In Vitro Kinematic Assessment of a Hinged Elbow Orthosis Following Lateral Collateral Ligament Injury

Purpose Elbow lateral collateral ligament injuries (LCLI) are often managed with protected mobilization using a hinged elbow orthosis (HEO). The objective of this investigation was to determine the effectiveness of an HEO in stabilizing the elbow following LCLI. Methods Seven fresh-frozen cadaveric upper extremity specimens were studied using a custom simulator that enabled elbow motion via computer-controlled actuators and servomotors attached to relevant tendons. Specimens were examined in 4 arm positions (dependent, overhead, horizontal, and varus) and 2 forearm positions (pronation and supination) during both passive and simulated active elbow extension. Specimens were examined before and after simulated LCLI, and then with the addition of an HEO. The lateral collateral ligament, common extensor origin, and lateral elbow capsule were sectioned in the injury model. An electromagnetic tracking system measured ulnohumeral kinematics. Results The orthosis did not change elbow stability in any arm position during active motion. Muscle activation and forearm pronation enhanced stability in the dependent, horizontal, and varus positions while the HEO was applied. Conclusions This HEO does not improve the in vitro stability of the elbow following simulated LCLI. Copyright (C) 2018 by the American Society for Surgery of the Hand. All rights reserved.