Arch Hand Microsurg.  2018 Jun;23(2):78-86. 10.12790/ahm.2018.23.2.78.

Medial Instability of the Elbow

• Jung HS
• Park MJ

• KMID: 2412476
• DOI: http://doi.org/10.12790/ahm.2018.23.2.78

Abstract

Medial elbow instability has been a debilitating problem for the athlete performing overhead throwing and the increase in the number of participants in throwing sports has brought increase in its incidence in non-athletes. Instability can occur as a result of a single traumatic event, but, in most cases, it develops as a result of repetitive micro-trauma over a long period of time. During the overhead throwing, tensile force is applied to the medial stabilizing structures and compressive force is applied to the lateral structures. Common injuries encountered in the throwing elbow include medial collateral ligament tear, ulnar nerve neuropathy, flexor-pronator tendinitis or tear and valgus extension overload syndrome. Knowledge of the anatomy and biomechanics of the elbow joint, along with an understanding of throwing mechanism, is necessary to properly diagnose and treat the throwing athlete. The purpose of this article is to review the functional anatomy of medial elbow stabilizing structure, pathophysiology of medial elbow instability and its diagnostic method and treatment option including reconstruction of medial collateral ligament.

Keyword

Medial elbow instability; Medial collateral ligament; Ulnar nerve

MeSH Terms

Athletes
Collateral Ligaments
Elbow Joint
Elbow*
Humans
Incidence
Methods
Sports
Tears
Tendinopathy
Ulnar Nerve

Figure

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  Fig.1. (A) Anatomy of the medial collateral ligament. (B) The anterior band is the most important structure for valgus stability. Cited from the Park MJ. Hand and Upper Extremity Surgery: The Wrist and Elbow. Seoul: Panmun; 2017.

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  Fig.2. The 6 phases of the overhead thrwoing motion. Cited from the Park MJ. Hand and Upper Extremity Surgery: The Wrist and Elbow. Seoul: Panmun; 2017.

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  Fig.3. (A) Valgus stress test. (B) Moving valgus stress test.

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  Fig.4. Schematic of medial collateral ligament reconstruction with figure of 8 technique (A) and docking technique (B). Cited from the Park MJ. Hand and Upper Extremity Surgery: The Wrist and Elbow. Seoul: Panmun; 2017.

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