Title : Clinical and functional results of lateral ulnar collateral ligament repair for posterolateral rotatory instability of elbow.
Abstract:
Lateral Ulnar Collateral Ligament (LUCL) injury can result in posterolateral rotatory instability requiring surgical fixation. Ligament reconstruction is widely used but here we evaluate the surgical outcome direct repair of Lateral Ulnar Collateral Ligament.
Methods: In this retrospective observational study, we included all cases of direct repair of LUCL that were performed in the last five years. Patients were identified from theatre coding and confirmed with operation notes. Electronic Patient Records were reviewed for demographics, diagnosis, intraoperative findings and complications. Patient reported outcome scores, using Mayo Elbow Performance Score (MEPS) was used as the primary outcome.
Results: 15 patients with avulsion and/or attenuation of the LUCL underwent direct repair between 2018 and 2022. Two were lost to follow up and 13 included. Eight were on the dominant arm side. The mean age of patients at the time of injury was 38.8 (range 18-61 years). 6 patients were operated on for acute trauma (mean days to operation = 20), 6 for trauma sequelae (mean days to operation = 299) and 3 for chronic instability (mean days to operation = 715). In all cases pathology was at the humeral attachment and the quality of the ligament assessed to be good for repair. LUCL was fixed with a 3.5mm anchor in all cases. At a mean follow up of 26 months, the mean MEPS score was 99. According to Nestor grading, 12 patients had excellent and 1 had good result. One patient underwent cubital tunnel decompression three months post LUCL repair.
Conclusion: In the management of both acute and chronic elbow posterolateral rotary instability, a direct repair of the LUCL when possible, achieved excellent to good clinical outcomes and eliminated the need for ligament reconstruction.
