In vivo changes in length of elbow collateral ligaments during pronation and supination on an outstretched arm

Wang, Yan; Sun, Yucheng; Chen, Jing; Kholinne, Erica; Jeon, In-Ho; Tan, Jun

doi:10.1007/s00276-020-02451-5

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…In the current study setting, the distal radioulnar joint was transfixed in neutral position to prevent undesired prosupination; the neutral position was chosen because it is the one which best resembles the position used in many office-based jobs, which is based on elbow suspension, varus stress and only minimal pronation of the forearm. However, conflicting results on the contribution of forearm rotation to elbow stability have been published [ 10 , 12 , 26 , 27 , 41 , 51 , 52 ], encouraging future studies aimed at comparing the differences in elbow laxity caused by R-LCL release at different degrees of forearm rotation. Flexion angles also affect ligamentous tension, but were not shown to affect the stability patterns significantly after muscular releases [ 12 , 31 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound evaluation shows increase in laxity after partial common extensor origin detachment but not after additional lesion of the radial band of the lateral collateral ligament

Arrigoni

Cucchi

Luceri

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose The lateral elbow musculature conveys a dynamic valgus moment to the elbow, increasing joint stability. Muscular or tendinous lesions to the anterior half of the common extensor origin (CEO) may provoke a deficiency in the elbow dynamic stabilizers, regardless of their traumatic, degenerative, or iatrogenic aetiology. Furthermore, a role for the radial band of the lateral collateral ligament (R-LCL) has been postulated in the aetiology of lateral elbow pain. This study aimed to evaluate the effects of sequential lateral releases with dynamic ultrasound, evaluating its capability to detect lesions of the CEO and of the R-LCL. Methods Ultrasound investigation of the lateral compartment of the elbow was performed on nine cadaveric specimens with a 10 MHz linear probe in basal conditions, after the release of the anterior half of the CEO and after complete R-LCL release. The lateral joint line widening (λ) was the primary outcome parameter, measured as the linear distance between the humeral and radial articular surfaces. Results The release of the anterior half of the CEO significantly increased λ by 200% compared to the starting position (p = 0.0008) and the previously loaded position (p = 0.0015). Conversely, further release of the R-LCL caused only a marginal, non-significant increase in λ. Conclusions Ultrasound evaluation can detect changes related to tendon tears or muscular avulsions of the CEO and can depict lateral elbow compartmental patholaxity by assessing articular space widening while scanning under dynamic stress. However, it cannot reliably define if the R-LCL is injured. Iatrogenic damage to the CEO should be carefully avoided, since it causes a massive increase in compartmental laxity.

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Section: Discussionmentioning

confidence: 99%

Ultrasound evaluation shows increase in laxity after partial common extensor origin detachment but not after additional lesion of the radial band of the lateral collateral ligament

Arrigoni

Cucchi

Luceri

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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“…The forearm is placed in full supination, as this position better stabilizes the MCL, while not jeopardizing tension of the LUCL. 19,20 An assistant holds the graft tails that exit the humerus from both sides in tension. A knotless Swivelock 4.75 anchor (Arthrex, The graft and one looped suture are passed through the humeral tunnel from lateral to medial.…”

Section: Graft Passage and Augmentationmentioning

confidence: 99%

“…The elbow is held at 30 degrees of flexion. The forearm is placed in full supination, as this position better stabilizes the MCL, while not jeopardizing tension of the LUCL 19,20. An assistant holds the graft tails that exit the humerus from both sides in tension.…”

Section: Techniquementioning

confidence: 99%

Modified Graft Loop Technique Augmented With Nonabsorbable Suture Tape for Chronic Elbow Dislocation

Sachinis

Vasiadis

Yiannakopoulos

et al. 2022

Techniques in Hand &Amp; Upper Extremity Surgery

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The task of achieving a good clinical outcome on patients with chronic elbow dislocation is arduous. Any stabilization method used should be robust enough in order to allow for early elbow motion. Immobilization of the elbow for a prolonged time period may lead to stiffness and heterotopic ossification. Several methods of ligament reconstruction have tried to address the global instability that is present in such scenarios. We describe a technique of reconstructing both bands of the medial ligament, and the lateral ulnar collateral ligament of the elbow, by using a looped tendon graft and reinforcing the lateral side with nonabsorbable tape and anchors. The graft is passed as a loop once through the humerus and ulna, recreating the anterior portion of the medial collateral ligament and the lateral ulnar collateral ligament. Then the lateral side is augmented with the tape and anchors and the loop is fixed. Lastly, the medial tail of the graft is used in order to recreate the posterior part of the medial ligament. This technique uses a single graft along with nonabsorbable tape and anchors to make a robust construct that will withstand early range of motion, without jeopardizing elbow stability. Potential complications include damage to the ulnar nerve, infection, elbow stiffness, or persistent instability in complex cases with bone involvement.

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Knuckle-walking in Sahelanthropus? Locomotor inferences from the ulnae of fossil hominins and other hominoids

Meyer

Jung

Spear

et al. 2023

Journal of Human Evolution

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In vivo changes in length of elbow collateral ligaments during pronation and supination on an outstretched arm

Cited by 4 publications

References 26 publications

Ultrasound evaluation shows increase in laxity after partial common extensor origin detachment but not after additional lesion of the radial band of the lateral collateral ligament

Ultrasound evaluation shows increase in laxity after partial common extensor origin detachment but not after additional lesion of the radial band of the lateral collateral ligament

Modified Graft Loop Technique Augmented With Nonabsorbable Suture Tape for Chronic Elbow Dislocation

Knuckle-walking in Sahelanthropus? Locomotor inferences from the ulnae of fossil hominins and other hominoids

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