Anterior Elbow Capsulodesis

Abstract

The technique and role of an anterior elbow capsulodesis in restoring elbow instability following an unstable elbow fracture-dislocation are described. Six patients with an unstable posterior elbow fracture-dislocation were retrospectively reviewed. The average age of the patients was 45.5 years. Five of the 6 patients had a type I coronoid fracture, and 5 patients had a radial head fracture. All patients had an associated posterior dislocation of the elbow. Two patients had previous surgery. All patients underwent elbow reconstruction with restoration of the ulnohumeral joint and lateral collateral ligament complex repair. Five patients had a radial head replacement. An anterior elbow capsulodesis was performed in all patients for residual, postreconstruction, posterior elbow instability. A hinged fixator was used in 1 patient. At an average follow-up of 19 months (range, 6Y33 months), all patients had a stable elbow. The average extension-flexion arc was 26 to 133 degrees. Pronation and supination averaged 54 and 69 degrees, respectively. Conclusion: A stable elbow joint can be achieved by restoring ulnohumeral joint congruency, repairing the lateral collateral ligament complex, and repairing or replacing an injured radial head. An anterior elbow capsulodesis is used when further stabilization of residual posterior elbow instability is needed.