nach oben

Erschienen in:

25.09.2023 | Instabilitäten am Ellenbogengelenk | Leitthema

Internal Bracing am Ellenbogen als Add-on bei ligamentärer Instabilität

verfasst von: Pavel Kadantsev, Sebastian Lappen, Alexander Otto, Maximilan Hinz, Prof. Dr. med. Sebastian Siebenlist, MHBA

Erschienen in: Arthroskopie | Ausgabe 5/2023

Einloggen, um Zugang zu erhalten

Zusammenfassung

Das Internal Bracing des Ellenbogens hat in den vergangenen Jahren stetig an Bedeutung gewonnen. Biomechanische Untersuchungen zeigen eine vergleichbare Stabilität des Internal Bracing zu bandrekonstruktiven Verfahren. In der klinischen Anwendung muss insbesondere auf eine korrekte anatomische Positionierung der Verankerungen geachtet werden. Klinisch zeigen sich vielversprechende Ergebnisse bei rascher Rückkehr zum Sport und geringen Komplikationsraten. Dennoch sind weitere Untersuchungen notwendig, um den Stellenwert des Internal Bracing in der Versorgung der Ellenbogeninstabilität weiter zu evaluieren.

Kuhn MA, Ross G (2008) Acute elbow dislocations. Orthop Clin North Am 39(2):155–161. https://doi.org/10.1016/j.ocl.2007.12.004CrossRefPubMed

Stoneback JW, Owens BD, Sykes J, Athwal GS, Pointer L, Wolf JM (2012) Incidence of elbow dislocations in the United States population. J Bone Joint Surg Am 94(3):240–245. https://doi.org/10.2106/JBJS.J.01663CrossRefPubMed

Josefsson PO, Nilsson BE (1986) Incidence of elbow dislocation. Acta Orthop Scand 57(6):537–538. https://doi.org/10.3109/17453678609014788CrossRefPubMed

Morrey BF, Morrey BF, Sanchez-Sotelo J, Morrey ME (2018) Morrey’s the elbow and its disorders, 5. Aufl. Elsevier, Philadelphia

O’Driscoll SW (1999) Elbow instability. Acta Orthop Belg 65(4):404–415PubMed

O’Driscoll SW, Morrey BF, Korinek S, An KN (1992) Elbow subluxation and dislocation. A spectrum of instability. Clin Orthop Relat Res 280:186–197

Rhyou IH, Kim YS (2012) New mechanism of the posterior elbow dislocation. Knee Surg Sports Traumatol Arthrosc 20(12):2535–2541. https://doi.org/10.1007/s00167-011-1872-7CrossRefPubMed

Schreiber JJ, Potter HG, Warren RF, Hotchkiss RN, Daluiski A (2014) Magnetic resonance imaging findings in acute elbow dislocation: insight into mechanism. J Hand Surg Am 39(2):199–205. https://doi.org/10.1016/j.jhsa.2013.11.031CrossRefPubMed

Schreiber JJ, Warren RF, Hotchkiss RN, Daluiski A (2013) An online video investigation into the mechanism of elbow dislocation. J Hand Surg Am 38(3):488–494. https://doi.org/10.1016/j.jhsa.2012.12.017CrossRefPubMed

10.

Fitzpatrick MJ, Diltz M, McGarry MH, Lee TQ (2012) A new fracture model for “terrible triad” injuries of the elbow: influence of forearm rotation on injury patterns. J Orthop Trauma 26(10):591–596. https://doi.org/10.1097/BOT.0b013e31824135afCrossRefPubMed

11.

Rothermich MA, Fleisig GS, Conte SA, Hart KM, Cain EL Jr., Dugas JR (2021) Short-term trends in elbow ulnar collateral ligament surgery in collegiate baseball players: an analysis of 25,587 player-years. Orthop J Sports Med 9(7):23259671211016846. https://doi.org/10.1177/23259671211016846CrossRefPubMedPubMedCentral

12.

Moore AR, Fleisig GS, Dugas JR (2019) Ulnar collateral ligament repair. Orthop Clin North Am 50(3):383–389. https://doi.org/10.1016/j.ocl.2019.03.005CrossRefPubMed

13.

Savoie FH, O’Brien M (2017) Chronic medial instability of the elbow. EFORT Open Rev 2(1):1–6. https://doi.org/10.1302/2058-5241.2.160037CrossRefPubMedPubMedCentral

14.

Rothermich MA, Pharr ZK, Mundy AC, Fleisig GS, Mussell EA, Ryan MK et al (2022) Clinical outcomes of ulnar collateral ligament surgery in nonthrowing athletes. Am J Sports Med 50(12):3368–3373. https://doi.org/10.1177/03635465221120654CrossRefPubMed

15.

Dzugan SS, Savoie FH 3rd, Field LD, O’Brien MJ, You Z (2012) Acute radial ulno-humeral ligament injury in patients with chronic lateral epicondylitis: an observational report. J Shoulder Elbow Surg 21(12):1651–1655. https://doi.org/10.1016/j.jse.2012.04.008CrossRefPubMed

16.

Schnetzke M, Aytac S, Studier-Fischer S, Grutzner PA, Guehring T (2015) Initial joint stability affects the outcome after conservative treatment of simple elbow dislocations: a retrospective study. J Orthop Surg Res 10:128. https://doi.org/10.1186/s13018-015-0273-xCrossRefPubMedPubMedCentral

17.

Coonrad RW, Roush TF, Major NM, Basamania CJ (2005) The drop sign, a radiographic warning sign of elbow instability. J Shoulder Elbow Surg 14(3):312–317. https://doi.org/10.1016/j.jse.2004.09.002CrossRefPubMed

18.

Modi CS, Wasserstein D, Mayne IP, Henry PD, Mahomed N, Veillette CJ (2015) The frequency and risk factors for subsequent surgery after a simple elbow dislocation. Injury 46(6):1156–1160. https://doi.org/10.1016/j.injury.2015.02.009CrossRefPubMed

19.

Greiner S, Koch M, Kerschbaum M, Bhide PP (2019) Repair and augmentation of the lateral collateral ligament complex using internal bracing in dislocations and fracture dislocations of the elbow restores stability and allows early rehabilitation. Knee Surg Sports Traumatol Arthrosc 27(10):3269–3275. https://doi.org/10.1007/s00167-019-05402-9CrossRefPubMed

20.

Uchida S, Kazuha K, Utsunomiya H, Yamanaka Y, Sakai A (2021) Elbow ulnar collateral ligament shoelace repair with internal bracing for treating throwing athletes who have ulnar collateral ligament instability. Arthrosc Tech 10(7):e1873–e1878. https://doi.org/10.1016/j.eats.2021.04.008CrossRefPubMedPubMedCentral

21.

O’Connell R, Hoof M, Heffernan J, O’Brien M, Savoie F (2021) Medial ulnar collateral ligament repair with internal brace augmentation: results in 40 consecutive patients. Orthop J Sports Med 9(7):23259671211014230. https://doi.org/10.1177/23259671211014230CrossRefPubMedPubMedCentral

22.

Bodendorfer BM, Looney AM, Lipkin SL, Nolton EC, Li J, Najarian RG et al (2018) Biomechanical comparison of ulnar collateral ligament reconstruction with the docking technique versus repair with internal bracing. Am J Sports Med 46(14):3495–3501. https://doi.org/10.1177/0363546518803771CrossRefPubMed

23.

Scheiderer B, Imhoff FB, Kia C, Aglio J, Morikawa D, Obopilwe E et al (2020) LUCL internal bracing restores posterolateral rotatory stability of the elbow. Knee Surg Sports Traumatol Arthrosc 28(4):1195–1201. https://doi.org/10.1007/s00167-019-05632-xCrossRefPubMed

24.

Leasure J, Reynolds K, Thorne M, Escamilla R, Akizuki K (2019) Biomechanical comparison of ulnar collateral ligament reconstruction with a modified docking technique with and without suture augmentation. Am J Sports Med 47(4):928–932. https://doi.org/10.1177/0363546518820304CrossRefPubMed

25.

Dugas JR, Walters BL, Beason DP, Fleisig GS, Chronister JE (2016) Biomechanical comparison of ulnar collateral ligament repair with internal bracing versus modified jobe reconstruction. Am J Sports Med 44(3):735–741. https://doi.org/10.1177/0363546515620390CrossRefPubMed

26.

Bachmaier S, Wijdicks CA, Verma NN, Higgins LD, Greiner S (2023) Biomechanical stability of lateral ulnar collateral ligament reconstruction and repair of the elbow: the role of ligament bracing on gap formation and stabilization. Am J Sports Med 51(5):1303–1311. https://doi.org/10.1177/03635465231157735CrossRefPubMed

27.

Ellwein A, Stryga M, Ferle M, Pastor MF, Lill H, Smith T (2022) Biomechanical comparison of two fixation techniques for lateral ulnar collateral ligament repair with ligament bracing. J Hand Surg Am 47(10):1016e1–1016e8. https://doi.org/10.1016/j.jhsa.2021.08.004CrossRef

28.

Morrey BF, An KN (1983) Articular and ligamentous contributions to the stability of the elbow joint. Am J Sports Med 11(5):315–319. https://doi.org/10.1177/036354658301100506CrossRefPubMed

29.

Erickson BJ, Harris JD, Chalmers PN, Bach BR Jr., Verma NN, Bush-Joseph CA et al (2015) Ulnar collateral ligament reconstruction: anatomy, indications, techniques, and outcomes. Sports Health 7(6):511–517. https://doi.org/10.1177/1941738115607208CrossRefPubMedPubMedCentral

30.

Solitro GF, Fattori R, Smidt K, Nguyen C, Morandi MM, Barton RS (2021) Role of the transverse ligament of the ulnar collateral ligament of the elbow: a biomechanical study. JSES Int 5(3):549–553. https://doi.org/10.1016/j.jseint.2021.01.009CrossRefPubMedPubMedCentral

31.

Labott JR, Aibinder WR, Dines JS, Camp CL (2018) Understanding the medial ulnar collateral ligament of the elbow: review of native ligament anatomy and function. World J Orthop 9(6):78–84. https://doi.org/10.5312/wjo.v9.i6.78CrossRefPubMedPubMedCentral

32.

Camp CL, Jahandar H, Sinatro AM, Imhauser CW, Altchek DW, Dines JS (2018) Quantitative anatomic analysis of the medial ulnar collateral ligament complex of the elbow. Orthop J Sports Med 6(3):2325967118762751. https://doi.org/10.1177/2325967118762751CrossRefPubMedPubMedCentral

33.

Kimata K, Yasui M, Yokota H, Hirai S, Naito M, Nakano T (2019) Transverse ligament of the elbow joint: an anatomic study of cadavers. J Shoulder Elbow Surg 28(11):2253–2258. https://doi.org/10.1016/j.jse.2019.04.048CrossRefPubMed

34.

Jones CM, Beason DP, Dugas JR (2018) Ulnar collateral ligament reconstruction versus repair with internal bracing: comparison of cyclic fatigue mechanics. Orthop J Sports Med 6(2):2325967118755991. https://doi.org/10.1177/2325967118755991CrossRefPubMedPubMedCentral

35.

Bachmaier S, Wijdicks CA, Verma NN, Higgins LD, Greiner S (2020) Biomechanical functional elbow restoration of acute ulnar collateral ligament tears: the role of internal bracing on gap formation and repair stabilization. Am J Sports Med 48(8):1884–1892. https://doi.org/10.1177/0363546520921174CrossRefPubMed

36.

Kouk SN, Beason DP, Rothermich MA, Dugas JR, Cain EL Jr. (2022) Intersurgeon consistency of ulnar collateral ligament repair with internal brace: a biomechanical analysis. Orthop J Sports Med 10(11):23259671221134829. https://doi.org/10.1177/23259671221134829CrossRefPubMedPubMedCentral

37.

Bernholt DL, Lake SP, Castile RM, Papangelou C, Hauck O, Smith MV (2019) Biomechanical comparison of docking ulnar collateral ligament reconstruction with and without an internal brace. J Shoulder Elbow Surg 28(11):2247–2252. https://doi.org/10.1016/j.jse.2019.04.061CrossRefPubMed

38.

Narvaez MV, Nelson TJ, Youssefzadeh K, Limpisvasti O, Metzger MF (2022) Biomechanical comparison of ulnar collateral ligament reconstruction with and without suture augmentation. Am J Sports Med 50(9):2508–2514. https://doi.org/10.1177/03635465221101421CrossRefPubMed

39.

Otto A, Muench LN, Mehl J, Baldino JB, Murphy M, Obopilwe E et al (2023) Dual bracing for ulnar collateral ligament injuries restores native Valgus laxity and native medial joint gapping of the elbow. Orthop J Sports Med 11(6):23259671231179179. https://doi.org/10.1177/23259671231179179CrossRefPubMedPubMedCentral

40.

Ellwein A, Fussler L, Ferle M, Smith T, Lill H, Pastor MF (2021) Suture tape augmentation of the lateral ulnar collateral ligament increases load to failure in simulated posterolateral rotatory instability. Knee Surg Sports Traumatol Arthrosc 29(1):284–291. https://doi.org/10.1007/s00167-020-05918-5CrossRefPubMed

41.

Melbourne C, Cook JL, Rocca DGJ, Loftis C, Konicek J, Smith MJ (2020) Biomechanical assessment of lateral ulnar collateral ligament repair and reconstruction with or without internal brace augmentation. JSES Int 4(2):224–230. https://doi.org/10.1016/j.jseint.2020.01.011CrossRefPubMedPubMedCentral

42.

Ott N, Harland A, Lanzerath F, Leschinger T, Hackl M, Wegmann K et al (2023) Locking suture repair versus ligament augmentation—a biomechanical study regarding the treatment of acute lateral collateral ligament injuries of the elbow. Arch Orthop Trauma Surg 143(2):857–863. https://doi.org/10.1007/s00402-022-04337-0CrossRefPubMed

43.

Ellwein A, Becker S, Nebel D, Horstmann H, Smith T, Lill H et al (2021) Biomechanical comparison of lateral collateral ligament reconstruction with and without additional internal bracing using a three-dimensional elbow simulator. Clin Biomech 81:105236. https://doi.org/10.1016/j.clinbiomech.2020.105236CrossRef

44.

Boksh K, Mishra P, Akram N, Abdolrazaghi S, Singh H (2023) Medial ulnar collateral ligament repair with augmentation: a systematic review and meta-analysis of preclinical studies. Orthop J Sports Med 11(5):23259671231158373. https://doi.org/10.1177/23259671231158373CrossRefPubMedPubMedCentral

45.

Dugas JR, Looze CA, Capogna B, Walters BL, Jones CM, Rothermich MA et al (2019) Ulnar collateral ligament repair with collagen-dipped fibertape augmentation in overhead-throwing athletes. Am J Sports Med 47(5):1096–1102. https://doi.org/10.1177/0363546519833684CrossRefPubMed

46.

Ozdag Y, Baylor JL, Nester JR, Foster BK, Daly CA, Grandizio LC (2023) Lateral ulnar collateral ligament repair with suture-tape augmentation for traumatic elbow instability. J Hand Surg Am 48(2):117–125. https://doi.org/10.1016/j.jhsa.2022.10.016CrossRefPubMed

47.

Szekeres M, Chinchalkar SJ, King GJ (2008) Optimizing elbow rehabilitation after instability. Hand Clin 24(1):27–38. https://doi.org/10.1016/j.hcl.2007.11.005CrossRefPubMed

48.

Wolff AL, Hotchkiss RN (2006) Lateral elbow instability: nonoperative, operative, and postoperative management. J Hand Ther 19(2):238–243. https://doi.org/10.1197/j.jht.2006.02.008CrossRefPubMed

49.

Lee AT, Schrumpf MA, Choi D, Meyers KN, Patel R, Wright TM et al (2013) The influence of gravity on the unstable elbow. J Shoulder Elbow Surg 22(1):81–87. https://doi.org/10.1016/j.jse.2012.08.012CrossRefPubMed

50.

Schreiber JJ, Paul S, Hotchkiss RN, Daluiski A (2015) Conservative management of elbow dislocations with an overhead motion protocol. J Hand Surg Am 40(3):515–519. https://doi.org/10.1016/j.jhsa.2014.11.016CrossRefPubMed

51.

Wilk KE, Arrigo CA, Bagwell MS, Rothermich MA, Dugas JR (2019) Repair of the ulnar collateral ligament of the elbow: rehabilitation following internal brace surgery. J Orthop Sports Phys Ther 49(4):253–261. https://doi.org/10.2519/jospt.2019.8215CrossRefPubMed

52.

Rothermich MA, Fleisig GS, Lucas HE, Ryan MK, Emblom BA, Cain EL et al (2021) Early complications of ulnar collateral ligament repair with collagen-coated suture tape augmentation. Orthop J Sports Med 9(10):23259671211038320. https://doi.org/10.1177/23259671211038320CrossRefPubMedPubMedCentral

53.

Ellwein A, Janning L, DeyHazra RO, Smith T, Lill H, Jensen G (2022) Prospective clinical results of an additive ligament bracing for stabilizing simple and complex elbow instabilities. Arch Orthop Trauma Surg 142(12):3837–3844. https://doi.org/10.1007/s00402-021-04276-2CrossRefPubMed

54.

Heo YM, Yi JW, Lee JB, Lee DH, Park WK, Kim SJ (2015) Unstable simple elbow dislocation treated with the repair of lateral collateral ligament complex. Clin Orthop Surg 7(2):241–247. https://doi.org/10.4055/cios.2015.7.2.241CrossRefPubMedPubMedCentral

55.

Kim BS, Park KH, Song HS, Park SY (2013) Ligamentous repair of acute lateral collateral ligament rupture of the elbow. J Shoulder Elbow Surg 22(11):1469–1473. https://doi.org/10.1016/j.jse.2013.06.018CrossRefPubMed

56.

Sanchez-Sotelo J, Morrey BF, O’Driscoll SW (2005) Ligamentous repair and reconstruction for posterolateral rotatory instability of the elbow. J Bone Joint Surg Br 87(1):54–61CrossRefPubMed

57.

Rodriguez MJ, Kusnezov NA, Dunn JC, Waterman BR, Kilcoyne KG (2018) Functional outcomes following lateral ulnar collateral ligament reconstruction for symptomatic posterolateral rotatory instability of the elbow in an athletic population. J Shoulder Elbow Surg 27(1):112–117. https://doi.org/10.1016/j.jse.2017.08.015CrossRefPubMed

Titel: Internal Bracing am Ellenbogen als Add-on bei ligamentärer Instabilität
verfasst von: Pavel Kadantsev
Sebastian Lappen
Alexander Otto
Maximilan Hinz
Prof. Dr. med. Sebastian Siebenlist, MHBA
Publikationsdatum: 25.09.2023
Verlag: Springer Medizin
Schlagwort: Instabilitäten am Ellenbogengelenk
Erschienen in: Arthroskopie / Ausgabe 5/2023
Print ISSN: 0933-7946
Elektronische ISSN: 1434-3924
DOI: https://doi.org/10.1007/s00142-023-00634-x

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Internal Bracing am Ellenbogen als Add-on bei ligamentärer Instabilität

Zusammenfassung

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

Lever-Sign-Test hilft beim Verdacht auf Kreuzbandriss

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

Update Orthopädie und Unfallchirurgie

Springer Medizin

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2023

Arthroskopische Gelenkkörperentfernung nach anterior-superiorer Hüftluxation durch Low-Impact Trauma – ein Fallbericht

Ligament-Bracing bei der lateralen Instabilität des Sprunggelenks

Synthetische Stabilisierung des Kapsel-Band-Apparats am Akromioklavikular- und Sternoklavikulargelenk

Arthroskopisches Ligament-Bracing des hinteren Kreuzbands

AGA-Mitteilungen

Behandlung einer Verletzung der tibiofibularen Syndesmose mit einem Kordel-Knopf-Konstrukt

Arthropedia

Neu im Fachgebiet Orthopädie und Unfallchirurgie

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

Lever-Sign-Test hilft beim Verdacht auf Kreuzbandriss

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

Update Orthopädie und Unfallchirurgie