Posterolateral Rotatory Instability of the Elbow

Symptomatic posterolateral rotatory instability (PLRI) results from a lateral collateral ligament complex injury and presents with pain, clicking, and subluxation within the flexion and extension arcs of elbow motion. Often, symptoms and examination characteristics are subtle and can be easily misdiagnosed. Therefore, a thorough history and provocative physical examination maneuvers are important to correctly establish the diagnosis. Patients frequently have a history of elbow trauma such as an episode(s) of elbow dislocation, prior surgery, or previous cortisone injections. Radiographs and advanced imaging can aid in the diagnosis, and examination under anesthesia, manipulation with arthroscopic visualization, and/or stress radiographs can be confirmatory. Symptomatic cases of PLRI can be effectively treated with a repair or isometric ligament reconstruction.