Postoperative Outcomes of Anteromedial Approach in Patients with Elbow Varus Posteromedial Rotatory Instability: A Retrospective Study.

BACKGROUND Traumatic elbow varus posteromedial rotatory instability can involve an anteromedial coronoid fracture, proximal avulsion of the lateral collateral ligaments, and a tear of the ulnar collateral ligament posterior bundle, leading to chronic elbow instability, cartilage damage, and osteoarthritis. This retrospective study evaluated postoperative outcomes at 6 months in 9 patients with elbow varus posteromedial rotatory instability following an anteromedial surgical approach using a steel plate and high-strength suture. MATERIAL AND METHODS This retrospective study analyzed the data of 9 patients (6 females, 3 males; mean age 50±22.97 years) who underwent surgical treatment for varus posteromedial rotatory instability between April 2017 and January 2024. The procedure involved repairing varus posteromedial rotatory instability using high-strength sutures and steel-plate fixation via an anteromedial approach. Postoperative elbow function was assessed using the Mayo elbow performance score (MEPS). RESULTS During the 8.5-19.5 (12.38±3.43) month postoperative period, we treated 9 patients. Within 6-14 weeks, fracture healing occurred. Although 2 patients developed mild heterotopic ossification, there were no obvious postoperative complications such as elbow joint instability, infection, or vascular or nerve damage. Assessment of elbow joint function was conducted using MEPS, with results indicating 8 cases rated as excellent and 1 case as good. CONCLUSIONS In varus posteromedial rotatory instability, the anteromedial approach allows direct visualization of the anteromedial fracture and the medial collateral ligament. The combination of high-strength sutures and plate fixation effectively stabilizes small anteromedial bone fragments. This approach provides a reference for surgical management of similar injuries.