RESULT OF ULNAR COLLATERAL LIGAMENT RECONSTRUCTION IN POST–TRAUMATIC VALGUS INSTABILITY OF ELBOW

Abstract

BACKGROUND Ulnar collateral ligament is the major valgus stabiliser of the elbow. Its injury mainly occurs in athletes involving in overhead throwing activity. In general population, it occurs in those doing manual labour with overhead throwing activity. Our aim is to study the result of MCL reconstruction in traumatic valgus instability of elbow. MATERIALS AND METHODS Inclusion criteria were 1) age < 50 years, 2) valgus stress test positive, 3) positive moving valgus stress test & milking manoeuvre. Exclusion criteria were 1) age > 50 years, 2) positive posterolateral rotatory instability test, 3) positive apprehension in pivot shift manoeuvre. Total 34 patients were studied. Among them, 14 were athletes & 20 were not. A trial of conservative management was tried in the non-athlete group & 6 of them responded well. Finally, total 28 patients were operated & followed up for 2 years. RESULTS There was significant improvement of Mean pre-op MAYO elbow, DASH & VAS score between pre-op & 2 years follow-up values both in athlete & non-athlete groups. All the patients returned to their pre-injury activity level within 1.5 years after surgery. CONCLUSION Isolated MCL injury can occur in manual labourers involving in overhead throwing activity. Conservative treatment can be tried in non-athlete group with good result. Reconstruction of MCL using Gracilis autograft gives good functional outcome & return to preinjury level of activity in both athlete and non-athlete groups.