title: Unstable Simple Elbow Dislocation Treated with the Repair of Lateral Collateral Ligament Complex.
abstract: BACKGROUND
  Unstable simple elbow dislocation (USED) repair is challenged by the maintenance of joint reduction; hence, primary repair or reconstruction of disrupted ligaments is required to maintain the congruency and allow early motion of the elbow. We evaluated the effectiveness and the outcome of lateral collateral ligament (LCL) complex repair with additional medial collateral ligament (MCL) repair in cases of USED.
  
  
  METHODS
  We retrospectively reviewed 21 cases of diagnosed USED without fractures around the elbow that were treated with primary ligament repair. In all cases, anatomical repair of LCL complex with or without common extensor origin was performed using suture anchor and the bone tunnel method. Next, the instability and congruency of elbow for a full range of motion were evaluated under the image intensifier. MCL was repaired only if unstable or incongruent elbow was observed. Clinical outcomes were evaluated using the Mayo elbow performance score (MEPS) and radiographic outcomes on last follow-up images.
  
  
  RESULTS
  All cases achieved a stable elbow on radiographic and clinical results. LCL complex repair alone was sufficient to obtain the stable elbow in 17 of 21 cases. Four cases required additional MCL repair after restoration of the LCL complex. The overall mean MEPS was 91 (range, 70 to 100): excellent in 12 cases, good in 7 cases, and fair in 2 cases. All 17 cases with LCL complex repair only and 2 of 4 cases with additional MCL repair had excellent or good results by MEPS.
  
  
  CONCLUSIONS
  USED requires surgical treatment to achieve a congruent and stable joint. If the repair of lateral stabilizer such as LCL complex acquires enough joint stability to maintain a full range of motion, it may not be necessary to repair the medial stabilizer in all cases of USED.
authors.affiliation: Department of Orthopedic Surgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Youn Moo
authors.initials: YM
authors.lastname: Heo
authors.affiliation: Department of Orthopedic Surgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Jin Woong
authors.initials: JW
authors.lastname: Yi
authors.affiliation: Department of Orthopedic Surgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Jung Bum
authors.initials: JB
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Dae Hee
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Won Keun
authors.initials: WK
authors.lastname: Park
authors.affiliation: Department of Orthopedic Surgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Sun Joong
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D017885:Collateral Ligaments / Q000601:surgery*; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D007593:Joint Instability / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D055815:Young Adult; D000092464:Elbow Injuries
keywords: Dislocation; Elbow joint; Lateral collateral ligament; Ligament repair