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Dynamic Anatomy of Elbow Stability

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Acta of Shoulder and Elbow Surgery | Volume 2 | Issue 2 | July-Dec 2017 | Page 30-32 | Juan Del Castillo, Rodrigo Fratelli, Mauricio Oehler, Nicolás Casales, Viviana Teske, Domingo Beltramelli

Authors: Juan Del Castillo [1], Rodrigo Fratelli [1], Mauricio Oehler [1], Nicolás Casales [1], Viviana Teske [1], Domingo Beltramelli [1].

[1] Departamento de Anatomía
Facultad de Medicina UdelaR (Anatomy Department, School of Medicine, University of the Republic of Uruguay

Address of Correspondence
Dr. Juan Del Castillo,
Departamento de Anatomía
Facultad de Medicina UdelaR
(Anatomy Department, School of Medicine, University of the Republic of Uruguay
Email:btorres@ceoecuador.com.

Abstract

Background: Elbow dislocation leads to varying degree of instabilities depending on the ligaments damaged and amount of damage to these ligaments. Various studies have noted role of these ligaments and present study is a dynamic cadaveric study to understand these instabilities better
Material and Methods: 10 cadaveric elbows maintained in 10% formaldehyde concentration were employed. Healthy joint upper limbs were prepared, and the elbow joint was further dissected. The different joint osseous and ligament stabilizers were sectioned by stages, and their implication on the stability of the elbow joint complex was recorded.
Results: Collateral ligaments were confirmed to be the main ligament stabilizers in the elbow. The lateral complex controls both varus and posterolateral stress. The medial collateral complex controls valgus stress, mainly thanks to its anterior bundle. The radial head plays a secondary role, controlling valgus stress once the medial collateral complex has been sectioned. Once radial head has been replaced, valgus stress stability is regained
Conclusion: The role of elbow stabilizers has been determined, and our results are consistent with those of international literature
Keywords: Elbow Instability, Cadaveric Study

References

1. O’Driscoll SW, Jupiter JB, King GJ, et al. The unstable elbow. Instr Course Lect 2001;50:89–102.
2. Crhis D. Bryce; April D. Armstrong. Anatomy and Biomechanics of the elbow. Orthop Clin N Am 39 (2008 141-154)
3. Miller Mark, Thompson S. DeLee & Drez ́s Orthopaedic Sports Medicine Principles and Practice 2015
4. Morrey B, The Elbow and its disorders, 3rd ed 2004

How to Cite this article: Castillo JD, Fratelli R, Oehler M, Casales N, Teske V, Beltramelli D. Dynamic anatomy of elbow stability . Acta of Shoulder and Elbow Surgery July – Dec 2017;2(2):30-32.

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Experience of surgical management of acute and chronic post-traumatic elbow instability. A retrospective study

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Acta of Shoulder and Elbow Surgery | Volume 2 | Issue 2 | July-Dec 2017 | Page 5-8 | Felipe Patricio Cichero, Warner Larrondo, Juan Antonio Castellaro, Gonzalo Díaz, Julio Terán

Authors: Felipe Patricio Cichero [1], Warner Larrondo [2], Juan Antonio Castellaro [3], Gonzalo Díaz [3], Julio Terán [3]

[1] Fellow of shoulder and elbow surgery Clínica Dávila, Santiago, Chile.
[2] Chief of shoulder and elbow surgery unit Clínica Dávila, Santiago, Chile.
[3] Staff surgeon of shoulder and elbow unit Clínica Dávila, Santiago, Chile.

Address of Correspondence
Dr. Felipe Patricio Cichero,
Clínica Dávila, Recoleta 464, Recoleta, Santiago, Chile.
Email: felipe.cichero@gmail.com

Abstract

Background: The elbow is the second most commonly dislocated major joint in adults.Elbow dislocation can lead to acute or chronic instability. There are different surgical options and functional outcomes in both cases. The purpose of this study is to assess the functional outcomes and the postoperative complications of these two groups.
Methods: We retrospectively reviewed the functional outcomes of cases of acute and chronic post-traumatic elbow instability that were surgically managed between 2013 and 2016 in adult population. All patients were assessed radiographically and clinically using the Mayo Elbow Performance Score and The Disabilities of the Arm, Shoulder and Hand Score at six months follow-up.
Results: Four male patients were included, two in each group of acute and chronic instability. In Three cases the medial and lateral collateral ulnar ligaments were reconstructed using semitendinosus allograft. In one case the repair of both collateral ligaments was performed usingsuture anchors. Two acute coronoid fractures were managed by using the lasso-type technique and one nonunion treated with two cannulated screws. The mean post operative Mayo Elbow Performance Score were 95 for the acute instability group and 85 for the chronic instability group. The mean Disabilities of the Arm, Shoulder and Hand post operative scores were 5,8 and 18,3 for the acute and chronic instability groups respectively. There was one case of ulnar neuropaxia that resolved spontaneously at two months follow-up. All patients had a reduced and concentric elbow in control radiographs at six months follow-up.
Conclusions: Both groups presented satisfactory results after being managed by different surgical techniques.
Keywords: Elbow instability, elbow dislocation, collateral ligaments.

References

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How to Cite this article: Cichero FP, Larrondo W, Castellaro JA, Díaz G, Terán J. Experience of surgical management of acute and chronic post-traumatic elbow instability. A retrospective study. Acta of Shoulder and Elbow Surgery July – Dec 2017;2(2):5-8.

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