Snapping of the annular ligament: a uncommon injury characterised by snapping or locking of the elbow with good surgical outcomes

Purpose: Snapping annular ligament is an uncommon cause of lateral elbow pain. The purpose of this case series was to evaluate the clinical presentation and surgical outcomes for snapping annular ligament. Methods: Included were 23 patients with snapping annular ligament who received surgical treatment between 2007 and 2016. There were two treatment groups with either resection (arthroscopic or open procedure, n = 15) or open annular ligament reconstruction (n = 8). Patients were assessed with the Mayo Elbow Performance Index and the Oxford Elbow Score. Preoperative and postoperative scores were compared with a paired t test. Results: Pain was located laterally in nine patients (39.1%), anteriorly in three patients (13.0%), anterolaterally in two patients (8.7%), and diffusely in nine patients (39.1%). In total, 16 patients (69.6%) experienced a snapping sensation and ten patients (43.5%) locking of the elbow. According to the patients’ reported outcomes, their symptoms improved significantly after both procedures. Conclusions: This is the largest case series in the literature on snapping annular ligament, an uncommon cause of lateral elbow pain. Good treatment results are expected with resection of the interpositioned part of the annular ligament or annular ligament reconstruction. Level of evidence: IV