Abstract
AbstractInternal bracing is an augmentation of ligament repair or reconstruction using a non-absorbable suture tape. The suture reinforcement of the ligament is intended to absorb the forces applied to the joint while the ligament repair or reconstruction underneath is healing. The rigidity of the construct is expected to improve primary stability, which should facilitate and accelerate postoperative mobilization and rehabilitation. Nevertheless, internal bracing is a novel treatment and data is limited. Therefore, this review describes the surgical techniques and provides an overview of the current literature regarding acute and chronic instabilities of the medial and lateral elbow treated with internal bracing.
Highlights
Internal bracing is an augmentation of ligament repair or reconstruction using a nonabsorbable suture tape
lateral ulnar collateral ligament (LUCL) repair with additional internal bracing is performed through the Kocher interval
Internal bracing is a novel technique to augment ligament repair or reconstruction
Summary
Elbow dislocation is the second most common dislocation of the major joints in adults with an incidence of 5.2 per 100,000 person-years [3]. While LUCL repair without internal bracing failed at 12.1 Nm, the maximum load-to-failure for the internal bracing groups was 26.6 Nm and 23.2 Nm, and significantly higher (p < 0.05) This significant increase in primary stability allows early functional treatment without bracing and limitations in range of motion. Two different techniques for humeral fixation of the LUCL repair with additional internal bracing were compared. In group 1 the internal bracing was inserted in the humeral centre of rotation and an additional suture anchor was placed posterolaterally for the repair of the LUCL, in order to achieve the most anatomical situation.
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