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Posterolateral rotatory instability (PLRI) of the elbow occurs from chronic lateral ulnar collateral ligament (LUCL) injury leading to subluxation of the ulnohumeral joint and radial head. Patients with failed or untreated LUCL injury can go on to have chronic elbow instability and difficulty with activities that require an axial load on the elbow. Free grafts such as semitendinosus, Achilles, or palmaris longus require fixation on both the humerus and ulna, or may not represent the native LUCL kinematics as a native tendon such as anconeus. Split anconeus fascia transfer is a surgical treatment option for PLRI that does not require ulnar drilling or graft site morbidity. This surgical technique paper describes evaluation, management, and treatment of PLRI with accompanying video and description of the split anconeus fascia transfer technique.
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http://dx.doi.org/10.5435/JAAOS-D-24-01507 | DOI Listing |
J Am Acad Orthop Surg
August 2025
From the Department of Should and Elbow Surgery, MedStar Union Memorial Hospital, Baltimore, MD (Haislup and Murthi), the Portland Veterans Affairs Center, Portland, OR (Zhang), and the Department of Orthopaedic Surgery, University of South Florida, Tampa, FL (Chebli).
Posterolateral rotatory instability (PLRI) of the elbow occurs from chronic lateral ulnar collateral ligament (LUCL) injury leading to subluxation of the ulnohumeral joint and radial head. Patients with failed or untreated LUCL injury can go on to have chronic elbow instability and difficulty with activities that require an axial load on the elbow. Free grafts such as semitendinosus, Achilles, or palmaris longus require fixation on both the humerus and ulna, or may not represent the native LUCL kinematics as a native tendon such as anconeus.
View Article and Find Full Text PDFJSES Int
January 2024
Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
Background: The split anconeus fascia transfer (SAFT) is an option for reconstruction of the lateral ulnar collateral ligament (LUCL) in chronic posterolateral rotatory instability (PLRI) of the elbow with potential advantages of using only local tissue within the surgical exposure and not requiring ulnar fixation. This study aimed to assess SAFT strength compared to a traditional free graft reconstruction in a PLRI biomechanical model.
Methods: To measure biomechanical strength, eight cadaveric upper extremity pairs were utilized.
J Shoulder Elbow Surg
April 2024
Department of Orthopaedic and Trauma Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Bone and Motion Center, Hirslanden Clinique Bois-Cerf, Lausanne, Switzerland. Electronic address:
J Hand Surg Am
January 2023
Department of Hand Surgery, Sheba Medical Center, Affiliated with Sackler School of Medicine, Tel Aviv University, Ramat Gan, Israel.
JBJS Essent Surg Tech
May 2021
Shriners Hospitals for Children, Philadelphia, Pennsylvania.
Background: The goal of the osteochondral autograft transplantation (OAT) procedure is to replace both the bone and cartilage that have been compromised by osteonecrosis of the capitellum, a condition known as osteochondritis dissecans (OCD). In children, the vascularity of the capitellum is limited compared with that in adults because the physis acts as a physical barrier to vascular ingrowth from the metaphysis to the epiphysis. The necrotic subchondral bone cannot keep up with the weight-bearing demands of certain high-level athletes such as gymnasts, accumulating microfractures and eventually crumbling.
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