- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.;
【Abstract】 Objective To review the progress in pathoanatomy, diagnosis, and treatment of posterolateral rotatory instability (PLRI) of the elbow. Methods Related literature concerning PLRI of the elbow was extensively reviewed, comprehensive analysis was done. Results The lateral collateral ligament complex (LCLC), radial head, capitellum, and coronoid process are important constraints to PLRI. Muscle groups that cross the lateral elbow are secondary constraints to PLRI. Clinical examination includes lateral pivot-shift test, lateral pivot-shift apprehension test, chair sign, active floor push-up sign, tabletop relocation test, and posterolateral rotatory drawer test. Radiology, arthroscopy, and ultrasound can help diagnosis of PLRI. Reconstruction of bony fixation or soft tissue fixation can be used for treatment of injured LCLC. Conclusion The primary constraints to PLRI is LCLC. Ultrasound imaging is accurate for identification and measurement of normal LCLC. Therefore, ultrasound may prove valuable in assessment of abnormal lateral ulnar collateral ligaments. Reconstruction of soft tissue fixation, which can avoid iatrogenic fracture, is a selective treatment method.
Citation： XIAO Cong,HUANG Fuguo.. RESEARCH PROGRESS OF POSTEROLATERAL ROTATORY INSTABILITY OF THE ELBOW. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(1): 36-40. doi: Copy
| 1. | radial head excision and lateral collateral ligament rupture: efficacy of prosthetic replacement and ligament repair. J Shoulder Elbow Surg, 2005, 14(1): 78-84. |
| 2. | rotatory stability. J Shoulder Elbow Surg, 2005, 14(3): 298-301. |
| 3. | |
| 4. | defect of the capitellum associated with instability of the elbow. AJR Am J Roentgenol, 2008, 191(3): 727-729. |
| 5. | for posterolateral rotatory instability of the elbow: osborne-cotterill lesion of the elbow. J Trauma, 2011, 71(3): E45-49. |
| 6. | ligamentous disruption in complex elbow instability. J Shoulder Elbow Surg, 2003, 12(4): 391-396. |
| 7. | instability of the elbow due to cubitus varus. J Bone Joint Surg (Am), 2001, 83-A(9): 1358-1369. |
| 8. | to the radial head: biomechanical comparison with the posterolateral. |
| 9. | approach. J Hand Surg (Am), 2007, 32(10): 1576-1582. |
| 10. | epicondylitis. J Shoulder Elbow Surg, 1992, 1(1): 47-55. |
| 11. | in association with lateral epicondylitis. A report of three cases. J Bone Joint Surg (Am), 2005, 87(5): 1120-1125. |
| 12. | of the coronoid process and radial head. Arch Orthop Trauma Surg, 2007, 127(10): 925-931. |
| 13. | signs for posterolateral instability of the elbow. J Shoulder Elbow Surg, 2006, 15(3): 344-346. |
| 14. | Surg, 2006, 15(6): 707-708. |
| 15. | of the elbow: usefulness of MR imaging in diagnosis. Radiology, 1997, 204(1): 185-189. |
| 16. | in diagnosis of chronic posterolateral rotatory instability of the elbow. Am J Orthop (Belle Mead NJ), 2003, 32(10): 501-503. |
| 17. | AJR Am J Roentgenol, 2009, 193(6): 1615-1619. |
| 18. | of the elbow. J Bone Joint Surg (Br), 2003, 85(3): 342-346. |
| 19. | constrains of the elbow joint. J Shoulder Elbow Surg, 1996, 5(5): 333-341. |
| 20. | ligament reconstruction using the triceps tendon. Tech Hand Up Extrem Surg, 2009, 13(1): 34-36. |
| 21. | and lateral ulnar collateral ligament in posterolateral rotator instability of the elbow. Knee Surg Sports Traumatol Arthrosc, 2011, 19(6): 1009-1012. |
| 22. | shrinkage of chronic posterolateral elbow instability: good or moderate outcome in 21 patients followed for an average of 2.5 years. Acta Orthop, 2006, 77(2): 285-289. |
| 23. | O’Driscoll SW, Bell DF, Morrey BF. Posterolateral rotatory instability of the elbow. J Bone Joint Surg (Am), 1991, 73(3): 440-446. |
| 24. | Cohen MS, Hastings H 2nd. Rotatory instability of the elbow. The anatomy and role of the lateral stabilizers. J Bone Joint Surg (Am), 1997, 79(2): 225-233. |
| 25. | Jensen SL, Olsen BS, Tyrdal S, et al. Elbow joint laxity after experimental. |
| 26. | Seki A, Olsen BS, Jensen SL, et al. Functional anatomy of the lateral collateral ligament complex of the elbow: configuration of Y and its role. J Shoulder Elbow Surg, 2002, 11(1): 53-59. |
| 27. | McAdams TR, Masters GW, Srivastava S. The effect of arthroscopic sectioning of the lateral ligament complex of the elbow on posterolateral. |
| 28. | Dunning CE, Zarzour ZD, Patterson SD, et al. Ligamentous stabilizers against posterolateral rotatory instability of the elbow. J Bone Joint Surg (Am), 2001, 83-A(12): 1823-1828. |
| 29. | Schneeberger AG, Sadowski MM, Jacob HA. Coronoid process and radial head as posterolateral rotatory satabilizers of the elbow. J Bone Joint Surg (Am), 2004, 86-A(5): 975-982. |
| 30. | Hall JA, McKee MD. Posterolateral rotatory instability of the elbow following radial head resection. J Bone Joint Surg (Am), 2005, 87(7): 1571-1579. |
| 31. | Jeon IH, Micic ID, Yamamoto N, et al. Osborne-cotterill lesion: an osseous. |
| 32. | Jeon IH, Min WK, Micic ID, et al. Surgical treatment and clinical implication. |
| 33. | Ring D, Jupiter JB. Fracture-dislocation of the elbow. J Bone Joint Surg (Am), 1998, 80(4): 566-580. |
| 34. | Mehta JA, Bain GI. Posterolateral rotatory instability of the elbow. J Am Acad Orthop Surg, 2004, 12(6): 405-415. |
| 35. | Olsen BS, Søjbjerg JO, Nielsen KK, et al. Posterolateral elbow joint instability: the basic kinematics. J Shoulder Elbow Surg, 1998, 7(1): 19-29. |
| 36. | O’Driscoll SW, Morrey BF, Korinek S, et al. Elbow subluxation and dislocation. A spectrum of instability. Clin Orthop Relat Res, 1992, (280): 186-197. |
| 37. | McKee MD, Schemitsch EH, Sala MJ, et al. The pathoanatomy of lateral. |
| 38. | Abe M, Ishizu T, Morikawa J. Posterolateral rotatory instability of the elbow after posttraumatic cubitus varus. J Shoulder Elbow Surg, 1997, 6(4): 405-409. |
| 39. | O’Driscoll SW, Spinner RJ, McKee MD, et al. Tardy posterolateral rotatory. |
| 40. | Beuerlein MJ, Reid JT, Schemitsch EH, et al. Effect of distal humeral varus deformity on strain in the lateral ulnar collateral ligament and ulnohumeral joint stability. J Bone Joint Surg (Am), 2004, 86-A(10): 2235-2242. |
| 41. | Charalambous CP, Stanley JK, Siddique I, et al. The Wrightington approach. |
| 42. | Morrey BF. Reoperation for failed surgical treatment of refractory lateral. |
| 43. | Kalainov DM, Cohen MS. Posterolateral rotatory instability of the elbow. |
| 44. | Kälicke T, Muhr G, Frangen TM. Dislocation of the elbow with fractures. |
| 45. | 陈硕, 黄富国, 钟刚, 等. 尺骨冠突骨折合并内侧副韧带前束损伤致肘关节后外侧旋转不稳定的生物力学研究. 中国修复重建外科杂志, 2010, 24(2): 215-218. |
| 46. | Azam MQ, Iraqi AA, Syed A, et al. Posterolateral rotatory instability of elbow: an uncommon entity. Indian J Orthop, 2008, 42(3): 355-356. |
| 47. | Savoie FH, Field LD, Ramsey JR. Posterolateral rotatory instability of the elbow: diagnosis and management. Oper Tech Sports Med, 2006, 14(2): 81-85. |
| 48. | Regan W, Lapner PC. Prospective evaluation of two diagnostic apprehension. |
| 49. | Arvind CH, Hargreaves DG. Tabletop relocation test: a new clinical test for posterolateral rotatory instability of the elbow. J Shoulder Elbow. |
| 50. | Potter HG, Weiland AJ, Schatz JA, et al. Posterolateral rotatory instability. |
| 51. | Grafe MW, McAdams TR, Beaulieu CF, et al. Magnetic resonance imaging. |
| 52. | Terada N, Yamada H, Toyama Y. The appearance of the lateral ulnar collateral ligament on magnetic resonance imaging. J Shoulder Elbow Surg, 2004, 13(2): 214-216. |
| 53. | Stewart B, Harish S, Oomen G, et al. Sonography of the lateral ulnar collateral ligament of the elbow: study of cadavers and healthy volunteers. |
| 54. | Cheung EV. Chronic lateral elbow instability. Orthop Clin North Am, 2008, 39(2): 221-228. |
| 55. | Stein JA, Murthi AM. Posterolateral rotatory instability of the elbow: Our approach. Oper Tech Orthop, 2009, 19(4): 251-257. |
| 56. | Jones KJ, Dodson CC, Osbahr DC, et al. The docking technique for lateral ulnar collateral ligament reconstruction: surgical technique and clinical outcomes. J Shoulder Elbow Surg, 2011. [Epub ahead of print]. |
| 57. | Charalambous CP, Stanley JK. Posterolateral rotatory instability of the elbow. J Bone Joint Surg (Br), 2008, 90(3): 272-279. |
| 58. | Sanchez-Sotelo J, Morrey BF, O’Driscoll SW. Ligamentous repair and reconstruction for posterolateral rotatory instability of the elbow. J Bone Joint Surg (Br), 2005, 87(1): 54-61. |
| 59. | Cheng CY. Long-term sequel of posterolateral rotatory instability of the elbow: a case report. J Orthop Surg Res, 2010, 27(5): 5. |
| 60. | Olsen BS, Søjbjerg JO. The treatment of recurrent posterolateral instability. |
| 61. | King GJ, Dunning CE, Zarzour ZD, et al. Single-strand reconstruction of the lateral ulnar collateral ligament restores varus and posterolateral rotatory stability of the elbow. J Shoulder Elbow Surg, 2002, 11(1): 60-64. |
| 62. | Olsen BS, Søjbjerg JO, Dalstra M, et al. Kinematics of the lateral ligamentous. |
| 63. | Gong HS, Kim JK, Oh JH, et al. A new technique for lateral ulnar collateral. |
| 64. | Rhyou IH, Park MJ. Dual reconstruction of the radial collateral ligament. |
| 65. | Savoie FH 3rd, O’Brien MJ, Field LD, et al. Arthroscopic and Open-radial ulnohumeral ligament reconstruction for posterolateral rotatory instability of the elbow. Clin Sports Med, 2010, 29(4): 611-618. |
| 66. | Spahn G, Kirschbaum S, Klinger HM, et al. Arthroscopic electrothermal. |
- 1. radial head excision and lateral collateral ligament rupture: efficacy of prosthetic replacement and ligament repair. J Shoulder Elbow Surg, 2005, 14(1): 78-84.
- 2. rotatory stability. J Shoulder Elbow Surg, 2005, 14(3): 298-301.
- 3.
- 4. defect of the capitellum associated with instability of the elbow. AJR Am J Roentgenol, 2008, 191(3): 727-729.
- 5. for posterolateral rotatory instability of the elbow: osborne-cotterill lesion of the elbow. J Trauma, 2011, 71(3): E45-49.
- 6. ligamentous disruption in complex elbow instability. J Shoulder Elbow Surg, 2003, 12(4): 391-396.
- 7. instability of the elbow due to cubitus varus. J Bone Joint Surg (Am), 2001, 83-A(9): 1358-1369.
- 8. to the radial head: biomechanical comparison with the posterolateral.
- 9. approach. J Hand Surg (Am), 2007, 32(10): 1576-1582.
- 10. epicondylitis. J Shoulder Elbow Surg, 1992, 1(1): 47-55.
- 11. in association with lateral epicondylitis. A report of three cases. J Bone Joint Surg (Am), 2005, 87(5): 1120-1125.
- 12. of the coronoid process and radial head. Arch Orthop Trauma Surg, 2007, 127(10): 925-931.
- 13. signs for posterolateral instability of the elbow. J Shoulder Elbow Surg, 2006, 15(3): 344-346.
- 14. Surg, 2006, 15(6): 707-708.
- 15. of the elbow: usefulness of MR imaging in diagnosis. Radiology, 1997, 204(1): 185-189.
- 16. in diagnosis of chronic posterolateral rotatory instability of the elbow. Am J Orthop (Belle Mead NJ), 2003, 32(10): 501-503.
- 17. AJR Am J Roentgenol, 2009, 193(6): 1615-1619.
- 18. of the elbow. J Bone Joint Surg (Br), 2003, 85(3): 342-346.
- 19. constrains of the elbow joint. J Shoulder Elbow Surg, 1996, 5(5): 333-341.
- 20. ligament reconstruction using the triceps tendon. Tech Hand Up Extrem Surg, 2009, 13(1): 34-36.
- 21. and lateral ulnar collateral ligament in posterolateral rotator instability of the elbow. Knee Surg Sports Traumatol Arthrosc, 2011, 19(6): 1009-1012.
- 22. shrinkage of chronic posterolateral elbow instability: good or moderate outcome in 21 patients followed for an average of 2.5 years. Acta Orthop, 2006, 77(2): 285-289.
- 23. O’Driscoll SW, Bell DF, Morrey BF. Posterolateral rotatory instability of the elbow. J Bone Joint Surg (Am), 1991, 73(3): 440-446.
- 24. Cohen MS, Hastings H 2nd. Rotatory instability of the elbow. The anatomy and role of the lateral stabilizers. J Bone Joint Surg (Am), 1997, 79(2): 225-233.
- 25. Jensen SL, Olsen BS, Tyrdal S, et al. Elbow joint laxity after experimental.
- 26. Seki A, Olsen BS, Jensen SL, et al. Functional anatomy of the lateral collateral ligament complex of the elbow: configuration of Y and its role. J Shoulder Elbow Surg, 2002, 11(1): 53-59.
- 27. McAdams TR, Masters GW, Srivastava S. The effect of arthroscopic sectioning of the lateral ligament complex of the elbow on posterolateral.
- 28. Dunning CE, Zarzour ZD, Patterson SD, et al. Ligamentous stabilizers against posterolateral rotatory instability of the elbow. J Bone Joint Surg (Am), 2001, 83-A(12): 1823-1828.
- 29. Schneeberger AG, Sadowski MM, Jacob HA. Coronoid process and radial head as posterolateral rotatory satabilizers of the elbow. J Bone Joint Surg (Am), 2004, 86-A(5): 975-982.
- 30. Hall JA, McKee MD. Posterolateral rotatory instability of the elbow following radial head resection. J Bone Joint Surg (Am), 2005, 87(7): 1571-1579.
- 31. Jeon IH, Micic ID, Yamamoto N, et al. Osborne-cotterill lesion: an osseous.
- 32. Jeon IH, Min WK, Micic ID, et al. Surgical treatment and clinical implication.
- 33. Ring D, Jupiter JB. Fracture-dislocation of the elbow. J Bone Joint Surg (Am), 1998, 80(4): 566-580.
- 34. Mehta JA, Bain GI. Posterolateral rotatory instability of the elbow. J Am Acad Orthop Surg, 2004, 12(6): 405-415.
- 35. Olsen BS, Søjbjerg JO, Nielsen KK, et al. Posterolateral elbow joint instability: the basic kinematics. J Shoulder Elbow Surg, 1998, 7(1): 19-29.
- 36. O’Driscoll SW, Morrey BF, Korinek S, et al. Elbow subluxation and dislocation. A spectrum of instability. Clin Orthop Relat Res, 1992, (280): 186-197.
- 37. McKee MD, Schemitsch EH, Sala MJ, et al. The pathoanatomy of lateral.
- 38. Abe M, Ishizu T, Morikawa J. Posterolateral rotatory instability of the elbow after posttraumatic cubitus varus. J Shoulder Elbow Surg, 1997, 6(4): 405-409.
- 39. O’Driscoll SW, Spinner RJ, McKee MD, et al. Tardy posterolateral rotatory.
- 40. Beuerlein MJ, Reid JT, Schemitsch EH, et al. Effect of distal humeral varus deformity on strain in the lateral ulnar collateral ligament and ulnohumeral joint stability. J Bone Joint Surg (Am), 2004, 86-A(10): 2235-2242.
- 41. Charalambous CP, Stanley JK, Siddique I, et al. The Wrightington approach.
- 42. Morrey BF. Reoperation for failed surgical treatment of refractory lateral.
- 43. Kalainov DM, Cohen MS. Posterolateral rotatory instability of the elbow.
- 44. Kälicke T, Muhr G, Frangen TM. Dislocation of the elbow with fractures.
- 45. 陈硕, 黄富国, 钟刚, 等. 尺骨冠突骨折合并内侧副韧带前束损伤致肘关节后外侧旋转不稳定的生物力学研究. 中国修复重建外科杂志, 2010, 24(2): 215-218.
- 46. Azam MQ, Iraqi AA, Syed A, et al. Posterolateral rotatory instability of elbow: an uncommon entity. Indian J Orthop, 2008, 42(3): 355-356.
- 47. Savoie FH, Field LD, Ramsey JR. Posterolateral rotatory instability of the elbow: diagnosis and management. Oper Tech Sports Med, 2006, 14(2): 81-85.
- 48. Regan W, Lapner PC. Prospective evaluation of two diagnostic apprehension.
- 49. Arvind CH, Hargreaves DG. Tabletop relocation test: a new clinical test for posterolateral rotatory instability of the elbow. J Shoulder Elbow.
- 50. Potter HG, Weiland AJ, Schatz JA, et al. Posterolateral rotatory instability.
- 51. Grafe MW, McAdams TR, Beaulieu CF, et al. Magnetic resonance imaging.
- 52. Terada N, Yamada H, Toyama Y. The appearance of the lateral ulnar collateral ligament on magnetic resonance imaging. J Shoulder Elbow Surg, 2004, 13(2): 214-216.
- 53. Stewart B, Harish S, Oomen G, et al. Sonography of the lateral ulnar collateral ligament of the elbow: study of cadavers and healthy volunteers.
- 54. Cheung EV. Chronic lateral elbow instability. Orthop Clin North Am, 2008, 39(2): 221-228.
- 55. Stein JA, Murthi AM. Posterolateral rotatory instability of the elbow: Our approach. Oper Tech Orthop, 2009, 19(4): 251-257.
- 56. Jones KJ, Dodson CC, Osbahr DC, et al. The docking technique for lateral ulnar collateral ligament reconstruction: surgical technique and clinical outcomes. J Shoulder Elbow Surg, 2011. [Epub ahead of print].
- 57. Charalambous CP, Stanley JK. Posterolateral rotatory instability of the elbow. J Bone Joint Surg (Br), 2008, 90(3): 272-279.
- 58. Sanchez-Sotelo J, Morrey BF, O’Driscoll SW. Ligamentous repair and reconstruction for posterolateral rotatory instability of the elbow. J Bone Joint Surg (Br), 2005, 87(1): 54-61.
- 59. Cheng CY. Long-term sequel of posterolateral rotatory instability of the elbow: a case report. J Orthop Surg Res, 2010, 27(5): 5.
- 60. Olsen BS, Søjbjerg JO. The treatment of recurrent posterolateral instability.
- 61. King GJ, Dunning CE, Zarzour ZD, et al. Single-strand reconstruction of the lateral ulnar collateral ligament restores varus and posterolateral rotatory stability of the elbow. J Shoulder Elbow Surg, 2002, 11(1): 60-64.
- 62. Olsen BS, Søjbjerg JO, Dalstra M, et al. Kinematics of the lateral ligamentous.
- 63. Gong HS, Kim JK, Oh JH, et al. A new technique for lateral ulnar collateral.
- 64. Rhyou IH, Park MJ. Dual reconstruction of the radial collateral ligament.
- 65. Savoie FH 3rd, O’Brien MJ, Field LD, et al. Arthroscopic and Open-radial ulnohumeral ligament reconstruction for posterolateral rotatory instability of the elbow. Clin Sports Med, 2010, 29(4): 611-618.
- 66. Spahn G, Kirschbaum S, Klinger HM, et al. Arthroscopic electrothermal.