Baylor College of Medicine, University of Texas, Houston, Texas, USA.
Am J Sports Med. 2010 Jan;38(1):153-9. doi: 10.1177/0363546509346049. Epub 2009 Oct 1.
Lateral ulnar collateral ligament (LUCL) reconstruction using a tendon graft is a well-accepted procedure used in the treatment of posterolateral rotatory instability. However, unlike most other ligament reconstructions, anatomical guidelines for the isometric points for tunnel placement of LUCL reconstruction have not been defined.
To determine if isometric points exist for tunnel placement for LUCL reconstruction and, if so, to determine their anatomical guidelines.
Controlled laboratory study.
A series of 1.8-mm drill holes was placed in potential ligament reconstruction origin and insertion sites in 13 normal cadaveric elbows along the supinator crest of the ulna and in the lateral epicondyle of the humerus. The prepared specimens were mounted in a plastic test frame with electromagnetic sensors inserted into the drill holes. The distance between each potential pair of insertion sites was measured throughout the arc of elbow motion to determine the most isometric combinations of humeral and ulnar insertion sites.
We could not locate truly isometric points for tunnel placement for LUCL reconstruction. For LUCL reconstruction, the position of most isometric tunnel placement was on the supinator crest 16 to 20 mm distal to the proximal margin of the radial head for the proximal wall of the ulnar tunnel, and between the 3:00 and 4:30 o'clock positions on the lateral epicondyle for the posterior/distal wall of the humeral tunnel.
Similar to the native LUCL, there is no truly isometric location for LUCL tendon graft reconstruction tunnels. Also similar to the native LUCL, the distance between the optimal tunnel position decreases in elbow extension and often increases in elbow flexion.
The most isometric position for LUCL reconstruction tunnel placement was defined using anatomical references.
外侧尺侧副韧带（LUCL）重建使用肌腱移植物是一种广泛接受的治疗后外侧旋转不稳定的方法。然而，与大多数其他韧带重建不同，LUCL 重建隧道等距点的解剖学指南尚未确定。
确定 LUCL 重建隧道放置是否存在等距点，如果存在，确定其解剖学指南。
对照实验室研究。
在 13 个正常尸体肘部的尺骨桡侧嵴和肱骨外髁上沿，在潜在的韧带重建起点和止点处放置一系列 1.8 毫米的钻孔。制备的标本用插入钻孔的电磁传感器安装在塑料测试框架中。在肘部运动的整个弧线上测量每个潜在的插入点对之间的距离，以确定肱骨和尺骨插入点最等距的组合。
我们无法找到 LUCL 重建隧道放置的真正等距点。对于 LUCL 重建，最接近等距隧道放置位置的是在尺骨桡侧嵴上，距离桡骨头近端边缘 16 至 20 毫米处，用于尺骨隧道的近端壁，以及在肱骨隧道的后/远端壁上的 3 点至 4 点 30 分位置，位于外髁的外侧。
与天然 LUCL 相似，LUCL 肌腱重建隧道没有真正的等距位置。与天然 LUCL 相似，最佳隧道位置之间的距离在肘部伸展时减小，在肘部弯曲时通常增加。
使用解剖参考定义了 LUCL 重建隧道放置的最等距位置。
