J Korean Soc Surg Hand.  2014 Sep;19(3):150-153. 10.12790/jkssh.2014.19.3.150.

Posterolateral Rotatory Instability of the Elbow without Epiphyseal Injury in Children

• Lee SU
• Jeong C
• Kim HW

• KMID: 2194137
• DOI: http://doi.org/10.12790/jkssh.2014.19.3.150

Abstract

Posterolateral rotatory instability of the elbow in the absence of epiphyseal injury is extremely rare in children. We present a case of 12-year-old child in whom recurrent dislocation of the elbow was associated with a stretched lateral ulnar collateral ligament. We performed surgical repair and reefing of a stretched lateral ulnar collateral ligament by using a suture anchor and a continuous locking suture in order to avoid donor site morbidity and damage of the growth plate, which could occur when a transosseous tunnel for reconstruction was made. At 12 months after operation, satisfactory symptom relief was observed with no evidence of recurrence.

Keyword

Children; Elbow; Posterolateral rotatory instability; Surgical treatment

MeSH Terms

Child*
Collateral Ligaments
Dislocations
Elbow*
Growth Plate
Humans
Recurrence
Suture Anchors
Sutures
Tissue Donors

Figure

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  Fig. 1. Initial plain radiographs showing posterior dislocation of elbow joint.

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  Fig. 2. Preoperative photograph taken during Pivot-shift test of elbow showing osseous prominence caused by posterior subluxation of radial head and skin dimpling just proximal to prominence.

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  Fig. 3. Intraoperative photographs showing attenuated lateral ulnar collateral ligament (white arrow head) and capsular laxity (black arrow head, radial head).

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  Fig. 4. Intraoperative photograph after plication of attenuated lateral ulnar collateral ligament with anchor suture and posterior capsular reefing.

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  Fig. 5. Anteroposterior and lateral radiographs taken at 12 months after surgery show concentrically reduced elbow joint.

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