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Reoperative Concerns for the Unstable Elbow

  • Paul Maloof
  • Virak TanEmail author
Chapter

Abstract

The unstable elbow can be caused by not only problems with the bony anatomy but of course the soft tissue envelope as well. The unstable elbow may require correction of any bony deficits as well as reconstruction of ligaments in order to obtain an elbow that the patient feels confident in from a stability standpoint. The dissection after previous surgeries in these areas can be difficult because of bone loss as well as significant scar tissue about neurovascular structures. Frequently these surgeries may require more than one procedure in order to rectify anatomical deficiencies in a step-by-step fashion. Ultimately, if reconstructive efforts fail, the patient may be looking at elbow arthroplasty or fusion in order to find usage and stability from the arm.

Keywords

Elbow Instability Collateral Ligament Reconstruction 

References

  1. 1.
    Regan W, Morrey B. Fractures of the coronoid process of the ulna. J Bone Joint Surg Am. 1989;71(9):1348–54.PubMedGoogle Scholar
  2. 2.
    Morrey B, Tanaka S, Kai-Nan A. Valgus stability of the elbow. Clin Orthop Relat Res. 1991;265:187–95.PubMedGoogle Scholar
  3. 3.
    Morrey BF. The elbow and its disorders. 4th ed. Toronto: Saunders; 2008. p. 839–41.Google Scholar
  4. 4.
    O’Driscoll SW, Bell DF, Morrey BF. Posterolateral rotatory instability of the elbow. J Bone Joint Surg Am. 1991;73:440–6.PubMedGoogle Scholar
  5. 5.
    Mathew P, Athwal G, King G. Terrible triad of the elbow: current concepts. J Am Acad Orthop Surg. 2009;17:137–51.PubMedGoogle Scholar
  6. 6.
    McKee M, Pugh D, Wild L, Schemitsch E, King G. Standard protocol to treat elbow dislocations with radial head and coronoid fractures. J Bone Joint Surg Am. 2005;87:22–32.PubMedCrossRefGoogle Scholar
  7. 7.
    Nestor B, O’Driscoll S, Morrey B. Ligamentous reconstruction for posterolateral rotatory instability of the elbow. J Bone Joint Surg Am. 1992;74:1235–41.PubMedGoogle Scholar
  8. 8.
    Sanchez-Sotelo J, Morrey B, O’Driscoll S. Ligamentous repair and reconstruction for posterolateral rotatory instability of the elbow. J Bone Joint Surg Br. 2005;87-B:54–61.Google Scholar
  9. 9.
    Jepegnanam TS. Salvage of the radial head in adult Monteggia fractures. J Bone Joint Surg Br. 2006;88-B:645–8.CrossRefGoogle Scholar
  10. 10.
    Ring D, Jupiter J, Simpson S. Monteggia fractures in adults. J Bone Joint Surg Am. 1998;80:1733–44.PubMedGoogle Scholar
  11. 11.
    Ring D, Jupiter J, Zilberfarb J. Posterior dislocation of the elbow with fractures of the radial head and coronoid. J Bone Joint Surg Am. 2002;84:547–51.PubMedGoogle Scholar
  12. 12.
    Ring D, Jupiter J. Reconstruction of posttraumatic elbow instability. Clin Orthop Relat Res. 2000;370:44–56.PubMedCrossRefGoogle Scholar
  13. 13.
    King G, Patterson S. Metallic radial head arthroplasty. Tech Hand Up Extrem Surg. 2001;5(4):196–203.PubMedCrossRefGoogle Scholar
  14. 14.
    Tan V, Daluiski A, Capo J, Hotchkiss R. Hinged elbow external fixators: indications and uses. J Am Acad Orthop Surg. 2005; 13(8):503–14.PubMedGoogle Scholar
  15. 15.
    Bennett J, Mehlhoff T. Total elbow arthroplasty: surgical technique. J Hand Surg Am. 2009;34A:933–9.CrossRefGoogle Scholar
  16. 16.
    Celli A, Morrey B. Total elbow arthroplasty in patients forty years of age or less. J Bone Joint Surg Am. 2009;91:1414–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Ramsey M, Adams R, Morrey B. Instability of the elbow treated with semiconstrained total elbow arthroplasty. J Bone Joint Surg Am. 1999;81:38–47.PubMedGoogle Scholar
  18. 18.
    Koller H, Kolb K, Assuncao A, Kolb W, Holz U. The fate of elbow arthrodesis: indications, techniques, and outcome in fourteen patients. J Shoulder Elbow Surg. 2008;2(17):293–306.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of OrthopedicsUniversity of Medicine and Dentistry of New Jersey and University HospitalNewarkUSA

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