Valgus Instability 841.1

synonyms:

Elbow Valgus Instability ICD-9

• 841.1 Sprains and strains of elbow; ulnar collateral ligament
  

Elbow Valgus Instability Etiology / Epidemiology / Natural History

• Generally occurs after chronic valgus overload, but can occur after acute injury.
• Results from incompetance or rupture of the MCL.

Elbow Valgus Instability Anatomy

• Primary constraints=ulnohumeral articulation(coronoid), medial collateral ligament(MCL), lateral collateral ligament(LCL)  (King GJ, JSES 2;165:1993).
• Secondary constraints=radial head, common flexor and extensor origins, capsule. (Morrey BF, CORR 1991;265:187).
• Dynamic constaints=mucles which cross the elbow, mainly the triceps, anconeus and brachialis.
• Anterior band of medial collateral ligament is the primary constraint to valgus instability.
• See also Elbow anatomy.

Elbow Valgus Instability Clinical Evaluation

Elbow Valgus Instability Xray / Diagnositc Tests

• A/P, lateral and oblique elbow films indicated.

Elbow Valgus Instability Classification / Treatment

Elbow Valgus Instability Associated Injuries / Differential Diagnosis

• Radial head fracture
• Varus posteromedial rotatory dislocation / instablity (occurs during axial loading of elbow in flexion=anteromedial coronoid fractureand avulsion of LCL).
• Posterolateral rotatory instability
• Terrible triad (elbow dislocation with radial head and coronoid fracture)
• Elbow Dislocation

Elbow Valgus Instability Complications

Elbow Valgus Instability Follow-up Care

Elbow Valgus Instability Review References

• OKU - Shoulder and Elbow 2nd ed, 2002
• Advanced Reconstruction-Elbow, AAOS 2007