Abstract
Aim: We prove the importance of the medial ligamentary system of the elbow for its stability and the usefulness of the ligamentoplasty by palmaris longus tendon as reconstructive technique.
Methods and patients: 9 patients aged between 17 and 58 (17,18,28,32,35,38,40,56,58,), 6 male, 3 female suffered the following injuries:1)elbow luxation or sub-luxation with rupture of the medial collateral elbow ligament, associated with: 1)Forearm bone fractures, 2)Ulnar nerve pulsy, 3)fracture of the coronoidal process, 4)Fracture of the radius head, 5)fracture of the humerus with radial and musculocutaneous nerve pulsy. The lesions happened since 2 week, 2 month and 2 yrs respectively. The 17 yrs old young man was injured during a weightlifting championship game and the next 4 suffered traffic and work accidents, while the 18 yrs old last one suffered an iatrogenic ligamentary lesion, the rest of the lesions have been caused to work accidents or to motor vehicle accidents
All patients were operated by ligamentoplasty with palmaris longus by medial incision, fenestration of the medial epicondyl and olecranon and transoseus pivoting of the palmaris longus which was enforced by 2 anchor sutures.
An elbow flexion-extension functional splint was applied postoperatively, initially fixated between 110–85 degrees. The splint was removed 2 months postoperatively, while full rang of motion has been obtained.
Results: Follow up was between 6 and 18 month. The 16 yrs old boy return in full sport activity and obtained at the elbow joint full range of motion. the second –young man-patient presents an extension defect of 15 degrees and the 56 yrs old women has a 25degreed deficit of both extension and flexion but she continues the therapy program.
Conclusion: The medial ligamentary system lesion with elbow instability must be repaired by medial ligamentoplasty and the well done technique followed by correct therapy program improved results.
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