Today's News

Sunday, February 07, 1999

Reconstructed UCL may protect implant from failing

Authors of a study presented in poster exhibit 218 Friday recommended that the treatment for dislocation of the elbow associated with radial head fractures is to first reconstruct the ulnar collateral ligament (UCL) with a tendon graft and then to repair the radial head in Mason type I or II fractures and replace the radial head in highly comminuted Mason type III fractures.

The reconstructed UCL may protect the silastic implant from excessive valgus loading and subsequent failure," said co-author Michael Hausman, MD, clinical associate professor, orthopaedic surgery, Mount Sinai-New York Medical Center, New York. "Unlimited range of motion without braces should be initiated within 12 hours postoperatively using indwelling axillary catheters for pain relief."

Twelve patients with complete posterior elbow dislocations associated with radial head fractures were treated with acute reconstruction of the UCL with tendon graft and repair or replacement of the radial head. All twelve patients were available for a comprehensive eval-uation including motion, strength, stability, pain, ability to perform activities and radiographic evaluation. Stability was evaluated clinically and by stress radiographs. Six men and six women with an average age of 40 (range: 20 to 60) were studied. The mean follow-up was 3 years (range: 6 months to 9 years).

According to an elbow performance index, eight patients had excellent results and four had good results. There were no fair or poor results. All patients were stable upon stress radiographs. Those patients that had silastic implants had maintenance of the implant position; no evidence of fragmentation was seen radiographically.

Eight patients had no pain and four had pain with continuous use of the arm. The mean range of motion was 6 degrees of flexion, 125 extension, 70 degrees of pronation and 60 degrees of suppination. Grip strength was an average of 85 to 90 percent of the opposite side.

In addition to Dr. Hausman, Joe DiGiovanni, MD, was co-author of the study.

1999 Academy News Feb. 7 Index A
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Last modified 07/February/1999