Summary
LUCL repair with internal bracing in elbow dislocations and fracture-dislocations allows for early mobilization, with 20 out of 31 patients developing heterotopic ossification but only one requiring reoperation, leading to favorable functional outcomes, including a Quick-DASH score of 9 and a Mayo Elbow Performance Score of 90 at one year
Abstract
Introduction
Elbow dislocations, particularly when accompanied by fractures, often require surgical intervention to prevent instability and stiffness. The optimal approach remains debated, especially in complex injuries like the "terrible triad." This study evaluates outcomes following lateral ulnar collateral ligament (LUCL) repair with internal bracing, including cases with fracture-dislocations.
Purpose
This retrospective cohort study examines early mobilization and functional outcomes after LUCL repair with internal bracing in acute and subacute elbow instability, with a subgroup analysis of fracture-dislocations.
Materials And Methods
Thirty-one patients with elbow instability (14 with posterolateral dislocations, 10 with radial head fractures, and 7 with terrible triad injuries) underwent LUCL repair with internal bracing. Preoperative Quick-DASH and Mayo Elbow Performance Scores (MEPS) were recorded. Postoperative follow-up was conducted at 6, 12, 24, and 52 weeks, with early mobilization after a maximum 7-day bracing period.
Results
At one year, the median Quick-DASH score was 9, and MEPS was 100, with a median range of motion (ROM) of 10° extension and 130° flexion. Heterotopic ossification occurred in 20 of 31 patients, but only one patient (the case with postoperative stiffness) required re-operation. All patients returned to pre-injury activity levels.
Conclusion
LUCL repair with internal bracing is a safe and effective method for restoring elbow stability, facilitating early mobilization, and minimizing long-term complications, particularly in complex fracture-dislocations. Heterotopic ossification was common but rarely required re-operation.