Chronic medial elbow instability-status quo

Chronic valgus instability can result from acute trauma, iatrogenic injury or overuse. Especially the overhead athlete's and thrower's elbow experience high valgus loads. Repetitive microtraumata weaken the medial collateral ligament. Increasing valgus instability leads to increasing compressing forces in the radial column which may lead to severe cartilage damage. Contact stress of the olecranon and medial fossa cause typical osteophyte formations and loose bodies. This article reviews the fundamentals and diagnostics of chronic valgus instability. Nonoperative and operative therapy options are discussed in the light of the current literature.