title: Unstable elbow dislocations: the description and cadaveric feasibility study of a new surgical technique.
abstract: BACKGROUND
  A small proportion of simple elbow dislocations are grossly unstable and joint congruence is not maintained after reduction. In this rare situation operative treatment is indicated. We describe a new intra articular reconstruction that utilises a slip of triceps tendon to provide immediate stability to the elbow.
  
  
  METHODS
  We assessed 20 cadaveric elbows, measuring the length of triceps tendon available and required to complete the reconstruction. We then sequentially sectioned the ligamentous stabilisers of an elbow before performing the new technique. We measured the displacement and angulation possible at the elbow before and after the reconstruction.
  
  
  RESULTS
  All 20 elbows had sufficient triceps tendon length to complete the new technique. Prior to the reconstruction greater than 30 mm of joint distraction and 90 degrees varus or valgus angulation was possible. Following the reconstruction it was not possible to re-dislocate the elbow. Only 2 mm of joint distraction and 10 degrees of varus or valgus angulation were possible with the triceps graft fixed in position.
  
  
  CONCLUSIONS
  This novel technique elegantly avoids many of the problems associated with current methods. We have demonstrated that it is technically feasible and easy to perform with minimal equipment requirements or costs.
authors.affiliation: Department of Orthopaedic surgery, St Georges NHS Foundation Trust Blackshaw Road Tooting, London SW17 0QT UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Harris
authors.affiliation: Department of Orthopaedic surgery, St Georges NHS Foundation Trust Blackshaw Road Tooting, London SW17 0QT UK.
authors.forename: Timothy
authors.initials: T
authors.lastname: Bishop
authors.affiliation: Department of Orthopaedic surgery, St Georges NHS Foundation Trust Blackshaw Road Tooting, London SW17 0QT UK.
authors.forename: Jason
authors.initials: J
authors.lastname: Bernard
keywords: Elbow dislocation; Surgical stabilisation