Elbow Lateral Collateral Ligament Injuries: Treatment Options

Elbow Lateral Collateral Ligament Injuries: Treatment Options

This video will provide an overview of the treatment options for injuries to the elbow’s lateral collateral ligament complex, also known as the L C L. The LCL complex is an essential soft tissue structure composed of multiple ligaments on the elbow's lateral or outer side. Damage to the LCL typically occurs because of trauma to the elbow and results in instability. If left untreated, patients can have worsening pain and function in the elbow.

Treatment without surgery will be considered in patients with mild symptoms that do not interfere with activities. Patients with lower energy demands may be better served without surgery as well. Treatment without surgery will consist of modifying activities that may aggravate the condition, physical therapy to strengthen the nearby muscles, anti-inflammatories as needed for pain, and elbow bracing to limit motion and provide stability in the joint.

Elbow dislocations may occur with an LCL injury and will require additional treatment, including reducing the joint back to its normal position and temporarily immobilizing the joint. Elbow stiffness is common after a dislocation and may require physical therapy. Treatment with surgery is often advised in those with chronic instability as treatment without surgery has shown to be less effective in these patients. Additionally, those with persistent pain and those who have increasing difficulty using the arm will need surgery.

Many surgical techniques exist and provide excellent results. Techniques focus on either repairing or reconstructing the complex. A repair will be considered if the ligaments are in good condition or the injury recently occurred. This is typically done with a strong suture repair. An internal support suture may also be used to provide additional stability. If the ligaments are not in good condition, as seen in a patient with chronic instability, surgery to reconstruct the ligament may be required with a tissue graft.

If a patient has a prior injury, such as a break in the bone, surgery to correct the underlying problem may be necessary first. Following surgery to repair or reconstruct the LCL, a patient will be immobilized in a splint or brace. Rehabilitation will begin focusing on regaining elbow range of motion, followed by strengthening exercises. Patients are allowed to return to all activities without restrictions around 3-6 months after surgery.