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Background <p>Posterolateral rotatory instability (PLRI) is the most common form of chronic elbow instability and is primarily caused by insufficiency of the lateral collateral ligament complex, particularly the lateral ulnar collateral ligament (LUCL). Due to non-specific symptoms, it is frequently overlooked; the diagnosis is primarily carried out clinically.</p> Objective <p>The aim of this study is to provide a&#xa0;systematic overview of the diagnostic criteria and treatment decision-making between conservative and surgical management of PLRI.</p> Material and methods <p>Narrative review based on a&#xa0;selective literature search in PubMed including clinical studies, systematic reviews and case series on elbow PLRI.</p> Results <p>Conservative treatment can be appropriate in patients with mild symptoms, no evidence of structural ligament insufficiency and low functional demands. In cases of clinically relevant instability, confirmed structural lesion of the lateral collateral ligament complex or persistent symptoms, surgical stabilization is indicated.</p> Conclusion <p>Early surgical stabilization is associated with better functional outcomes. Delayed surgery significantly worsens the prognosis. The indications for surgery are based on clinical examination and confirmed structural instability.</p>

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Posterolaterale Rotationsinstabilität: wann operativ, wann konservativ?

  • 期刊论文

  • 发表日期：

    2026年5月26日

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  • Julian Heß,
  • Sebastian Lappen

摘要

Background

Posterolateral rotatory instability (PLRI) is the most common form of chronic elbow instability and is primarily caused by insufficiency of the lateral collateral ligament complex, particularly the lateral ulnar collateral ligament (LUCL). Due to non-specific symptoms, it is frequently overlooked; the diagnosis is primarily carried out clinically.

Objective

The aim of this study is to provide a systematic overview of the diagnostic criteria and treatment decision-making between conservative and surgical management of PLRI.

Material and methods

Narrative review based on a selective literature search in PubMed including clinical studies, systematic reviews and case series on elbow PLRI.

Results

Conservative treatment can be appropriate in patients with mild symptoms, no evidence of structural ligament insufficiency and low functional demands. In cases of clinically relevant instability, confirmed structural lesion of the lateral collateral ligament complex or persistent symptoms, surgical stabilization is indicated.

Conclusion

Early surgical stabilization is associated with better functional outcomes. Delayed surgery significantly worsens the prognosis. The indications for surgery are based on clinical examination and confirmed structural instability.