Ligamentous reconstruction of the elbow in a 13-year old using a circumferential technique

Riet, Roger P. van; Lim, Yeow Wai; Baird, Robert W.; Bain, Gregory I.

doi:10.1016/j.injury.2008.02.037

Cited by 7 publications

(7 citation statements)

References 17 publications

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“…Chronic elbow instability is a disabling pathology, which may cause chronic pain, feelings of instability, recurrent joint subluxation or dislocation and movement limitations, thus seriously affecting the patient's daily routine [16][17][18] . Two different circumferential graft techniques have been recently described by Finkbone and O'Driscoll 14 and by van Riet et al 19,20 , to treat the combined medial and lateral insufficiency observed in multidirectional elbow instability. 14 provides equal elbow joint stability, compared with conventional techniques, but it shows a superior biomechanical profile with respect to graft stiffness.…”

Section: Discussionmentioning

confidence: 99%

Box-loop technique in the management of complex elbow instability: a prospective controlled trial

Vincenti

Solarino

Carrozzo

et al. 2019

Muscle Ligaments and Tendons J

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Introduction: Chronic elbow instability is a disable complication. This prospective study reports our experience with the box-loop reconstruction technique, compared with traditional Lateral Collateral Ligament (LCL) and eventual Medial Collateral Ligament (MCL) reconstruction, showing its functional outcome at 12-month follow-up. Methods: From January 2013 to February 2017, 27 patients with complex elbow instability were recruited. Group-A patients were managed using box-loop technique; in Group-B patients LCL reconstruction was performed and MCL lesions were always intraoperatively tested, under fluoroscopy, and eventually treated. Clinical evaluations were performed at baseline (T0) and at 1month (T1), 6-month (T2) and 12-month (T3) follow-up. X-rays were performed at T0 and T3. Intergroup and intragroup variability was assessed. Results: In all the patients, an improvement of both the range of movement and the joint stability was observed after surgery. The mean increase in flexion-extension arch was 52° in Group-A patients at 12-month follow-up. A significant improvement (p<0.05) of Mayo Elbow Performance Score, Oxford Elbow Scores and Visual Analogue Scale was observed at 12-month follow-up in both groups. Conclusion: Box-loop technique revealed safe and effective in the management of multidirectional elbow instability. Level of evidence: IV, Cases Series.

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Section: Discussionmentioning

confidence: 99%

Box-loop technique in the management of complex elbow instability: a prospective controlled trial

Vincenti

Solarino

Carrozzo

et al. 2019

Muscle Ligaments and Tendons J

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“…A similar circumferential grafting technique has been described by van Riet et al 18,19 Their technique involves drilling 2 ulnar tunnels, using gracilis autograft, and using a posterior midline approach. They have described singleloop and double-loop techniques.…”

Section: Discussionmentioning

confidence: 99%

“…At 2 years of follow-up, this patient was doing very well with a stable elbow. 19 The box-loop technique is also useful in cases involving ossification of the collateral ligaments. Two of the patients in this study required ligament reconstruction for this reason at the time of surgical excision of HO.…”

Section: Discussionmentioning

confidence: 99%

Box-loop ligament reconstruction of the elbow for medial and lateral instability

Finkbone¹,

O’Driscoll²

2015

Journal of Shoulder and Elbow Surgery

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“…They described a single and a double circumference technique and utilized Endo-button and interference fit screws for fixation. They also used a modified double loop method in a 13-year-old girl with recurrent elbow dislocation 10. Finkbone and O’Driscoll7 presented a cohort of 14 patients with residual medial and lateral elbow instability.…”

Section: Techniquementioning

confidence: 99%

“…Pasternack et al9 in 2020 reported a final ROM of 106 degrees of flexion-extension, that is consistent with standard techniques used for terrible triad and complex elbow dislocation injuries. Various techniques for the augmentation and reconstruction of acute and chronic elbow dislocations have been reported 5–8,10. Greiner et al11 in acute elbow dislocations supplemented the repair of the lateral ulnar collateral ligament (LUCL) with a nonabsorbable suture tape.…”

mentioning

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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Ligamentous reconstruction of the elbow in a 13-year old using a circumferential technique

Cited by 7 publications

References 17 publications

Box-loop technique in the management of complex elbow instability: a prospective controlled trial

Box-loop technique in the management of complex elbow instability: a prospective controlled trial

Box-loop ligament reconstruction of the elbow for medial and lateral instability

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

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