Elbow Dislocations, Instability and Contracture-The Results of Operative Treatment Without Repair of the Medial Collateral Ligament

The Results of Operative Treatment Without Repair of the Medial Collateral Ligament

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The study aimed to determine the effectiveness of a treatment protocol for fracture-dislocations of the elbow. Over a 5-year period, 34 patients with a dislocated elbow and associated fractures were treated. The fractures were repaired or reconstructed, and the lateral collateral ligament complex was reattached to the lateral epicondyle. However, repair of the medial collateral ligament (MCL) was not performed. Two patients experienced postoperative instability due to noncompliance and required reconstructive procedures. The remaining 32 patients regained an average of 120° ulnohumeral motion and 142° forearm rotation. According to the Broberg and Morrey system, 74% of the patients had good or excellent results. Patients with terrible triad injuries had an average of 117° ulnohumeral motion and 137° forearm rotation, with 77% experiencing good or excellent results. The study concluded that MCL repair is unnecessary in the treatment of elbow dislocation with associated intra-articular fractures when the articular fractures and lateral collateral ligament (LCL) are repaired or reconstructed. The study suggested that restoration of bony stability, the LCL, and dynamic components of stability provide enough elbow stability for functional use of the arm. The study also recommended routine prophylaxis against heterotopic ossification to reduce subsequent operations. Overall, the results showed that satisfactory function and elbow stability can be achieved without MCL repair in most dislocated elbows with associated intra-articular fractures.

Keywords

effectiveness

treatment protocol

fracture-dislocations

elbow

associated fractures

lateral collateral ligament complex

ulnohumeral motion

forearm rotation

Broberg and Morrey system

terrible triad injuries