Biomechanical effect of anteromedial coronoid facet fracture and lateral collateral ligament complex injury on posteromedial rotational stability of elbow_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DONGHongxian ¹ ,  HUANGFuguo ²

1. Department of Hand and Foot Microsurgery, Yibin Second People’s Hospital, Yibin Sichuan, 644000, P.R.China;
2. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

HUANGFuguo, Email: huang-f-g@163.com

Keywords：

Elbow; posteromedial rotational stability; coronoid facet fracture; lateral collateral ligament complex injury; biomechanics

DOI：

10.7507/1002-1892.201610006

Video：

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Objective To investigate the effect of anteromedial coronoid facet fracture and lateral collateral ligament complex (LCLC) injury on the posteromedial rotational stability of the elbow joint. Methods The double elbows were obtained from 4 fresh adult male cadaveric specimens. Complete elbow joint (group A,n=8), simple LCLC injury (group B,n=4), simple anteromedial coronoid facet fracture (group C,n=4), and LCLC injury combined with anteromedial coronoid facet fracture (group D,n=8). The torque value was calculated according to the load-displacement curve. Results There was no complete dislocation of the elbow during the experiment. The torque values of groups A, B, C, and D were (10.286±0.166), (5.775±0.124), (6.566±0.139), and (3.004±0.063) N·m respectively, showing significant differences between groups (P<0.05). Conclusion Simple LCLC injury, simple anteromedial coronoid facet fracture, and combined both injury will affect the posteromedial rotational stability of the elbow.

Citation： DONGHongxian, HUANGFuguo. Biomechanical effect of anteromedial coronoid facet fracture and lateral collateral ligament complex injury on posteromedial rotational stability of elbow. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(2): 176-179. doi: 10.7507/1002-1892.201610006 Copy

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2.	Jawa A, Jupiter JB, Hotchkiss RN. Complex traumatic elbow dislocation//Green's operative hand surgery. 6th ed. Philadelphia: Churchill Livingstone, 2011: 869-886.
3.	Huri G, Huri G, Leblebicioğlu G,et al. Chronic elbow instabilities: medial and lateral instability. Sports Injuries, 2012, 17(10): 217-221.
4.	Heo YM, Yi JW, Lee JB,et al. Unstable simple elbow dislocation treated with the repair of lateral collateral ligament complex. Clin Orthop Surg, 2015, 7(2): 241-247.
5.	Hackl M, Bercher M, Wegmann K,et al. Functional anatomy of the lateral collateral ligament of the elbow. Arch Orthop Trauma Surg, 2016, 136(7): 1031-1037.
6.	Rhyou IH, Kim KC, Lee JH,et al. Strategic approach to O'Driscoll type 2 anteromedial coronoid facet fracture. J Shoulder Elbow Surg, 2014, 23(7): 924-932.
7.	Broekhuis D, Bessems JH, Colaris JW. Avulsion fracture of the supinator crest as an indication for a sustained posterolateral (sub)luxation of the elbow. A case report, anatomical evaluation and review of the literature. Orthop Traumatol Surg Res, 2016, 102(8): 1113-1116.
8.	Hanada M, Kadota H, Matsunobu T,et al. Non-anatomical reconstruction of lateral ulnar collateral ligament of the elbow after tumor resection. Strategies Trauma Limb Reconstr, 2015, 10(3): 195-199.
9.	Fedorka CJ, Oh LS. Posterolateral rotatory instability of the elbow. Curr Rev Musculoskelet Med, 2016, 9(2): 240-246.
10.	Kovacevic D, Vogel LA, Levine WN. Complex elbow instability: radial head and coronoid. Hand Clin, 2015, 31(4): 547-556.
11.	Armstrong A. Simple elbow dislocation. Hand Clin, 2015, 31(4): 521-531.
12.	Gajendran VK, Bishop JA. Terrible triad elbow fracture-dislocation with triceps and flexor-pronator mass avulsion. Orthopedics, 2015, 38(2): e143-146.
13.	Doornberg JN, Ring D. Coronoid fracture patterns. J Hand Surg (Am), 2006, 31(1): 45-52.
14.	O’Driscoll SW. Elbow dislocations//Morrey BF. The elbow and its disorders. Philadelphia: W.B. Saunders, 2000: 409-420.
15.	McAdams TR, Masters GW, Srivastava S. The effect of arthroscopic sectioning of the lateral ligament complex of the elbow on posterolat-eral rotatory stability. J Shoulder Elbow Surg, 2005, 14(3): 298-301.
16.	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.
17.	查晔军, 蒋协远, 公茂琪. 肘关节内翻-后内侧旋转不稳定的诊断与治疗. 中华创伤骨科杂志, 2012, 14(1): 68-72.
18.	Ring D. Fractures of the coronoid process of the ulna. J Hand Surg (Am), 2006, 31(10): 1679-1689.

1. Mellema JJ, Doornberg JN, Dyer GS,et al. Distribution of coronoid fracture lines by specific patterns of traumatic elbow instability. J Hand Surg (Am), 2014, 39(10): 2041-2046.
2. Jawa A, Jupiter JB, Hotchkiss RN. Complex traumatic elbow dislocation//Green's operative hand surgery. 6th ed. Philadelphia: Churchill Livingstone, 2011: 869-886.
3. Huri G, Huri G, Leblebicioğlu G,et al. Chronic elbow instabilities: medial and lateral instability. Sports Injuries, 2012, 17(10): 217-221.
4. Heo YM, Yi JW, Lee JB,et al. Unstable simple elbow dislocation treated with the repair of lateral collateral ligament complex. Clin Orthop Surg, 2015, 7(2): 241-247.
5. Hackl M, Bercher M, Wegmann K,et al. Functional anatomy of the lateral collateral ligament of the elbow. Arch Orthop Trauma Surg, 2016, 136(7): 1031-1037.
6. Rhyou IH, Kim KC, Lee JH,et al. Strategic approach to O'Driscoll type 2 anteromedial coronoid facet fracture. J Shoulder Elbow Surg, 2014, 23(7): 924-932.
7. Broekhuis D, Bessems JH, Colaris JW. Avulsion fracture of the supinator crest as an indication for a sustained posterolateral (sub)luxation of the elbow. A case report, anatomical evaluation and review of the literature. Orthop Traumatol Surg Res, 2016, 102(8): 1113-1116.
8. Hanada M, Kadota H, Matsunobu T,et al. Non-anatomical reconstruction of lateral ulnar collateral ligament of the elbow after tumor resection. Strategies Trauma Limb Reconstr, 2015, 10(3): 195-199.
9. Fedorka CJ, Oh LS. Posterolateral rotatory instability of the elbow. Curr Rev Musculoskelet Med, 2016, 9(2): 240-246.
10. Kovacevic D, Vogel LA, Levine WN. Complex elbow instability: radial head and coronoid. Hand Clin, 2015, 31(4): 547-556.
11. Armstrong A. Simple elbow dislocation. Hand Clin, 2015, 31(4): 521-531.
12. Gajendran VK, Bishop JA. Terrible triad elbow fracture-dislocation with triceps and flexor-pronator mass avulsion. Orthopedics, 2015, 38(2): e143-146.
13. Doornberg JN, Ring D. Coronoid fracture patterns. J Hand Surg (Am), 2006, 31(1): 45-52.
14. O’Driscoll SW. Elbow dislocations//Morrey BF. The elbow and its disorders. Philadelphia: W.B. Saunders, 2000: 409-420.
15. McAdams TR, Masters GW, Srivastava S. The effect of arthroscopic sectioning of the lateral ligament complex of the elbow on posterolat-eral rotatory stability. J Shoulder Elbow Surg, 2005, 14(3): 298-301.
16. 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.
17. 查晔军, 蒋协远, 公茂琪. 肘关节内翻-后内侧旋转不稳定的诊断与治疗. 中华创伤骨科杂志, 2012, 14(1): 68-72.
18. Ring D. Fractures of the coronoid process of the ulna. J Hand Surg (Am), 2006, 31(10): 1679-1689.

Chinese Journal of Reparative and Reconstructive Surgery

Biomechanical effect of anteromedial coronoid facet fracture and lateral collateral ligament complex injury on posteromedial rotational stability of elbow

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