A New Technique for Lateral Ulnar Collateral Ligament Reconstruction Using the Triceps Tendon

Abstract

Lateral ulnar collateral ligament (LUCL) is the principal static stabilizer of the posterolateral elbow, and reconstruction of this ligament has been the standard treatment of symptomatic chronic posterolateral instability of the elbow. We report our modified technique of single-strand LUCL reconstruction using the triceps tendon, which simplifies the ulnar-side fixation. Through a posterolateral incision, a triceps tendon graft of 10 x 1 cm is harvested from the midportion of the triceps, with its distal attachment on the olecranon preserved and augmented by sutures. This graft is passed from the medial to the lateral cortex of the proximal ulna to emerge at the insertion point of the proximal strand of the conventional double-strand technique. The graft is tightened, passed through a drill hole made on the lateral epicondyle, and sutured to itself. This technique does not need another incision for tendon harvest, simplifies the ulnar fixation by obviating the need for bone anchors or multiple tendon routing, and avoids the risk of fracture of the bone bridge between the tunnels.