Functional anatomy of the lateral collateral ligament complex of the elbow

Postero-lateral instability of the elbow joint is a rare clinical condition , commonly related to a disruption of the lateral collateral Ligament compl ex of the elbow. Twenty elbow joint specimens were studied in order to desc ribe the morphologic characteristics of this complex, and to determine the role of its different components in the stability of the elbow. After a mor phologic and morphometric investigation, serial divisions of the medial bun dle of the lateral collateral ligament were performed, with or without sect ion of the annular ligament and the anterior bundle of the lateral collater al ligament. The anterior and medial bundles of the lateral collateral liga ment had close relationships with the annular ligament and a common proxima l course. Isolated section of the medial bundle of the lateral collateral l igament induced only minor laxity of the elbow joint. Combined divisions of the medial and the anterior bundles at their humeral insertion, or the med ial bundle and the annular ligament at their ulnar insertion resulted in a reproducible subluxation of the ulno-humeral joint. Thus, posterolateral ro tatory stability of the elbow joint is largely maintained by the lateral co llateral Ligament complex, composed of three elements: the anterior and med ial bundles of the lateral collateral ligament, and the annular ligament. I n clinical practice, chronic postero-lateral instability is best treated by a ligamentous reconstruction, that must take into account all these anatom ic considerations. We report here a new technique of ligamentoplasty using the fascia of the extensor carpi ulnaris muscle.