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Archives of Orthopaedic and Trauma Surgery

Erschienen in:

06.01.2022 | Trauma Surgery

Prospective clinical results of an additive ligament bracing for stabilizing simple and complex elbow instabilities

verfasst von: Alexander Ellwein, Larissa Janning, Rony-Orijit DeyHazra, Tomas Smith, Helmut Lill, Gunnar Jensen

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 12/2022

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Abstract

Introduction

Ligament bracing augments ligament repair using a non-absorbable suture tape. Although biomechanically an increase in primary stability has been proven, there is a lack of clinical evidence. Purpose of this study was to evaluate clinical results of patients treated with ligament bracing due to primary elbow instability, including an analysis of complications. Furthermore, clinical results for patients treated with and without early functional mobilization were compared.

Materials and methods

This prospective case-series evaluated clinical and functional results from patients treated with ligament bracing due to primary elbow instability. Clinical outcome measures were range of motion (ROM) as well as objective and subjective elbow scores [Mayo Elbow Performance Score (MEPS); Disabilities of Arm, Shoulder and Hand Score (DASH score)]. Stability was evaluated sonographically by humero-radial gapping under varus stress.

Results

This study involved 34 patients treated with ligament bracing. After a mean follow-up of 12.9 months ROM was 112° ± 29, MEPS 88 ± 13 points, DASH 91 ± 11 points, and 84% were satisfied with their result. Lateral joint gapping was 2.4 mm. No significant difference was observed regarding a postoperative mobilization with and without limitations. Most common complication after ligament bracing was elbow stiffness including heterotopic ossifications in four patients (12%).

Conclusion

Operatively treated elbow instability with additional ligament bracing results in good clinical outcomes with high patient satisfaction and recovery of elbow stability. The high primary stability of the ligament bracing allows early functional mobilization without bracing, which facilitates postoperative rehabilitation. Elbow stiffness with heterotopic ossification seems to be a potential complication. Furthermore, the optimal tensioning of the ligament bracing remains challenging, including the risk of an over tensioning.

Level of evidence

III.

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Titel: Prospective clinical results of an additive ligament bracing for stabilizing simple and complex elbow instabilities
verfasst von: Alexander Ellwein
Larissa Janning
Rony-Orijit DeyHazra
Tomas Smith
Helmut Lill
Gunnar Jensen
Publikationsdatum: 06.01.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 12/2022
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-04276-2

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Abstract

Introduction

Materials and methods

Results

Conclusion

Level of evidence

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