The Posterolateral Ligament of the Elbow: Surgical Anatomy, Assessment and Repair Technique

The posterolateral ligament of the elbow arises from the back of the lateral epicondyle and posterior capitellum and fans out to insert into the ulna along the ulnohumeral joint line proximal to the supinator crest. Avulsion injuries can occur as a result of elbow subluxation, sometimes in association with a radial head fracture, and may be purely soft tissue or include a bony avulsion from the posterior capitellum, and Osborne-Cotterill lesion. This injury can cause persistent lateral elbow pain and stiffness after trauma due to instability, even with an intact lateral ligament complex. MR arthrography is the preferred imaging tool to make the diagnosis. Repair of the ligament can be undertaken as an arthroscopic or arthroscopy-assisted procedure with a suture anchor placed in the posterior capitellum.