Treatment of Combined Medial and Lateral Collateral Ligament Insufficiency
The medial and lateral collateral ligament complexes represent primary elbow ligament stabilizers. Injury to these structures may occur because of an elbow dislocation or due to a severe varus or valgus force. Most elbow dislocations are stable once reduced and may be treated conservatively. However, if the elbow remains unstable surgical treatment is recommended. Repair should be anatomical and should restore stability to the elbow in order to permit an early active range of motion. Reconstruction may be required in severe cases and where primary repair is not possible. Depending on the degree of instability, either one or both of the collateral ligament complexes may need to be repaired o…
Mesh Plates for Scapula Fixation
While scapula fractures are often treated nonoperatively, there are a number of displaced fractures in which surgical treatment can be considered. When necessary, open reduction and internal fixation with plates is the accepted method for stabilization. However, there are limited options of commercially available plates for fixation of the scapula. The authors describe 2 cases of scapula fracture and 1 scapula osteotomy that were managed with internal fixation using low-profile mesh plates. The mesh plate is a stainless steel lattice that can be molded and trimmed to create a plate that matches the unusual 3-dimensional anatomy of the scapula. It accepts 2.4/2.7 mm cortical and variable ang…
Lateral Ligament Reconstruction
The lateral collateral ligament complex represents the primary lateral elbow ligament stabilizers. In cases of lateral elbow instability, surgical treatment is recommended. Repair should be anatomical and should restore stability to the elbow in order to permit an early active range of motion. Anatomic repair of soft tissue avulsions from bone can be performed with trans-osseous suture or suture anchors. Reconstruction may be required in severe cases and where primary repair is not possible. This chapter describes the surgical techniques for repair and reconstruction of the lateral collateral ligament of the elbow.
Circumferential graft for elbow instability
For those patients with instability of the medial and lateral sided of the elbow, there is a place for a circumferential graft. This has the main advantage of simplifying the bone tunnel creation and graft fixation, compared to having both medial- and lateral-sided reconstructions.