Reconstruction of medial collateral ligament defects with a flexor-pronator fascia patch in complete open release of stiff elbows.
BACKGROUND
Because medial elbow stability is essential for stiff elbow release, surgical techniques have been reported for reconstructing medial elbow stability. However, medial collateral ligament (MCL) defects, caused by inevitable detachment and resection performed for complete release, make the reconstruction more challenging. To our knowledge, no study has evaluated the outcomes after using a flexor-pronator fascia patch in medial elbow reconstruction for open release of stiff elbows. We hypothesized that this technique is effective for repairing MCL defects.


METHODS
We retrospectively reviewed the records of 10 patients. The MCL defects were all reconstructed with a flexor-pronator fascia patch. An external fixator was used in all patients. One patient could not be contacted and was thus excluded from the study. Outcome measures included stability, range of motion, Mayo Elbow Performance Score, ulnar nerve symptoms, power grip, and radiographic findings.


RESULTS
The mean follow-up period was 19.6 months; all elbows were stable by the last follow-up. One patient presented with moderate elbow instability and then regained stability 3 months after the external fixator was removed. The Mayo Elbow Performance Score improved from 58 points to 94 points, and the mean flexion arc improved from 40° to 133°. No radiographic manifestations of elbow dislocation or suture anchor looseness were observed.


CONCLUSIONS
A flexor-pronator fascia patch provides sufficient stability for repairing MCL defects without restricting the range of motion gained during arthrolysis.
Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Shuai
S
Chen
Division of Plastic and Hand Surgery, Department of Orthopaedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Hede
H
Yan
Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Wei
W
Wang
Section of Orthopedic Surgery, Department of Surgery, University of Calgary, Calgary, AB, Canada.
Mei
M
Zhang
Section of Orthopedic Surgery, Department of Surgery, University of Calgary, Calgary, AB, Canada.
Kevin A
KA
Hildebrand
Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. Electronic address: fancunyi888@163.com.
Cun-Yi
CY
Fan
D000293:Adolescent; D000328:Adult; D017885:Collateral Ligaments / Q000601:surgery*; D004551:Elbow Joint; D016267:External Fixators; D005205:Fascia / Q000637:transplantation*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D053441:Suture Anchors; D013709:Tendon Transfer / Q000379:methods*; D055815:Young Adult
Flexor-pronator fascia patch; elbow stiffness; medial collateral ligament defects; medial collateral ligament reconstruction; open release; stiff elbow; suture anchor