Management of complications of traumatic elbow instability

Traumatic elbow dislocations and fracture dislocations are severe injuries, which jeopardize the stability of the elbow joint. Various possibilities for complications arise as a result of the complexity of these injuries. A thorough understanding of the anatomical and biomechanical characteristics is required to provide an optimal management of complications. The patients frequently present with a painful restriction in range of motion, while joint instability is not necessarily subjectively perceived. A detailed physical examination in combination with 3D imaging diagnostics help to specify the cause of the problem. The subsequent treatment strategy depends on the underlying pathology. Chronic defects of the coronoid process can be reconstructed by bone grafts, usually taken from the iliac crest, to restore joint congruity and stability. Reconstruction of the radial column after unstable radial head defects is reliably achieved with radial head arthroplasty. After reconstruction of the bony defects, restoration of the collateral ligament complex and the dynamic stabilizers is an equally important step in the management of traumatic elbow instability. While ligament repair is usually achieved in (sub)acute cases, chronic instability is commonly treated with ligament replacement grafts to restore sufficient joint stability