Background
Elbow instability can occur after an acute dislocation event or in the setting of chronic instability. Our study aims to evaluate the outcomes of ligament repair and/or reconstruction in both acute and chronic elbow instability.
Methods
Our study consists of three parts and started with a literature review. We subsequently performed a comprehensive review of the patient files for the 35 elbow ligament repairs and/or reconstructions performed at Middlemore, Ormiston and Mercy Ascot Hospitals between 2010 and 2021. Finally, we invited patients to participate in our clinical review study.
Results
At the time of abstract submission, we had reviewed 18 of the 35 patients (51.4%) with 8 being acute and being 10 chronic. The average follow-up time was 70.8 months. The primary outcome of elbow stability was achieved in all but one case, where a patient had ongoing subjective, symptomatic elbow instability. In the acute cases, the average post-operative flexion arc was 25.0-139.4° and the average pronation/supination arc was 70.1/72.0°. For chronic instability, the average post-operative flexion arc was 3.5–146.0° and the average pronation/supination arc was 75.0/80.0°. These patients had statistically significant improvements in their pre-operative flexion and extension; 6.6 ± 5.7° and 21.5 ± 12.4° and respectively. Table 1. shows that self-reported elbow scores were higher in acute instability. The only other complication was a patient who required a washout for a post-operative haematoma.
Discussion
Patients with acute instability achieved lower range of motion (ROM) arcs, but had higher elbow scores. The ROM could be attributed to these patients having high-energy mechanisms of injury, which results in more extensive soft-tissue damage and a higher incidence of associated fractures.
Conclusions
Ligament repair and/or reconstruction is a worthwhile operation for acute and chronic instability to restore elbow stability and improve the ROM. Only 1 patient experienced ongoing symptomatic instability.