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30. Coronoid reconstruction with autologous iliac crest bone graft in chronic elbow instability through a medial approach

Author

Schneider, M. M., Zimmermann, F., Hollinger, B., Zimmerer, A., Burkhart, K. J., Schneider, M. M., Zimmermann, F., Hollinger, B., Zimmerer, A., and Burkhart, K. J.

Abstract

Objective Neutralizing a posteromedial rotatory instability (PMRI) caused by coronoid deficiency by restoration of the humeroulnar joint surface with an autologous iliac crest bone graft. Indications Surgery is indicated in patients with chronic deficiency of the anteromedial facet of the coronoid with subsequent PMRI. Contraindications Coronoid reconstruction is not recommended in patients with advanced osteoarthritis of the elbow caused by subluxation of the humeroulnar joint. General contraindications like acute infection, pregnancy and lack of operability should also be taken into account. Surgical technique First, a medial approach is established and the base of the coronoid is prepared. Afterwards an autologous iliac crest bone graft is placed onto the defect and secured by screws or a plate. In addition, a reconstruction of the anterior bundle of the medial collateral ligament with an autologous tendon graft is performed. Postoperative management An elbow orthesis is worn for 6 weeks after surgery to avoid valgus or varus stress. There is no restriction in range of motion. A continuous passive motion elbow chair supports the patient in regaining elbow mobility. Results Between 2015 and 2017, we treated 10 patients suffering from chronic coronoid defects with coronoid reconstruction. Eight of the patients were available for follow-up 86 weeks after surgery. The mean age was 41.4 years. In all patients, elbow range of motion and patient-related outcome measures were improved after surgery. Plain radiographs illustrated correct centering of the elbow joint. One patient had to undergo elbow arthroplasty and was excluded. Coronoid reconstruction with an autologous iliac crest bone graft restored humeroulnar joint congruency and improved satisfaction in patients suffering from chronic coronoid deficiency.

Published
2022

37. Sport-specific problems of the elbow

Author

Rippke, J. -N., Burkhart, K. J., Rippke, J. -N., and Burkhart, K. J.

Abstract

An unrestricted elbow function is crucial for many athletes to be able to perform their sport at the highest level. Besides macrotrauma, overloading damage due to microtrauma must be borne in mind, particularly in throwing athletes, gymnasts, martial arts and weightlifting athletes, volleyball, handball as well as tennis and golf players. Overloading injuries need to be distinguished from medial and lateral epicondylopathy. This article presents an overview of the diagnostics and treatment of less common sport-specific pathologies of the elbow.

Published
2021

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