Treatment of combined medial and lateral collateral ligament insufficiency

The medial and lateral collateral ligament complexes represent primary elbow ligament stabilizers. Injury to these structures may occur because of an elbow dislocation or due to a severe varus or valgus force. Most elbow dislocations are stable once reduced and may be treated conservatively. However, if the elbow remains unstable surgical treatment is recommended. Repair should be anatomical and should restore stability to the elbow in order to permit an early active range of motion. Reconstruction may be required in severe cases and where primary repair is not possible. Depending on the degree of instability, either one or both of the collateral ligament complexes may need to be repaired or reconstructed. This review describes the pathoanatomy of the unstable elbow and outlines the surgical techniques for repair and reconstruction of both collateral ligaments.