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J Shoulder Elbow Surg. 2009 May-Jun;18(3):408-17. doi: 10.1016/j.jse.2009.01.009.

The influence of type II coronoid fractures, collateral ligament injuries, and surgical repair on the kinematics and stability of the elbow: an in vitro biomechanical study.

Author information

  • 1The Ottawa Hospital, General Campus, Ottawa, Ontario, Canada. jwpollock@gmail.com

Abstract

PURPOSE:

This study determined whether elbow stability could be restored with open reduction and internal fixation (ORIF) of type II coronoid fractures and evaluated the role of collateral ligament repair.

METHODS:

Passive varus and valgus and simulated active vertical motion were performed using an in vitro elbow motion simulator. Varus/valgus angle and internal/external rotation were measured with the coronoid intact, with 50% removed, and after ORIF. Testing was performed with the collateral ligaments detached and repaired.

RESULTS:

Vertical: stability was normal when both the lateral collateral ligament (LCL) and medial collateral ligament (MCL) were repaired, irrespective of the coronoid state. Kinematics were altered with a repaired LCL, incompetent MCL, and type II coronoid fracture (P < .05). Varus: LCL repair restored coronal stability but did not restore internal rotation (P < .05).

CONCLUSIONS:

These findings suggest that repair of type II coronoid fractures and injured collateral ligaments should be performed where possible. Over-tensioning the LCL, in the setting of MCL and coronoid deficiency, may contribute to instability.

PMID:
19393931
[PubMed - indexed for MEDLINE]
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