Elbow Ligament Reconstruction

The elbow is a complex joint of the upper limb formed by the articulation of the long bone of the upper arm or humerus and the two bones of the forearm, namely, radius and ulna. It is one of the important joints of the upper limb and is involved in basic movements such as flexion and extension of the upper limb and rotation of the forearm.

The elbow joint is supported by the ulnar collateral ligament, radial collateral ligament and the annular ligament. These ligaments provide stability and strength to the elbow joint.

The elbow joint also has the attachment of the common flexor and common extensor tendons. The groups of muscles, associated with the respective tendons, assist in rotational movement of the forearm as well as the movements of the wrist and hand.

Injuries

The common conditions affecting the tendons around the elbow joint include tennis elbow and golfer’s elbow which result from an overuse injury to the tendons or result from repetitive activities such as sports, mechanical activities or weight lifting.

The ligaments around the elbow may be injured secondary to a sprain, rupture, trauma or any accident. The sprain or trauma may result from repetitive stress, overuse or a direct injury.

Symptoms

The common symptoms of injury to the elbow joint and its surrounding structures include swelling and pain, which may extend from the elbow to the forearm and palm and be aggravated by movements of the wrist. Sometimes instability of the joint may also be seen.

Surgical procedure

Ligament reconstruction

Ligament reconstruction is considered in patients with ligament rupture. Your surgeon will make an incision over the elbow. Care is taken to move muscles, tendons and nerves out of the way. The donor tendon is harvested from either the forearm or below the knee. Your surgeon drills holes into the bones of the upper arm and the forearm, around the elbow joint. The donor tendon is inserted through the drilled holes in a pattern like that of the original ligament complex. The tendon is then attached to the bone surfaces with special sutures. The incision is closed with sutures and covered with sterile dressings. A splint is applied to support the elbow for a few weeks. After the surgery, you might be advised for regular follow-up and for a rehabilitation program for a better and quicker recovery.

Complications

Common complications of the elbow ligament and tendon repair surgeries include infection, injury to the adjacent nerve and blood vessels, and a loss of strength or flexibility of the elbow joint.

Rehabilitation

The success of the surgery depends on the post-operative rehabilitation program which includes the use of a removable splint immediately after surgery as well as ice therapy, electrical stimulation and massage for reducing pain, swelling or muscle spasm. Isometric exercises, strengthening and range of motion exercises may be useful for long term rehabilitation.