Mid-term results of the treatment of acute postero-lateral rotational instability of the elbow joint

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Abstract

Background: Dislocations of the forearm are rare injuries with the annual incidence of 6.1 cases per 100 000 population. Postero-lateral rotational instability is the most common complication after the conservative treatment of forearm dislocations. To restore the congruency and provide early movements in the elbow joint, the primary repair or reconstruction of the damaged ligaments of the elbow are required.

Aim: to evaluate the clinical and functional results after the surgical repair of the elbow joint ligaments in acute postero-lateral rotational instability.

Methods: The study was based on a retrospective analysis of a series of clinical cases, including 17 patients with acute postero-lateral rotational instability, among them 5 simple forearm dislocations, 9 fracture-dislocations of the forearm and 3 fractures of the radial head. Refixation of the lateral ulnar ligament was performed with anchor fixation or bone tunnels. The evaluation was performed using the clinical aspects (the «lateral pivot shift» test, the range of motion), according to the scale for the evaluation of the elbow joint functional condition (MEPS), Oxford scale of the elbow joint evaluation (OEC), the X-ray results were also estimated.

Results: In all the cases the elbow joint stability had been achieved, according to the X-ray and clinical aspects. In 4 cases, additional plasty of the medial collateral ligament was needed and performed after the restoration of the lateral ligament complex. According to the MEPS scale, 58% of the achieved results were excellent, 35% were good and 5.8% were satisfactory.

Conclusion: The restoration of the lateral ulnar collateral ligament complex is a safe and effective procedure, which restores the elbow joint stability and allows the patients to return to full physical activity and avoid the development of postero-lateral rotational joint instability.

About the authors

Mohamed A. Haj Hmaidi

Peoples’ Friendship University of Russia; Moscow City Clinical Hospital in honor of V.M. Buyanov

Author for correspondence.
Email: hajhmaidi@mail.ru
ORCID iD: 0009-0000-0079-6350
Russian Federation, Moscow; Moscow

Fedor L. Lazko

Peoples’ Friendship University of Russia; Moscow City Clinical Hospital in honor of V.M. Buyanov

Email: fedor_lazko@mail.ru
ORCID iD: 0000-0001-5292-7930
SPIN-code: 8504-7290

Dr. Sci. (Med.)

Russian Federation, Moscow; Moscow

Aleksey P. Prizov

Peoples’ Friendship University of Russia; Moscow City Clinical Hospital in honor of V.M. Buyanov

Email: aprizov@yandex.ru
ORCID iD: 0000-0003-3092-9753
SPIN-code: 6979-6480

MD, PhD

Russian Federation, Moscow; Moscow

Nikolai V. Zagorodniy

Peoples’ Friendship University of Russia; Priorov Central institute for Trauma and Orthopedics

Email: zagorodniy51@mail.ru
ORCID iD: 0000-0002-6736-9772
SPIN-code: 6889-8166

Dr. Sci. (Med.), Professor, Corr. member of the Russian Academy of Sciences

Russian Federation, Moscow; Moscow

Evgeniy A. Belyak

Peoples’ Friendship University of Russia; Moscow City Clinical Hospital in honor of V.M. Buyanov

Email: belyakevgen@mail.ru
ORCID iD: 0000-0002-2542-8308
SPIN-code: 7337-1214

MD, PhD

Russian Federation, Moscow; Moscow

Alexander A. Akhpashev

Peoples’ Friendship University of Russia; Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies

Email: akhpashev@gmail.com
ORCID iD: 0000-0002-2938-5173
SPIN-code: 9965-1828

MD, PhD

Russian Federation, Moscow; Moscow

Maxim F. Lazko

Peoples’ Friendship University of Russia; Moscow City Clinical Hospital in honor of V.M. Buyanov

Email: maxim_lazko@mail.ru
ORCID iD: 0000-0001-6346-824X

MD, PhD

Russian Federation, Moscow; Moscow

Aleksander V. Kuznetsov

Peoples’ Friendship University of Russia; Moscow City Clinical Hospital in honor of V.M. Buyanov

Email: dr.smith_a@icloud.com
ORCID iD: 0009-0002-8596-3086
Russian Federation, Moscow; Moscow

Georgiy A. Strashinskiy

Peoples’ Friendship University of Russia

Email: egorstr1996@gmail.com
ORCID iD: 0009-0002-7509-135X
Russian Federation, Moscow

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2. Fig. 1. Medial and lateral collateral ligament complex [1].

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