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肘关节韧带重建（稳定术）

PDF Evidence Consent
Updated Sep 2026
Illustration: 肘关节韧带重建（稳定术）

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

为何建议进行此手术

Mater Private Hospital Rockhampton 的上肢外科医生 Kieran Hirpara 医生会根据您的具体伤情制定治疗方案。患者通常由全科医生（GP）转诊至我们的诊所；如果理疗师建议您就诊，您仍需获得全科医生的转诊才能符合 Medicare 报销资格。在您的预约就诊时，我们会采集病史，检查您的肘部，并在必要时安排扫描以明确病因。

肘部韧带重建术是一种手术，通过移植一段供体肌腱来重建磨损或撕裂的韧带，以稳定关节。我们通常在经过其他治疗后改善效果不佳，且您的肘部仍感觉不稳或无法保持原位时建议进行此手术。此外，当肘部仅能在接近伸直位时维持关节稳定，或关节周围的骨折导致关节不稳定时，也会提供此手术。手术目标是获得一个稳定、可活动、可使用且无痛的肘部。同种异体肌腱重建术在约 85% 的后外侧旋转不稳定肘部中恢复了肘部稳定性。我们将与您详细讨论，并共同决定该手术是否适合您的肘部状况及您的目标。

术前

在手术前的几周，我们将通过扫描完成手术计划，例如X光、MRI（一种显示韧带等软组织的扫描）或超声检查。手术当天，请提前七小时停止进食和饮水。我们要求提前七小时禁食，以便如果手术室手术列表提前完成，您的手术可以提前进行；您的外科医生将确认您确切的禁食时间。您可能需要在手术前暂停服用某些药物，我们将为您提供明确的指示，说明哪些药物以及暂停多久。请携带一份书面清单，列出您服用的所有药物，包括药片、滴剂和药膏。安排有人在术后开车送您回家。穿着宽松、舒适的衣服，袖子可以滑过肘部。如果您有其他医疗状况，可能还需要进行血液检查或与麻醉师（负责实施麻醉的医生）进行会诊。

手术当日

您将抵达医院的手术入院病区，在此办理入院手续并做术前准备。您将在该处见到麻醉医生。本手术在全身麻醉下进行。有时会追加区域神经阻滞以缓解术后疼痛；麻醉医生将在当日就此与您沟通。随后，您将被送入手术室进行手术。手术结束后，您将在复苏室苏醒，护士会在此监测您的状况，直至麻醉作用消退。待您的生命体征平稳后，根据手术类型及您的恢复情况，您将被转入病房或直接回家。

当日的目标很简单：恢复肘部足够的稳定性，以便术后尽早开始活动。术后长时间固定肘部往往会导致关节僵硬，因此早期活动是治疗方案的一部分。

手术内容

具体步骤取决于肘部周围哪些结构受损，我们会在手术当天之前根据您的影像检查结果制定方案。如果骨折是问题的一部分，外科医生会首先使用螺钉或小型钢板固定断裂的骨块。如果前臂上端的骨块无法修复，可能会用金属植入物进行置换。一旦骨骼固定稳固，撕裂的韧带将被修复或重建。

韧带重建意味着用一段肌腱制作新的韧带。这段肌腱可能来自供体组织，也可能取自您自身的身体。小型锚钉将新韧带固定在骨骼的正确位置，外科医生会在结束手术前检查肘关节在整个活动范围内是否保持关节对位。有时，会在修复处旁边添加一条坚固的缝合带，起到类似内部支架的作用，在韧带愈合期间提供支撑。如果肘关节仍然无法自行保持稳定，可能会安装一个临时铰链，以便在情况稳定期间将其固定到位。

手术通常可以通过小切口完成，而不是一个长切口。对于某些韧带重建手术，约 2 至 3 厘米的切口就足够了。通过小切口操作可以保护关节周围健康的肌腱和肌肉，并避免干扰关节囊本身。

修复完成后，切口用缝线关闭并覆盖敷料。整个手术的目标是获得一个稳定的肘关节，使其能够很快开始活动，因为长时间保持静止往往会导致关节僵硬。

术后

您将在恢复区苏醒，麻醉消退期间，护士会密切观察您的情况。您的手臂将置于吊带中或用枕头支撑，伤口处覆盖敷料。我们会为您提供镇痛治疗，并在您下床活动前确认其效果。回家后，前24小时内应有人陪同。您的医疗团队会告知您是当天出院还是住院一晚。敷料通常保留约10天；除非我们告知您，否则请勿提前拆除。复诊时我们会更换或拆除敷料。大多数人可以立即下床活动并进行轻度家务，但在起身活动时，请让肘部在吊带中保持休息状态。

恢复

术后最初几天，您的肘部会感到疼痛和肿胀。这种情况会逐渐缓解。休息、抬高手臂以及我们提供的止痛药将有助于减轻不适。当您刚开始活动关节时，出现一些酸痛感是正常的，并会随着时间推移而改善。

您将佩戴吊带（悬臂带）回家。您可以立即下床走动并进行轻度活动，但在起身活动时，请保持肘部在吊带中休息。您的手和手腕可以早期活动，针对它们的轻柔锻炼通常在几天内开始。术后手部治疗由 Extend Rehabilitation 的 Ruby Doolan 负责。Ruby 是一名手部治疗师：她将指导您的锻炼，并根据需要为您制作任何夹板。治疗的目标是平稳、早期的活动，因为肘部静止时间过长往往会导致僵硬。

随着肿胀消退，您将更多地使用手臂：进食、书写和轻度家务。一旦您的外科医生确认修复部位稳固，即可拆除吊带，并开始弯曲和伸直肘关节本身。活动能力起初往往改善较快，随后变慢。当您能够无痛地抓握和持物时，日常活动会感觉更轻松。在手臂佩戴吊带期间，驾驶是不安全的，您需要能够双手握住方向盘，并在紧急刹车时做出反应，且不能处于强效止痛药的影响下。我们的指南 上肢手术后的驾驶 解释了您何时可以恢复驾驶。

每个人的愈合速度各不相同。您的时间表可能有所不同，您的外科医生和治疗师将在整个过程中为您提供指导。

可能出现的问题

大多数患者恢复良好，但偶尔可能出现并发症。您的外科医生和医疗团队会密切监测您的状况，以便尽早发现任何问题。

沿肘部内侧走行的神经在手术后可能会受到刺激。您可能会注意到无名指和小指出现刺痛、针刺感或麻木。这种情况通常会自行缓解，但如果症状未减轻，或手指感觉无力，请告知我们。

肘关节有时会保持松弛状态，或再次出现不稳感。如果您的肘关节开始感觉不稳，或发生脱位，请立即联系诊所。

肘关节也可能变得僵硬。您可能会发现手臂难以完全伸直或弯曲，且活动受限的感觉更像是被阻挡而非疼痛。请在复诊时提及此情况，因为额外的治疗或进一步的治疗可能有所帮助。

感染虽不常见但很严重。请留意那种不随普通止痛药缓解的深部搏动性疼痛，伤口周围扩散的红肿，或伤口渗液。如果您注意到这些症状，请在当天致电诊所，或者如果您感到发烧或身体不适，请前往急诊科。

用于固定修复部位的小型金属锚钉或螺钉有时会引起刺激，或临时铰链可能会松动。您可能会感觉到新的咔哒声、卡顿感或皮肤下的肿块。请在下次复诊时提及。

如果使用您自身的肌腱片段来重建韧带，该部位可能会在一段时间内保持压痛或酸痛。如果症状恶化而非改善，请告知我们。

骨骼有时会在关节周围或关节内部形成异位骨。这可能限制活动或导致卡顿和摩擦感。如果您的肘关节恢复停滞不前，请在复诊时提出。

疤痕本身偶尔可能会破裂或渗液。如果伤口裂开、变得更红或开始有分泌物，请联系我们，不要等待。

如果您想了解具体数据，本页上的并发症表格列出了典型的发病率。

何时联系我们

大多数问题都会较早出现，我们更希望尽早得知。如果您出现发热、伤口变红或开始渗出液体，或疼痛持续加重而非缓解，请致电我们。如果您出现小腿肿胀或疼痛，或突发呼吸困难，请立即前往急诊。如果您的无名指和小指出现麻木、手部感觉无力，或手臂完全无法活动，请立即联系我们。如果您的肘关节再次脱位或感觉再次不稳，请在当天联系诊所。

Reviewed by AI synthesis (v2) — pending human review · 21 August 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • An all-arthroscopic technique for reconstruction of the lateral ulnar collateral ligament (LUCL) is reproducible and avoids residual instability [1].
  • Open posterolateral ligament plication and LUCL repair using an all-suture construct allows for complete posterolateral stabilization of the elbow with a single implant and bone preservation [2].
  • A suture-augmented LUCL and radial collateral ligament reconstruction method provides a reproducible, anatomically based construct that restores posterolateral elbow stability [3].
  • The suture-augmented LUCL and radial collateral ligament reconstruction method addresses the complex spectrum of lateral-sided injuries observed in posterolateral rotatory instability (PLRI) [3].
  • An arthroscopic LUCL plication/reconstruction with augmented lateral collateral ligament imbrication is a minimally invasive method that allows effective management of elbow instability [4].
  • The arthroscopic LUCL plication/reconstruction with augmented lateral collateral ligament imbrication promotes quicker patient recovery and long-term functional restoration [4].
  • The use of suture button fixation for repair of the lateral ulnar collateral ligament in terrible triad injuries has not been previously described [5].
  • Reconstruction of the lateral ulnar collateral ligament with a tendon graft offers an alternative that restores stability through a dynamic “sling effect” rather than rigid constraint [6].

Anatomy & Pathophysiology

Bony Anatomy

  • The elbow is a trocho-ginglymoid joint consisting of medial and lateral articulations that provide bony stability [11].
  • The trochlea articulates with the ulna within the greater sigmoid notch to create the ulnohumeral, hinged, or trochoid portion of the elbow joint [11].
  • The ulnohumeral articulation has highly congruent anatomy through almost 180° of articular contact, except for the bare area of the greater sigmoid notch which is devoid of cartilage [11].
  • The coronoid has a medial and lateral facet which buttresses the trochlea anteriorly [11].
  • The sublime tubercle is located just distal and medial to the coronoid and provides the attachment site for the anterior bundle of the medial ulnar collateral ligament [11].
  • The medial epicondyle forms the attachment site for the origins of the flexor pronator mass and is larger and more posteriorly oriented than the lateral epicondyle [11].
  • The capitellum and radial head form the radiocapitellar joint [11].
  • The radius is held in close approximation to the ulna at the proximal radioulnar joint by the annular ligament [11].
  • The area of the ulna which articulates with the margin of the radial head at the proximal radioulnar joint is known as the lesser sigmoid notch [11].
  • The radial head is a concave elliptical structure covered with articular cartilage along the radiocapitellar joint and approximately 270° of the articular margin [11].
  • The radial head articulates with both the capitellum and the lesser sigmoid notch [11].
  • The lateral epicondyle is the origin of the lateral extensor musculature [11].
  • The origin of the lateral ulnar collateral ligamentous complex is located just distal to the lateral epicondyle at the geometric center of the radiocapitellar articulation [11].
  • The distal humeral articulation is angled 30° from the longitudinal axis [11].
  • The anterior humeral line should pass through the center of the axis of rotation [11].
  • The axis of rotation is 5° to 7° angulated in the coronal plane to the epicondylar axis, with the medial side more distal than the lateral side [11].
  • The angulation of the distal humeral articulation accounts for the change from a valgus carrying angle to a more varus position as the elbow is flexed [11].
  • There is a high correlation between the size of the radius and capitellum on the left and right sides in the same individual [11].
  • The olecranon allows for a broad attachment site of the triceps [11].
  • The ulna medially bends approximately 8° at 8 cm from the tip of the olecranon [11].
  • The articulation to the tip of the coronoid is approximately 30° from the long axis of the ulna in the sagittal plane [11].
  • The radial head should line up with the capitellum at all arm positions on all radiographic views [12, 13].
  • Tensile forces are present at the medial elbow and compressive forces are present at the lateral elbow [12, 13].

Ligaments & Stability

  • Elbow stability is conferred by bony articular anatomy and ligamentous structures on the medial and lateral sides [9].
  • The three primary stabilizers of the elbow are the ulnohumeral articulation, the medial ulnar collateral ligament, and the lateral ulnar collateral ligament complex [9].
  • Secondary stabilizers of the elbow include the radiocapitellar articulation, the common flexor tendon, the common extensor tendon, and the joint capsule [9].
  • The lateral ulnar collateral ligament is the posterolateral stabilizer of the elbow [12, 13].
  • The medial or ulnar collateral ligament is the primary valgus stabilizer of the elbow [12, 13].
  • The anterior bundle of the medial ulnar collateral ligament is the most important component for stability [12, 13].
  • The posterior bundle of the medial ulnar collateral ligament has the greatest change in length and becomes taut at flexion beyond 120 degrees [12, 13].
  • The lateral ulnar collateral ligament arises from the epicondyle and inserts on the annular ligament [18].
  • A separate band of the lateral ligamentous complex, the lateral ulnar collateral ligament, arises at the lateral epicondyle and blends with fibers of the annular ligament before inserting on the tubercle on the crest of the supinator of the ulna [18].
  • The lateral ulnar collateral ligament is described as the main lateral stabilizer, taut in flexion and extension [18].
  • Disruption of the lateral ulnar collateral ligament results in posterolateral rotatory instability [18].
  • The lateral collateral ligament contributes 14% of the varus stability of the elbow with the joint in full extension [18].
  • The lateral collateral ligament contributes 9% of the varus stability of the elbow with the joint in 90 degrees of flexion [18].
  • The remainder of varus stability is contributed by the bony articular surfaces and the anterior capsule, with the bony surfaces providing the stability [18].
  • The ulnar collateral ligament plays an important role in valgus stability [18].
  • Valgus stability is divided equally among the ulnar collateral ligament, the anterior capsule, and the bony articulation with the elbow in full extension [18].
  • At 90 degrees of flexion, the ulnar collateral ligament provides 55% of the stability to valgus stress [18].
  • The anterior bundle of the ulnar collateral ligament is the primary stabilizer for valgus stress at 90 degrees of flexion [18].
  • The primary stabilizers of the elbow are the anterior band of the medial ulnar collateral ligament and the lateral collateral ligament complex, consisting of the lateral collateral ligament, annular ligament, and the lateral ulnar collateral ligament [18].
  • Secondary stabilizers consist of the capsule, the ulnohumeral and radiocapitellar articulations, and dynamic stabilizers consisting of all muscle-tendon units that cross the elbow joint [18].
  • Dynamic stabilizers include the biceps, brachialis, triceps, wrist flexors, and wrist extensors [18].
  • Insufficiency of one or more stabilizers may result in a spectrum of instability from subtle valgus or posterolateral rotatory instability to recurrent dislocation [18].
  • The typical injury pattern for traumatic elbow dislocation involves a fall on a slightly flexed extremity with a valgus internal rotation force of the forearm [18].
  • In traumatic elbow dislocation, structures are disrupted on the lateral side, progressing medially as more force is applied [18].
  • When recurrence or persistence in instability results from traumatic dislocation, the posterolateral structures are most commonly affected [18].
  • Medial structures can also be involved in traumatic dislocation and cause significant instability [18].
  • A coronoid fracture in association with disruption of the posterior band of the ulnar collateral ligament can result in symptomatic posteromedial instability [18].
  • Isolated medial side disruptions from valgus stress can result from football tackling, gymnastics, or throwing a javelin [18].
  • Valgus instability from attritional disruption of the anterior bundle of the medial ulnar collateral ligament is the most common form of recurrent elbow instability [18].
  • The anterior bundle of the medial ulnar collateral ligament is divided into two nonisometric bands: an anterior band taut at 0 to 60 degrees and a posterior band taut at 60 to 120 degrees [18].
  • During the acceleration phase of throwing, up to 60 N of force is applied to the medial ulnar collateral ligament, which is near its tensile failure point [18].
  • Pitcher fatigue, poor mechanics, or repetition overuse can result in bundle fiber failure, partial tearing, and eventual complete disruption of the medial ulnar collateral ligament [18].
  • Failure of the primary stabilizer results in increased stress on secondary stabilizers [18].
  • Increased stress on secondary stabilizers can result in capsular contractures, chondromalacia, osteophytes, and loose bodies from compression of the radiocapitellar joint and shear forces to the posteromedial tip of the olecranon [18].
  • Ulnar nerve symptoms may develop from traction, scarring, or osteophyte impingement following primary stabilizer failure [18].

Muscles & Soft Tissue

  • The brachialis is the strongest elbow flexor and attaches to the coronoid 11 mm distal to the tip [12, 13].
  • The biceps brachii inserts at the ulnar margin of the radial tuberosity, with the long head proximal and short head distal [12, 13].
  • The biceps brachii is a powerful supinator of the forearm [12, 13].
  • The primary elbow extensor, the triceps, inserts on the olecranon process [12, 13].
  • The mobile wad consists of the brachioradialis, extensor carpi radialis longus, and extensor carpi radialis brevis [12, 13].
  • The flexor-pronator mass consists of the pronator teres, flexor carpi radialis, palmaris longus, flexor carpi ulnaris, and flexor digitorum superficialis [12, 13].
  • The common origin of the extensor muscles is attached to the lateral condyle and need not be disturbed in a lateral approach to a fracture of the lateral condyle [14].
  • The radial nerve enters the interval between the brachialis and brachioradialis muscles in the proximal angle of the lateral approach wound [14].
  • The deep branch of the radial nerve enters the supinator muscle and must be protected during lateral approach dissection [14].
  • The common extensor tendon is a secondary stabilizer of the lateral elbow [8].
  • The articular capsule is a secondary stabilizer of the lateral elbow [8].

Pathophysiology & Instability

  • Elbow instability may be congenital, traumatic, or attritional [18].
  • In a long-term follow-up study of simple elbow dislocations, 60% of patients had residual stiffness with loss of extension and residual pain [18].
  • In a long-term follow-up study of simple elbow dislocations, only 8% of patients had functional instability [18].
  • When fractures are associated with elbow dislocation, resulting in loss of bony stability provided by the greater sigmoid notch of the ulna or the radiocapitellar joint, greater instability and disability can be anticipated [18].
  • The docking technique for lateral ulnar collateral ligament reconstruction has shown recurrent instability rates as high as 25% [8].
  • Postoperative stiffness is a known complication of lateral ulnar collateral ligament reconstruction and occurs not uncommonly [8].

Classification

  • The docking technique originally described by Jones et al. in 2012 is the most common method in use in contemporary practice for LUCL reconstruction [8].
  • The docking technique has shown recurrent instability rates as high as 25% [8].
  • A knotless, onlay technique performs LUCL reconstruction with a tendon graft without violation of the extensor origin and soft tissue envelop [8].
  • The use of knotless anchors and an onlay technique shortens operative time, reduces the required surgical exposure, and removes the risk of tunnel osteolysis or fracture and resultant graft failure while maintaining a broad bone surface for graft incorporation [8].
  • Minimally-invasive dissection prevents iatrogenic injury to the common extensor origin, an important secondary stabilizer of the lateral elbow, and the articular capsule [8].
  • Remaining extracapsular with a minimally-invasive technique avoids plication of the capsular structures or risk of formation of intra-articular adhesions, theoretically reducing the risk of any postoperative loss of range of motion [8].

Clinical Presentation

  • Posterolateral rotatory instability of the elbow involves a complex spectrum of lateral-sided injuries [3].
  • High-grade atraumatic posterolateral rotatory instability is a clinical presentation managed by arthroscopic lateral collateral ligament reconstruction with tendon graft [6].
  • Subacute and chronic posterolateral rotatory instability is a clinical presentation managed by suture-augmented lateral ulnar collateral ligament and radial collateral ligament reconstruction [3].
  • Terrible triad injuries are a clinical presentation in which lateral ulnar collateral ligament repair using suture button fixation is indicated [5].

Investigations

Physical Examination

  • Elbow stability is determined by primary stabilizers (ulnohumeral articulation, MUCL, LUCL complex) and secondary stabilizers (radiocapitellar articulation, common flexor tendon, common extensor tendon, joint capsule) [9].
  • The normal elbow has a range of motion from 0° to 140° from extension to flexion and 75° and 85° in pronation and supination respectively [9].
  • A functional arc in each plane is 100° for flexion and extension and forearm rotation [9].
  • The physical exam is directed by history and the location of the patient's pain in the anterior, posterior, medial, or lateral aspect of the elbow [9].

Imaging

  • Plain radiographs remain the hallmark and the best screening test for elbow evaluation [9].
  • AP, lateral, and oblique radiographs are standard for elbow evaluation [17].
  • CT is helpful when assessing for malunion architecture and the location and pattern of osteophytes and/or loose bodies [17].
  • Three-dimensional CT is used to check for heterotopic ossification [17].
  • CT is not necessary when the stiffness is entirely soft-tissue related [17].
  • MRI can be used to evaluate ligaments and tendons, but it is rarely indicated for elbow stiffness [17].
  • Magnetic resonance evaluation of the elbow includes imaging of ligament complexes [16].
  • MR evaluation of instability patterns including the soft-tissue lesions that result from dislocation is emphasized [16].
  • MRI may be most helpful in evaluating associated injuries including partial or complete tears of the MCL in valgus extension overload syndrome [20].
  • CT with two-dimensional reconstruction and three-dimensional surface rendering best visualizes the pathology of valgus extension overload syndrome [20].
  • Radiographic evaluations are essential when diagnosing an OCD lesion of the elbow, however important aspects of the OCD lesions may be better seen with MRI [21].

Treatment

Arthroscopic Techniques

  • An all-arthroscopic reconstruction of the lateral ulnar collateral ligament is a reproducible technique that avoids residual instability [1].
  • Arthroscopic lateral ulnar collateral ligament plication or reconstruction with augmented lateral collateral ligament imbrication is a minimally invasive method that promotes quicker patient recovery and long-term functional restoration [4].
  • Arthroscopic lateral ulnar collateral ligament reconstruction with a tendon graft restores stability through a dynamic "sling effect" rather than rigid constraint [6].
  • Arthroscopic-assisted lateral ulnar collateral ligament reconstruction provides less insult and dissection to the soft tissue at the lateral side of the elbow [7].
  • Arthroscopic-assisted lateral ulnar collateral ligament reconstruction serves as an excellent tool to diagnose concomitant intraarticular pathologies [7].

Open and Mini-Invasive Techniques

  • Open posterolateral ligament plication and lateral ulnar collateral ligament repair using an all-suture construct allows for complete posterolateral stabilization of the elbow with a single implant and bone preservation [2].
  • Suture-augmented lateral ulnar collateral ligament and radial collateral ligament reconstruction provides a reproducible, anatomically based construct that restores posterolateral elbow stability [3].
  • Suture-augmented lateral ulnar collateral ligament and radial collateral ligament reconstruction addresses the complex spectrum of lateral-sided injuries observed in posterolateral rotatory instability [3].
  • A mini-invasive approach for lateral ulnar collateral ligament reconstruction uses a knotless, onlay technique that performs reconstruction without violation of the extensor origin and soft tissue envelop [8].
  • The knotless, onlay technique for lateral ulnar collateral ligament reconstruction shortens operative time and reduces the required surgical exposure [8].
  • The knotless, onlay technique for lateral ulnar collateral ligament reconstruction removes the risk of tunnel osteolysis or fracture and resultant graft failure while maintaining a broad bone surface for graft incorporation [8].
  • Minimally-invasive dissection for lateral ulnar collateral ligament reconstruction prevents iatrogenic injury to the common extensor origin and the articular capsule [8].
  • Minimally-invasive dissection for lateral ulnar collateral ligament reconstruction allows for earlier rehabilitation and return of range of motion, reduced postoperative pain, and reduced operative time [8].
  • Fluoroscopic guidance during minimally-invasive lateral ulnar collateral ligament reconstruction can help to reduce injuries to unintended structures [8].
  • Remaining extracapsular during lateral ulnar collateral ligament reconstruction avoids plication of the capsular structures and the risk of formation of intra-articular adhesions [8].
  • Remaining extracapsular during lateral ulnar collateral ligament reconstruction theoretically reduces the risk of postoperative loss of range of motion [8].

Specific Indications and Constructs

  • Suture button fixation for repair of the lateral ulnar collateral ligament in terrible triad injuries has not been previously described [5].

Complications

  • The docking technique for LUCL reconstruction has shown recurrent instability rates as high as 25% [8].
  • Postoperative stiffness is a known complication of LUCL reconstruction and occurs not uncommonly [8].
  • The use of a knotless, onlay technique removes the risk of tunnel osteolysis or fracture and resultant graft failure [8].
  • Minimally-invasive dissection prevents iatrogenic injury to the common extensor origin, an important secondary stabilizer of the lateral elbow [8].
  • Minimally-invasive dissection prevents iatrogenic injury to the articular capsule [8].
  • Remaining extracapsular with a minimally-invasive technique avoids plication of the capsular structures [8].
  • Remaining extracapsular with a minimally-invasive technique avoids the risk of formation of intra-articular adhesions [8].
  • Fluoroscopic guidance can help to reduce injuries to unintended structures that could be foreseen due to a limited exposure [8].

Recovery

  • The arthroscopic reconstruction of the lateral ulnar collateral ligament avoids residual instability [1].
  • The open posterolateral ligament plication and lateral ulnar collateral ligament repair technique allows for complete posterolateral stabilization of the elbow [2].
  • The open posterolateral ligament plication and lateral ulnar collateral ligament repair technique achieves bone preservation [2].
  • The suture-augmented lateral ulnar collateral ligament and radial collateral ligament reconstruction restores posterolateral elbow stability [3].
  • The arthroscopic lateral ulnar collateral ligament plication/reconstruction with augmented lateral collateral ligament imbrication promotes quicker patient recovery [4].
  • The arthroscopic lateral ulnar collateral ligament plication/reconstruction with augmented lateral collateral ligament imbrication promotes long-term functional restoration [4].
  • Reconstruction of the lateral ulnar collateral ligament with a tendon graft restores stability through a dynamic “sling effect” rather than rigid constraint [6].

Key Evidence

  • [L5] The presented arthroscopic technique is reproducible and achieves the reconstruction of the LUCL of the elbow as well as avoids residual instability. [1] (10.1016/j.eats.2024.103096)
  • [L5] The technique allows for complete posterolateral stabilization of the elbow with a single implant and bone preservation. [2] (10.1016/j.eats.2024.103172)
  • [L5] The described method provides a reproducible, anatomically based construct that restores posterolateral elbow stability and addresses the complex spectrum of lateral-sided injuries observed in PLRI. [3] (10.1016/j.eats.2025.103797)
  • [L5] This minimally invasive method allows effective management of elbow instability while promoting quicker patient recovery and long-term functional restoration. [4] (10.1016/j.eats.2025.103529)
  • [L4] The use of suture button fixation for repair of lateral ulnar collateral ligament has not been previously described. [5] (10.1016/j.eats.2023.10.004)
  • [L5] Reconstruction of the lateral ulnar collateral ligament with a tendon graft offers an alternative, restoring stability through a dynamic “sling effect” rather than rigid constraint. [6] (10.1002/atn2.70037)
  • [L5] It provides less insult and dissection to the soft tissue at the lateral side of the elbow while being an excellent tool to diagnose any concomitant intraarticular pathologies. [7] (10.1016/j.eats.2024.103101)
  • [L5] [8] (10.1002/atn2.70135)

References

[1] Posterolateral Elbow Dislocation: An All‐Arthroscopic Reconstruction of the Lateral Ulnar Collateral Ligament. Arthroscopy Techniques. 2024. DOI: 10.1016/j.eats.2024.103096

[2] Open Posterolateral Ligament Plication and Lateral Ulnar Collateral Ligament Repair in Posterolateral Rotatory Instability of the Elbow Using an All‐Suture Construct. Arthroscopy Techniques. 2024. DOI: 10.1016/j.eats.2024.103172

[3] Suture‐Augmented Lateral Ulnar Collateral Ligament and Radial Collateral Ligament Reconstruction for Subacute and Chronic Posterolateral Rotatory Instability. Arthroscopy Techniques. 2025. DOI: 10.1016/j.eats.2025.103797

[4] Arthroscopic Lateral Ulnar Collateral Ligament Plication/Reconstruction With Augmented Lateral Collateral Ligament Imbrication. Arthroscopy Techniques. 2025. DOI: 10.1016/j.eats.2025.103529

[5] Suture Button Repair for Lateral Ulnar Collateral Ligament in Terrible Triad Injuries: Surgical Technique. Arthroscopy Techniques. 2024. DOI: 10.1016/j.eats.2023.10.004

[6] Arthroscopic Lateral Collateral Ligament Reconstruction With Tendon Graft in High‐Grade Atraumatic Posterolateral Rotatory Instability in Elbows. Arthroscopy Techniques. 2026. DOI: 10.1002/atn2.70037

[7] Arthroscopic‐Assisted Lateral Ulnar Collateral Ligament Reconstruction for Posterolateral Rotatory Instability of the Elbow: A Technical Note. Arthroscopy Techniques. 2024. DOI: 10.1016/j.eats.2024.103101

[8] Lateral Ulnar Collateral Ligament Reconstruction Through a Mini‐Invasive Approach. Arthroscopy Techniques. 2026. DOI: 10.1002/atn2.70135

[9] Orthopaedic Knowledge Update 13 Ebook Without Multimedia. Anatomy, Biomechanics, Physical Examination, and Imaging of the Elbow > Summary and Conclusions.

[11] Orthopaedic Knowledge Update 13 Ebook Without Multimedia. Anatomy, Biomechanics, Physical Examination, and Imaging of the Elbow > Anatomy > Bony Anatomy.

[12] Miller S Review Of Orthopaedics. SECTION 16 PATELLAR TRACKING IN TOTAL KNEE ARTHROPLASTY > TABLE 2.3 Shoulder Spaces.

[13] Miller S Review Of Orthopaedics. Genetics of musculoskeletal conditions and abnormalities are summarized in Table 1.27 > TABLE 2.3 Shoulder Spaces.

[14] Campbell S Operative Orthopaedics 4 Volume Set. LATERAL APPROACHES.

[16] Orthopaedic Knowledge Update Sports Medicine 6. Magnetic Resonance Imaging of the Elbow > Annotated References.

[17] Aaos Comprehensive Orthopaedic Review 3. Elbow Stiffness* > IV. Evaluation.

[18] Campbell S Operative Orthopaedics 4 Volume Set. POSTERIOR SURGICAL APPROACH FOR QUADRILATERAL SPACE SYNDROME > MCLAUGHLIN PROCEDURE > ARTHROSCOPIC SURGERY.

[20] Aaos Comprehensive Orthopaedic Review 3. Elbow Injuries in the Athlete* > III. Valgus Extension Overload Syndrome and Posterior Impingement.

[21] Orthopaedic Knowledge Update. Osteochondritis Dissecans of the Knee and Elbow* > Summary.

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