We prove the importance of the complete osteoligamentary elbow reconstruction and the usefulness of the liga-mentoplasty by palmaris longus combined with other procedures in complex elbow unstable injuries. 17 patients aged between 17 and 72 suffered elbow luxation or subluxation with rupture of the medial collateral ligament, associated with:
Fracture of the radius head, fracture of the coronoidal process(terrible triade),1) olecranon fractures. In 3 compaound injuries we had open fractures with Brahial artery lesion, Ulnar nerve pulsy, radial nerve laceration, Brahial plexus injury. The lesions happened between 2 hours and 2 yrs pre-operatively, caused to work accidents or to traffic accidents with a follow up between 8–62 months. 10 of the injuries were operated almost in emergency by ligamen-toplasty with palmaris longus, coronoidal process fixation with screw or ancor, radial head osteosynthesis or prosthesis. The vascular injuries urgently operated while the nerve lesions left for secondary repair. A functional splint was applied postoperatively, initially fixated between 110–85 degrees. The splint removed 2 months postoperatively, while full rang of motion obtained. We performed both Mayo clinic, DAS scores and grasp strength force and Range of Motion measurement evaluation procedures Satisfactory to excellent results have been obtained in 11 cases with stable joints and range of motion with 20 degrees extension-flexion deficit while in I case the instability persited, in another one arrived 50% of the normal range of motion. The complex elbow injuries with ligamentary instability are effectively treated if except fractures we always repair The medial-anterior ligaments lesion with liga-mentoplasty and ancors.
