Reconstruction of the Elbow Lateral Ulnar Collateral Ligament (LUCL)

Abstract

Adequate stability of the elbow joint results from the combination of bone geometry and the surrounding soft tissues. The lateral collateral ligament complex represents the main soft tissue stabilizing structure on the lateral side of the elbow. The main bundle of collagen fibers providing ligamentous stability on the lateral side originates from the humeral lateral epicondyle and inserts on the lateral aspect of the proximal ulna at the tubercle of the crista supinatoris. This bundle of fibers is referred to as the lateral ulnar collateral ligament (LUCL). Incompetence of the LCL results in symptomatic elbow subluxation with posterolateral and/or varus stress of the forearm in reference to the distal humerus, the so-called posterolateral rotatory instability (PLRI). Reconstruction of the LUCL has been reported to provide satisfactory outcomes in patients with symptomatic PLRI. The objectives of this book chapter are to review the indications, technique, pearls, and pitfalls of this procedure and to provide some insight into future directions.