• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.236-241
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• 1998

Recurrent dislocation of elbow joint occurs relatively rarely by the injury of the collateral ligament which contributes elbow joint stability. Among them, posterolateral rotatory instability occurs by the injury to the lateral ulnar collateral ligament. We experienced a case of recurrent dislocation of elbow joint due to posterolateral rotatory instability. We treated operatively with lateral ulnar collateral ligament reconstruction using the palmaris longus tendon by technique of Nestor et al. We report it with literature analysis.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.98-102
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• 2004

Purpose: The purpose of this study was to make a report on the clinical prognosis of post traumatic lateral and posterolateral instability of the knee after LCL augmentation and popliteal tenodesis. Materials and Methods: The assessment was made among 21 cases who underwent augmentation of lateral collateral ligament(LCL) and popliteal tenodesis with allograft or artificial ligament (synthetic polyester, ABC ligament, Surgicraft, U.K.) at this Medical Center during the period from July 1996 to July 2003 and whose follow-up period was longer than one year. The authors recorded and analysed the physical findings (external rotation recurvatum test & posterolateral drawer test), stress roentgenograms(preoperative and postoperative) and Lysholm score. Results: The lateral and posterolateral instability of the knee were improved in 20 cases postoperatively, acccording to the clinical test and stress roentgenograms . Average Lysholm score was 52.5 preoperatively and 86.7 postoperatively .Conclusion: Our study found the surgery of lateral and posterolateral instability of the knee with augmentation of LCL and popliteal tenodesis using allograft or artiflcial ligament is simple technique. Taking these results into consideration, it seems to be one of effective methods of treatment.

• Journal of Korean Orthopaedic Sports Medicine
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• v.2 no.2
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• pp.136-141
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• 2003

Posterolateral instability of the knee is known as one of the most challenging injuries . Although several procedures have been designed for the posterolateral instability, there is no gold standard management yet. We present a technique for posterolateral instability of the knee using tibialis posterior tendon allograft, which reconstructed lateral collateral ligament and popliteal tendon.

• Journal of Korean Neurosurgical Society
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• v.30 no.1
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• pp.114-117
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• 2001

Generally, the posterolateral approach had been recommended in case of extraforaminal disc herniation or lateral stenosis but it has been speculated that this procedure may be feasible to posterolateral disc herniation at the high lumbar levels of the L1-L2 interspace. Topographically, a posterolateral approach should be able to access anteromedial side of the spinal canal without the risk of the bony instability and damage to the neural structures. During the past one year period, three patients with high lumbar discs at the L1-L2 level were treated by the modified posterolateral approach. This article describeds the details of this approach with pertinent literature review.

• Clinics in Shoulder and Elbow
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• v.4 no.2
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• pp.191-195
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• 2001

Posterolateral rotatory instability is the most common pattern of elbow instability especially which is recurrent, and is usually post-traumatic because of inadequate soft tissue healing. The lateral ulnar collateral ligament was reconstructed by using ipsilateral palmaris longus tendon. Functionally good result was obtained. This is a case report illustrating the posterolateral rotatory instability of the elbow and its reconstruction with palmaris longus.

• Clinics in Shoulder and Elbow
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• v.26 no.3
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• pp.287-295
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• 2023

Background: Posterolateral rotatory instability (PLRI) is a common mechanism of recurrent elbow instability. While the essential lesion is a deficiency in the lateral ulnar collateral ligament (LUCL), there are often associated concomitant bony lesions, such as an Osborne-Cotterill lesions (posterior capitellar fractures) and marginal radial head fractures, that compromise stability. Currently, there is no standard treatment for posterior capitellar deficiency associated with recurrent PLRI. Methods: We conducted a retrospective review of five patients with recurrent PLRI of the elbow associated with a posterior capitellar impaction fracture engaging with the radial head during normal range of motion. The patients were treated surgically with LUCL reconstruction or repair and off-label reconstruction of the capitellar joint surface using a small metal prosthesis designed for metatarsal head resurfacing (HemiCAP toe classic). Results: Five patients (three adolescent males, two adult females) were treated between 2007 and 2018. At a median follow-up of 5 years, all patients had complete relief of their symptomatic instability. No patients had pain at rest, but two patients had mild pain (visual analog scale 1-3) during physical activity. Three patients rated their elbow as normal, one as almost normal, and one as greatly improved. On short-term radiographic follow-up there were no signs of implant loosening. None of the patients needed reoperation. Conclusions: Recurrent PLRI of the elbow associated with an engaging posterior capitellar lesion can be treated successfully by LUCL reconstruction and repair and filling of the capitellar defect with a metal prosthesis. This treatment option has excellent clinical results in the short-medium term. Level of evidence: IV.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2003.11a
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• pp.51-56
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• 2003

The trained examiner can gain considerable information from visual inspections of the elbow joint, Because much of the joint is subcutaneous, any appreciable alteration in the skeletal anatomy often is detectable. Gross soft tissue swelling or muscle atrophy is also early observed. Inspection and palpation of the medial and lateral epicondyles and the tip of the otecranon from an equilateral triangle with the elbow is flexed. Normally, the arc of flexion extension, although variable, ranges from about O to 140 degrees plus or minus 10 degrees. The posterolateral rotatory instability(PLRI) of the elbow is most common pattern of elbow instability. The lateral collateral ligament complex also includes a narrow but stout band of ligamentous tissue blending with the distal and proterior fibers of the capsule to insert distally on the crista supinatoris of the ulna. This is the lateral ulnar collateral ligament(LUCL). A clinical elbow pivot shift test confirms the PLRI. There are also two active apprehension signs.

• Korean Journal of Applied Biomechanics
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• v.34 no.2
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• pp.93-103
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• 2024

Objective: The purpose of this study was to investigate whether dancers with chronic ankle instability (CAI) exhibit different characteristics in dynamic postural control ability and ankle joint laxity compared to dancers without CAI and non-dancers with CAI. Method: Twelve dancers with CAI, 14 dancers without CAI, and 12 non-dancers with CAI participated in the study. Dynamic balance was evaluated using the Star Excursion Balance Test (SEBT) and the single-leg hop balance. The laxity of the ankle joint was evaluated through the anterior drawer test and the talar tilt test. SEBT measured maximum reach distances in anterior, posteromedial, and posterolateral directions. Single-leg hop assessed center of pressure (COP) and time-to-boundary (TTB) outcomes. One-way ANOVA and Chi-square tests were performed to compare the outcome variables among the three groups. Results: Dancers with CAI demonstrated greater reach distance in the posterolateral direction compared to non-dancers with CAI during SEBT (p=.014). Secondly, dancers without CAI showed greater reach distance in the posterolateral (p<.001) and posteromedial (p=.001) directions during SEBT compared to non-dancers with CAI. Additionally, dancers without CAI exhibited better postural control with higher TTB AP mean of minima (p=.003) and TTB AP standard deviation of minima (p=.012) during single-leg hop compared to nondancers with CAI. Thirdly, dancers with CAI showed a lower positive rate during the anterior drawer test compared to non-dancers with CAI (p=.019). Conclusion: Dancers with CAI demonstrated better ankle function and reduced mechanical instability compared to non-dancers with CAI. Therefore, to elucidate the underlying mechanisms of lateral ankle sprain and CAI development exacerbation in dancers, additional factors that can affect ankle sprain, such as visual dependence during postural control and evaluation in dance movements, should be explored.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.189-190
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• 2009

• Clinics in Shoulder and Elbow
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• v.23 no.1
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• pp.27-30
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• 2020

Osborne-Cotterill lesion is an osteochondral fracture located in the posterolateral margin of the humeral capitellum, which may be associated with a defect of the radial head after an elbow dislocation. This lesion causes instability by affecting the lateral ulnar collateral ligament over its capitellar insertion, which is associated with a residual capsular laxity, thereby leading to poor coverage of the radial head, and hence resulting in frequent dislocations. We present a 54-year-old patient, a physician who underwent trauma of the left elbow after falling from a bike and suffered a posterior dislocation fracture of the elbow. The patient subsequently presented episodes of instability, and additional work-up studies diagnosed the occurrence of Osborne-Cotterill lesion. An open reduction and internal fixation of the bony lesion was performed, with reinsertion of the lateral ligamentous complex. Three months after surgery, the patient was asymptomatic, having a flexion of 130° and extension of 0°, and resumed his daily activities without any limitation. Currently, the patient remains asymptomatic 2 years after the procedure. Elbow instability includes a large spectrum of pathological conditions that affect the biomechanics of the joint. The Osborne-Cotterill lesion is one among these conditions. It is a pathology that is often forgotten and easily overlooked. Undoubtedly, this lesion requires surgical intervention.