title: Percutaneous lateral ulnar collateral ligament reconstruction.
abstract: OBJECTIVE
  Open surgical reconstruction of the lateral ulnar collateral ligament is the standard treatment for symptomatic posterolateral rotatory instability of the elbow. It involves dissection and retraction of the lateral elbow muscles, which have been shown to be secondary stabilizers of the lateral elbow. We introduce a new muscle-protecting technique for single-strand lateral ulnar collateral ligament reconstruction and report on the isometry and primary stability when compared with a conventional muscle-splitting procedure. It was hypothesized that percutaneous lateral ulnar collateral ligament reconstruction provided isometry over the range of motion and that stability was comparable with a conventional open procedure.
  
  
  METHODS
  In sixteen human cadaver arms, the intact and the lateral collateral ligament complex-deficient situation was tested. Open lateral ulnar collateral ligament reconstruction was performed using a single-strand palmaris graft with humeral and ulnar tenodesis screw fixation. Posterolateral rotational stability was compared with a new reconstruction method, which percutaneously places a single-strand palmaris graft with humeral and ulnar tenodesis screw fixation.
  
  
  RESULTS
  Both open and percutaneous lateral ulnar collateral ligament reconstruction provided isometry over the range of motion and restored posterolateral stability to that of the intact situation. No significant differences between open and percutaneous reconstruction were found.
  
  
  CONCLUSIONS
  Percutaneous lateral ulnar collateral ligament reconstruction aims to preserve the lateral elbow muscles and to minimize soft tissue dissection. It has been shown that in an in vitro setup, this new procedure provides isometry over the range of motion and sufficiently restores posterolateral rotatory stability.
authors.affiliation: Clinic for Orthopaedics and Trauma Surgery, University of Cologne, Joseph-Stelzmann Strasse 9, 50924, Cologne, Germany. jens.dargel@uk-koeln.de
authors.forename: Jens
authors.initials: J
authors.lastname: Dargel
authors.forename: Klaus
authors.initials: K
authors.lastname: Burkhart
authors.forename: Dietmar
authors.initials: D
authors.lastname: Pennig
authors.forename: Gregor
authors.initials: G
authors.lastname: Stein
authors.forename: Peer
authors.initials: P
authors.lastname: Eysel
authors.forename: Lars Peter
authors.initials: LP
authors.lastname: Müller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D017885:Collateral Ligaments / Q000601:surgery*; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged