Effect of ulnar tunnel location on elbow stability in double-strand lateral collateral ligament reconstruction

H. Mike Kim, Colin R. Andrews, Evan P. Roush, Gregory I. Pace, Gregory S. Lewis

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3 Scopus citations

Abstract

Background Double-strand lateral ulnar collateral ligament (LUCL) reconstruction is an effective treatment for posterolateral rotatory instability (PLRI) of the elbow, but anatomic landmarks for ulnar tunnel placement are often difficult to identify intraoperatively, which potentially can result in a nonanatomic LUCL reconstruction. This study investigated the effect of ulnar tunnel location on joint stability in double-strand LUCL reconstruction. Methods PLRI was artificially created in 7 cadaveric elbows, and double-strand LUCL reconstruction was performed. Five different ulnar tunnels were made along the length of the ulna. In each specimen, each possible pair of 2 tunnels (10 total) were used for graft passage. Varus and posterolateral joint gapping was measured after joint loading using a 3-dimensional digitizer system and X-ray image intensifier. Results No significant gapping was observed at the posterolateral ulnohumeral joint regardless of the location of the ulnar tunnels (P > .05). In contrast, the lateral radiocapitellar joint showed statistically significant varus gapping when both ulnar tunnels were placed proximal to the radial head-neck junction (P < .05). Discussion This findings of study suggest that the location of the ulnar tunnels may not be as critical as that of the humeral tunnel during double-strand LUCL reconstruction and that posterolateral rotatory elbow stability can be achieved reasonably well as long as at least 1 of the 2 ulnar tunnels is located at or distal to the radial head-neck junction level.

Original languageEnglish (US)
Pages (from-to)409-415
Number of pages7
JournalJournal of Shoulder and Elbow Surgery
Volume26
Issue number3
DOIs
StatePublished - Mar 1 2017

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All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

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