The lateral ulnar collateral ligament is the key component of the lateral collateral ligament complex, running from the lateral epicondyle to the supinator crest of the ulna. It is the primary restraint against posterolateral rotatory instability of the elbow.
Primary restraint against posterolateral rotatory instability (PLRI) — prevents the radius and ulna from rotating externally as a unit off the humerus. Acts as the lateral elbow check-rein against combined varus and external rotatory forces.
LUCL insufficiency (from traumatic disruption, surgical over-release, or repetitive valgus stress) produces PLRI, identified by the lateral pivot shift test of the elbow (supination-valgus-extension causing posterior subluxation of the radial head). LUCL reconstruction using a free tendon graft restores lateral elbow stability.
Lateral ulnar collateral ligament reconstruction using palmaris longus or gracilis graft from the lateral epicondyle isometric point to the supinator crest, restoring posterolateral elbow stability.
Over-release of the lateral elbow (during tennis elbow surgery or lateral epicondyle debridement) disrupting the LUCL producing post-operative PLRI — requiring subsequent LUCL reconstruction.
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