Surgical treatment of posterolateral rotatory instability of the elbow in children.

Posttraumatic instability of the elbow in children can be a very challenging problem to diagnose and treat. Posterolateral rotatory instability (PLRI) has been well described with regard to diagnosis and treatment in adults but best clinical practices are less clear for pediatric cases. Children with PLRI can present with unusual signs and symptoms and poorly documented, vague trauma. The need for and safety of formal reconstruction of the lateral ulnar collateral ligament in children has been somewhat controversial in the past; however, with careful consideration the diagnosis of PLRI in children can be recognized and successfully treated with ligamentous repair or reconstruction. This report presents an overview of the current practice in the diagnosis and treatment of PLRI in the pediatric population. Indications for surgical treatment and step-by-step surgical instructions for both ligamentous repair and reconstruction are presented.