Document Detail

Posterolateral rotatory instability of the elbow following radial head resection.
MedLine Citation:
PMID:  15995125     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Resection is a common procedure for the treatment of comminuted fractures of the radial head. While radial head resection is associated with a high success rate when performed for appropriate indications, a number of well-defined biomechanical complications have been reported following this procedure, including proximal migration of the radius, the development of valgus deformity, and recurrent elbow instability in the acute setting. However, posterolateral rotatory instability has not previously been recognized as a complication of radial head resection. While the absence of the radial head makes the diagnosis difficult, we have identified a series of patients with posterolateral rotatory instability following radial head resection. We believe that this instability is secondary to unrecognized lateral ulnar collateral ligament deficiency. METHODS: Between November 1995 and September 2000, forty-two patients were evaluated because of elbow or forearm complaints following radial head resection. Seven patients (17%) were diagnosed with posterolateral rotatory instability on the basis of characteristic clinical and radiographic findings. RESULTS: The study group included five men and two women with a mean age of forty-two years. All seven patients had had radial head excision for the treatment of a comminuted radial head fracture at a mean of forty-four months (range, four months to sixteen years) prior to referral. All seven patients had lateral elbow pain, a sense of instability and/or weakness, and a positive lateral pivot-shift test. Posterolateral rotatory instability secondary to lateral ulnar collateral ligament insufficiency was confirmed intraoperatively in the four patients who were managed surgically. CONCLUSIONS: Clinicians should be aware that posterolateral rotatory instability may be a cause of unexplained elbow pain and instability following radial head resection. This diagnosis has implications for the prevention and treatment of this condition.
Jeremy A Hall; Michael D McKee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  87     ISSN:  0021-9355     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-04     Completed Date:  2005-09-15     Revised Date:  2010-10-25    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1571-9     Citation Subset:  AIM; IM    
Division of Orthopaedics, Department of Surgery, St. Michael's Hospital and the University of Toronto, 55 Queen Street East, Suite 800, Toronto, Ontario M5C 1R6, Canada.
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MeSH Terms
Elbow Joint / injuries*,  surgery
Fractures, Comminuted / surgery
Joint Instability / etiology*
Middle Aged
Orthopedic Procedures / adverse effects*
Radius / surgery*
Radius Fractures / surgery*
Torsion Abnormality / etiology

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