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Instability of the elbow and ligament injuries

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Written by Garotta Lorenzo   

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A complication of dislocation of the elbow is its recurrence. Recurrent dislocation of the elbow may be favored by certain factors: hyper laxity, injury or rupture of ligaments, bone fractures, but the most important factor is the patient’s age at the onset of the first dislocation. As for the shoulder, the younger the elbow is luxated, greater is the risk of recurrence. 

Most of the time, ligament injuries are in the lateral collateral ligament: these can occur even after relatively small trauma (as in a golf swing ...) and the suspected diagnosis in  clinical examination can be confirmed by X-rays in stress. Surgical treatment may be proposed.

 

Diagnosis 
Testing for the laxity of an elbow is relatively very easy to do: the patient should rise from a chair, leaning on his arm with the elbow in extension: it can create some apprehension, if there is an injury to the ligaments

 

The specialist will find the dynamic "pivot shift" test described by the team at the Mayo Clinic (Prof. Dr. O'Driscoll and Morrey) which reproduces a subluxation of the radial head. 
X-rays are very important: often small calcifications are visible on the external lateral ligament and x-rays in stress confirm the diagnosis. Sometimes arthroscopy helps make the diagnosis.

 


Treatment 
Treatment is surgical: the surgeon performs a retention of the capsule combined with effective reconstruction with the palmaris longus tendon taken from the same patient (as in the reconstruction of the anterior cruciate ligament in the knee).

 

The results are very satisfactory, because the elbow becomes very stable.

 


Rehabilitation and Physiotherapy

 

Rehabilitation of elbow surgery is crucial to get a good result and is performed according to well codified protocols. The goal is to start early rehabilitation to prevent stiffness and muscle atrophy.

(This website only provides a general guidance: it is essential that you strictly follow the advise given by the surgeon and physiotherapist who are providing the treatment.)
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Last Updated on Sunday, 14 November 2010 22:09