{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T11:51:56Z","timestamp":1791114716424,"version":"4.1.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Orthop Trauma Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Posterolateral rotatory instability (PLRI) of the elbow results from lateral collateral ligament complex (LCLC) insufficiency. In the setting of failed conventional ligament reconstruction, no established salvage procedure is available. This study biomechanically evaluated partial triceps tendon transfer to the supinator crest as a dynamic stabilization concept for PLRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Nine fresh-frozen human elbow specimens underwent cyclic external rotational loading of 0.5 Nm. Specimens were tested sequentially in the native state, an LCLC\/common extensor origin-deficient unstable state, after transosseous LCLC repair, and after partial triceps tendon transfer to the supinator crest with the LCLC detached. Testing was performed under combined biceps\/triceps loading conditions with external forearm rotation relative to the humerus as the primary outcome. A two-factor repeated-measures analysis of variance (RM-ANOVA) compared unstable, repaired, and tendon-transfer conditions across loading conditions. The native state was assessed unloaded and reported separately in a one-factor RM-ANOVA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Intervention significantly affected external rotation (F(2,16) = 33.31,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001, \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      <jats:sub>p<\/jats:sub>\n                      = 0.81). Across loading conditions, partial triceps transfer significantly reduced external rotation compared to the unstable state (mean difference [MD]=-3.38\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005), while LCLC repair showed lower external rotation than triceps tendon transfer (MD=-3.13\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.012). External rotation also differed significantly across the combined biceps\/triceps loading conditions (Greenhouse\u2013Geisser corrected F(1.26,10.11) = 77.00,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001, \u03b7\n                      <jats:sup>2<\/jats:sup>\n                      <jats:sub>p<\/jats:sub>\n                      = 0.91), decreasing from 13.37\u00b0 at 0 kg biceps\/0 kg triceps to 2.42\u00b0 at 0.5 kg biceps\/4.0 kg triceps.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Partial triceps tendon transfer improved dynamic elbow stabilization and significantly reduced PLRI in a LCLC\u2011deficient in vitro model. However, it did not fully restore joint stability, supporting its role as a potential adjunct or salvage option rather than a primary procedure. The findings highlight the importance of dynamic muscle tension in lateral elbow stability, while the time\u2011zero, in vitro design limits direct clinical translation and warrants further in vivo investigations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-026-06520-z","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T18:22:56Z","timestamp":1791051776000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Partial triceps tendon transfer for dynamic stabilization in posterolateral rotatory instability of the elbow: a biomechanical study"],"prefix":"10.1007","volume":"146","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7389-379X","authenticated-orcid":false,"given":"Christoph-Johannes","family":"Pucher","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Lanzerath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie Lucina","family":"Kahmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hackl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars Peter","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Leschinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,3]]},"reference":[{"key":"6520_CR1","doi-asserted-by":"crossref","unstructured":"O\u2019Driscoll SW (2000) Classification and evaluation of recurrent instability of the elbow. 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Pucher, F. Lanzerath, s. Kahmann and T. Leschinger: This authors, their immediate family, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.L. M\u00fcller and M. Hackl: This author received royalties and consultant payments from Arthrex and Medartis, which are related to the subject of this work. The authors did not receive support from any organization for the submitted work.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was approved by the Institutional Review Board of the Medical University of Cologne (approval no. 22-1443). All body donors had provided written informed consent to the scientific use of their bodies during their lifetime. No living human subjects or patient data were involved in this study.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from all body donors during their lifetime in accordance with institutional regulations.","order":3,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the ethical standards of the institutional review board and with the 1964 Helsinki Declaration and its later amendments.","order":4,"name":"Ethics","label":"Research involving human participants","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"358"}}