Elbow Lateral Collateral Ligament Injuries: Ligament Reconstruction With Tape Augmentation

Elbow Lateral Collateral Ligament Injuries: Ligament Reconstruction With Tape Augmentation

This surgical video will demonstrate the repair of an elbow lateral collateral ligament, or L C L. The procedure will be demonstrated on a cadaveric specimen. The surgeon will demonstrate a technique using a tendon graft to reconstruct the ligament, as well as bone anchors and suture. Here is the outside of a right elbow. The surgeon has marked key structures that are felt under the skin to mark the location of the necessary incision to access the LCL.

These key structures are the outside tip of the humerus bone and the head of the radius. One bone anchor will go in the humerus, and the other one will go in the ulna, just below the head of the radius. The surgeon will begin by making the incision over the marked structures. The incision will then be extended deeper. The surgeon will use x-ray guidance to help determine the best location for a pin to be placed into the lateral epicondyle of the humerus. A bone anchor with a forked tip is shown and will soon be used to hold the tendon graft to the bone. A drill will be used over the pin to make a hole in the humerus bone.

Then, a pin and drill will be used to make a hole in the ulna bone. The graft is shown here. This tendon graft was harvested from a donor and sutured on each end. While holding the suture on the end of the graft taut, the forked bone anchor will capture the end of the graft. Both the anchor and the graft will be placed into the hole. The surgeon will then screw the anchor into place using the attached handle. The handle is then removed.

Another free blue suture will be captured at the end of another fork-tipped bone anchor. The graft will be draped over the hole in the humerus and pulled gently. The anchor, suture, and graft will all be captured and screwed into the hole. The graft is now secure. The 2 ends of the suture will be tied over the graft for additional support. Other suture types may be used to support the graft repair. Often, a flat braided suture is used. The end of the graft and sutures will be trimmed. The incision will be closed, and the surgery will be complete.