The accessory lateral collateral ligament runs from the annular ligament to the supinator crest of the ulna, providing additional lateral stability against varus and posterolateral rotation.
Prevents lateral ulnar opening and contributes to posterolateral rotatory stability of the elbow by anchoring the annular ligament to the ulna, resisting external rotation of the radius and ulna relative to the humerus.
The ALCL is disrupted in posterolateral rotatory instability (PLRI) of the elbow — along with the LUCL. Elbow PLRI produces a positive pivot shift test of the elbow and requires LUCL + ALCL reconstruction for restoration of lateral column stability.
Combined LUCL and ALCL disruption in posterolateral rotatory instability producing a positive elbow pivot shift test, managed by lateral collateral ligament complex reconstruction.
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