AANA Fellowship Education - Elbow Treatments: Throwing Injuries, PLRI, Valgus Extension Overload and More-Elbow Treatments: Throwing Injuries, PLRI, Valgus Extension Overload and More

Video Transcription

Video Summary

The webinar on elbow injuries featured expert presenters Drs. Reza Omid, Grant Gargis, and Serena Namdari, covering comprehensive topics on ulnar collateral ligament (UCL) reconstruction, posterolateral rotatory instability (PLRI), distal biceps, triceps injuries, and complex elbow trauma.<br /><br />Dr. Gargis detailed the anatomy, injury mechanisms, and treatment of UCL injuries, emphasizing that pitching generates forces near the UCL’s tensile limit. He discussed physical exam maneuvers, MRI arthrogram utility, surgical reconstruction techniques (e.g., docking method), graft choices, ulnar nerve management, and lengthy rehabilitation protocols, highlighting debates over repair versus reconstruction and novel internal brace innovations.<br /><br />Dr. Namdari focused on lateral elbow stability and PLRI, explaining the lateral ligament complex, clinical diagnosis challenges, provocative tests, and imaging. He stressed key surgical pearls such as accurate tunnel placement for ligament repair, graft harvesting caution (notably median nerve injury risk during palmaris harvest), and structured rehab to optimize outcomes.<br /><br />The distal biceps and triceps discussion underscored injury mechanisms like eccentric contraction and anatomical nuances including the bicipital tuberosity’s cam effect relevant to supination strength restoration. Various repair techniques (single vs. two-incision) were analyzed for risks such as nerve injury, heterotopic ossification, and postoperative supination weakness. Chronic biceps tears often require graft augmentation.<br /><br />Finally, management of complex elbow injuries like terrible triad fracture-dislocations was discussed, prioritizing lateral side repair, radial head replacement with smooth prostheses for stability, and careful coronoid fixation. Postoperative precautions include avoiding combined elbow extension with forearm supination and shoulder abduction to prevent recurrent instability.<br /><br />The session concluded with case discussions, emphasizing tailored diagnosis, imaging, and individualized surgical decision-making, reinforcing the value of thorough clinical assessment and multidisciplinary expertise in elbow sports injuries.

Keywords

elbow injuries

ulnar collateral ligament reconstruction

posterolateral rotatory instability

distal biceps injury

triceps injury

UCL anatomy and treatment

surgical reconstruction techniques

lateral elbow stability

nerve injury risks

complex elbow trauma management

rehabilitation protocols