Almigdad Ahmad, Challagundla Sudhakar, Yan Tingshan, Malhas Amar
Department of Orthopedics, Royal Medical Services, Amman, JOR.
Department of Orthopaedics, Royal Cornwall Hospital, Truro, GBR.
Cureus. 2024 Jan 31;16(1):e53291. doi: 10.7759/cureus.53291. eCollection 2024 Jan.
Background Posterolateral rotatory instability of the elbow arises from damage to the lateral ulnar collateral ligament (LUCL). While various methods exist for reconstructing or repairing the LUCL's attachment to the humerus, the most effective approach remains debatable. This study aims to assess the outcomes of directly repairing the LUCL when the injury occurs at the humeral attachment. Methodology This retrospective study, conducted at the Royal Berkshire Foundation Trust NHS hospital in Reading, UK, assessed outcomes through a review of 15 patients who underwent direct repair of the lateral ulnar collateral ligament between 2017 and 2022, evaluating a range of motion, the Mayo Elbow Performance Score, and the Nestor grading system. Results This study included nine males and six females, with an average age of 38.8 years. Most LUCL injuries arose from elbow dislocation (46.7%). The average follow-up period for patients was 26 months. At the final assessment, the mean Mayo Elbow Performance Score reached 99. According to the Nestor grading system, 12 patients achieved excellent results, and three had good outcomes. On average, there was an 11.3° loss of final extension and 5° of final flexion, yet achieving a comparable pronation-supination arch to the contralateral side. Conclusion Direct repair of the LUCL for elbow posterolateral rotary instability yielded excellent outcomes, obviating ligament reconstruction. Recognized as minimally invasive, it accelerates recovery, minimizes trauma, and offers a cost-effective procedure for managing instability.
背景 肘关节后外侧旋转不稳定源于尺侧副韧带(LUCL)损伤。虽然存在多种重建或修复LUCL肱骨附着点的方法,但最有效的方法仍存在争议。本研究旨在评估当损伤发生在肱骨附着点时直接修复LUCL的效果。方法 这项回顾性研究在英国雷丁的皇家伯克郡国民保健服务基金会信托医院进行,通过回顾2017年至2022年间接受尺侧副韧带直接修复的15例患者的情况来评估疗效,评估指标包括活动范围、梅奥肘关节功能评分和内斯特分级系统。结果 本研究包括9名男性和6名女性,平均年龄38.8岁。大多数LUCL损伤源于肘关节脱位(46.7%)。患者的平均随访期为26个月。在最终评估时,梅奥肘关节功能评分的平均值达到99分。根据内斯特分级系统,12例患者取得了优异的结果,3例取得了良好的结果。最终伸直平均损失11.3°,最终屈曲损失5°,但旋前 - 旋后弧度与对侧相当。结论 对于肘关节后外侧旋转不稳定,直接修复LUCL产生了优异的效果,无需进行韧带重建。该方法被认为是微创的,可加速恢复,将创伤降至最低,并为处理不稳定提供了一种经济高效的手术方式。