Lateral collateral ligament injuries of the elbow – chronic posterolateral rotatory instability (PLRI) (original) (raw)

Chronic posterolateral rotatory instability (PLRI) is the most common form of chronic elbow instability. PLRI usually occurs from a fall on the outstretched hand. On impact, the radial head and ulna rotate externally coupled with valgus displacement of the forearm. This leads to posterior displacement of the radial head relative to the capitellum, thus causing disruption of some or all of the lateral-sided stabilisers. PLRI is mainly a clinical diagnosis with a history of instability, clicking and lateral-sided pain, with a positive clinical examination including the pivot-shift test, push-up, chair and tabletop test. MRI can often help guide diagnosis but more commonly assists in surgical planning. Surgery is indicated in patients with persistent, symptomatic instability of the elbow causing pain or functional deficit. There are several surgical techniques to treat PLRI, often leading to good to excellent results. An open or arthroscopic technique has been successfully used in pati...