. Isolated section of the medial bundle of the lateral collateral ligament induced only minor laxity of the elbow joint. Combined divisions of the medial and the anterior bundles at their humeral insertion, or the medial bundle and the annular ligament at their ulnar insertion resulted in a reproducible subluxation of the ulno-humeral joint. Thus, postero-lateral rotatory stability of the elbow joint is largely maintained by the lateral collateral ligament complex, composed of three elements: the anterior and medial bundles of the lateral collateral ligament, and the annular ligament. In clinical practice, chronic postero-lateral instability is best treated by a ligamentous reconstruction, that must take into account all these anatomic considerations. We report here a new technique of ligamentoplasty using the fascia of the extensor carpi ulnaris muscle.

Influence of developing ligaments on the muscles in contact with them: a study of the annular ligament of the radius and the sacrospinous ligament in mid-term human fetuses

“…According to Mérida-Velasco et al [12], the first signs of the ANL are evident at 7 weeks, and the joint capsule becomes anchored to the ligament at 9 weeks. The thick intermuscular connecting band we observed at the elbow most likely corresponded to the lateral ulnar collateral ligament in adults described by O'Driscoll et al [20], Hannouche and Bégué [21] and Imatani et al [22]. Thus, at 15-18 weeks, the so-called lateral collateral ligament complex of the elbow [23] seemed to develop, with subsequent thickening of the ANL.…”

Ultrasound assessment of the lateral collateral ligamentous complex of the elbow: imaging aspects in cadavers and normal volunteers

“…However, more recent anatomical and biomechanical studies have challenged that concept and the entire LCL is now considered by many to be equally important for lateral elbow stability [2, 18, 23–28]. Although the anatomy of the LCL has been well described, only a few studies have focused on its ultrasound aspects [16, 29–32].…”

The treatment of recurrent posterolateral instability of the elbow

“…A lesion of the LCL is the first stage of dislocation of the elbow. 1,3,7,[16][17][18][19][20] There are few published surgical procedures for the treatment of recurrent instability of the elbow. In the past, T authors have described bone block procedures and tendon transfers [21][22][23] and, more recently, soft-tissue reconstructions of the lateral ligament.…”