The Naked Capitellum

It’s a surgeon’s guide to intraoperative identification of posterolateral rotatory instability

Dr. Guss publishes his research on elbow trauma and ligament injuries in the prestigious Journal of Shoulder and Elbow Surgery, providing surgeons an easy and reproducible way to identify elbow instability.

This study’s purpose was to provide a reproducible way for surgeons to intraoperatively assess the elbow’s lateral ulnar collateral ligament origin and determine whether there is posterolateral rotatory instability (PLRI) despite an intact common extensor origin (CEO). We hypothesized that we could re-create clinically relevant disruption of lateral supporting structures despite an intact CEO and illustrate progressive elbow PLRI.

Conclusion: The elbow’s lateral capsuloligamentous complex plays an important role in preventing PLRI. Larger degrees of elbow laxity is associated with further peel back of the capsuloligamentous complex despite an intact CEO. The surgeon must retract the extensor origin intraoperatively to assess for lateral ulnar collateral ligament and/or lateral capsule disruption to prevent a missed case of PLRI.

Read complete article of Dr. Guss here