Posterolateral Rotatory Instability of the Elbow without Epiphyseal Injury in Children

Sang-Uk Lee; Changhoon Jeong; Hyun Woo Kim

doi:10.12790/jkssh.2014.19.3.150

Journal List > J Korean Soc Surg Hand > v.19(3) > 1106463

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Lee, Jeong, and Kim: Posterolateral Rotatory Instability of the Elbow without Epiphyseal Injury in Children

CASE REPORT

J Korean Soc Surg Hand 2014;19(3):150-153.

Published online: 11 September 2014

DOI: https://doi.org/10.12790/jkssh.2014.19.3.150

Posterolateral Rotatory Instability of the Elbow without Epiphyseal Injury in Children

Sang-Uk Lee¹, Changhoon Jeong^2,, Hyun Woo Kim¹

¹Department of Orthopedic Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea

²Department of Orthopedic Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea

Correspondence to: Changhoon Jeong, Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, 327 Sosa-ro 327beon-gil, Wonmi-gu, Bucheon 420-717, Korea, TEL: +82-32-340-7089, FAX: +82-32-340-2671, E-mail: changhoonj@naver.com

Received 17 July 20142 September 2014 Accepted 4 September 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Posterolateral rotatory instability of the elbow in the absence of epiphyseal injury is extremely rare in children. We present a case of 12-year-old child in whom recurrent dislocation of the elbow was associated with a stretched lateral ulnar collateral ligament. We performed surgical repair and reefing of a stretched lateral ulnar collateral ligament by using a suture anchor and a continuous locking suture in order to avoid donor site morbidity and damage of the growth plate, which could occur when a transosseous tunnel for reconstruction was made. At 12 months after operation, satisfactory symptom relief was observed with no evidence of recurrence.

Keywords: Children, Elbow, Posterolateral rotatory instability, Surgical treatment

REFERENCES

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Fig. 1.

Initial plain radiographs showing posterior dislocation of elbow joint.

Fig. 2.

Preoperative photograph taken during Pivot-shift test of elbow showing osseous prominence caused by posterior subluxation of radial head and skin dimpling just proximal to prominence.

Fig. 3.

Intraoperative photographs showing attenuated lateral ulnar collateral ligament (white arrow head) and capsular laxity (black arrow head, radial head).

Fig. 4.

Intraoperative photograph after plication of attenuated lateral ulnar collateral ligament with anchor suture and posterior capsular reefing.

Fig. 5.

Anteroposterior and lateral radiographs taken at 12 months after surgery show concentrically reduced elbow joint.

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