title: Lateral elbow ligamentoplasty by autologous tendon graft in posterolateral rotatory instability: Results in 18 cases at a mean 5 years' follow-up.
abstract: BACKGROUND
  Posterolateral rotatory instability is the most frequent form of elbow instability. This clinical entity, described by O'Driscoll et al. in 1991, concerns young subjects following elbow trauma. Diagnosis is founded on symptomatology and positive posterolateral rotatory instability test. Treatment is based on reconstruction of the ulnar bundle of the lateral collateral ligament. The present study assessed medium-term clinical and radiological results in lateral ligamentoplasty for posterolateral elbow instability.
  
  
  METHODS
  A retrospective continuous single-center series included 19 cases: 11 male, 8 female, operated on between 1995 and 2010; mean age was 37.8 years (range, 20-63 years). Surgery consisted in lateral ulnar collateral ligament reconstruction by autologous palmaris longus tendon graft following Nestor et al. (1992).
  
  
  RESULTS
  Eighteen patients were assessed at a mean 61 months' follow-up. Mean time off work was 3.2 months (range, 2-7 months); all patients returned to work. No revision surgery was required. Mean range of motion in flexion, extension, pronation and supination was respectively 135°, 8°, 84° and 76°. Instability test was systematically negative at follow-up. Mean Mayo Clinic and Quick-DASH scores were respectively 90 (range, 60-100) and 21 (range, 0-63). All patients were satisfied or very satisfied with their result.
  
  
  CONCLUSIONS
  Lateral ulnar collateral ligament reconstruction by autologous palmaris longus tendon graft provided reliable and lasting results. We consider it to be the reference treatment for chronic instability, and sometimes in acute post-traumatic instability.
  
  
  METHODS
  IV.
authors.affiliation: Services de Chirurgie Orthopédique 1 et 2, Unité de Chirurgie de la Main et du Membre Supérieur, CHRU de Tours, 37044 Tours cedex 09, France.
authors.forename: E
authors.initials: E
authors.lastname: Vernet
authors.affiliation: Services de Chirurgie Orthopédique 1 et 2, Unité de Chirurgie de la Main et du Membre Supérieur, CHRU de Tours, 37044 Tours cedex 09, France.
authors.forename: G
authors.initials: G
authors.lastname: Bacle
authors.affiliation: Services de Chirurgie Orthopédique 1 et 2, Unité de Chirurgie de la Main et du Membre Supérieur, CHRU de Tours, 37044 Tours cedex 09, France.
authors.forename: E
authors.initials: E
authors.lastname: Marteau
authors.affiliation: Services de Chirurgie Orthopédique 1 et 2, Unité de Chirurgie de la Main et du Membre Supérieur, CHRU de Tours, 37044 Tours cedex 09, France.
authors.forename: L
authors.initials: L
authors.lastname: Favard
authors.affiliation: Services de Chirurgie Orthopédique 1 et 2, Unité de Chirurgie de la Main et du Membre Supérieur, CHRU de Tours, 37044 Tours cedex 09, France. Electronic address: j.laulan@chu-tours.fr.
authors.forename: J
authors.initials: J
authors.lastname: Laulan
mesh_terms: D000328:Adult; D017885:Collateral Ligaments / Q000601:surgery*; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D055815:Young Adult
keywords: Lateral collateral ligament reconstruction; Lateral ulnar collateral ligament; Palmaris longus; Posterolateral rotatory instability of the elbow; Recurrent dislocation of the elbow